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Paeds Vivaspreventive-and-community-paediatrics

Paeds Vivas · preventive-and-community-paediatrics

Rural, regional and remote child-health inequities — branching viva

Viva on rural inequity mechanisms, readiness, telehealth versus retrieval and medical-home design.

branching clinical structured oral1 min readVerification in progress

Target exams

RACP DCEMRCPCH Clinical
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Target exams

RACP DCEMRCPCH Clinical
Prompt
Phone call from a rural ED: febrile infant; optional second stem is outreach complex-care clinic with no GP.

Opening

Examiner: A rural ED rings you about a febrile infant with delayed capillary refill. Distance to paediatrics is hours. How do you structure the first minute of the call? [6]

Candidate model: Confirm identity and location; threat scan (airway, breathing, circulation, consciousness, glucose); local capability inventory; concurrent advice to treat and activate retrieval early if trajectory or capacity is unsafe; prefer video if available. [6] [14] [26]

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You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship library.

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References11ShowHide
  1. [1]Shipman SA Geographic maldistribution of primary care for children. Pediatrics, 2011.PMID 21172992
  2. [6]Gausche-Hill M A national assessment of pediatric readiness of emergency departments. JAMA pediatrics, 2015.PMID 25867088
  3. [7]Newgard CD Emergency Department Pediatric Readiness and Short-term and Long-term Mortality Among Children Receiving Emergency Care. JAMA network open, 2023.PMID 36637819
  4. [12]Curfman AL Telehealth: Improving Access to and Quality of Pediatric Health Care. Pediatrics, 2021.PMID 34462339
  5. [14]Marcin JP Impact of Tele-Emergency Consultations on Pediatric Interfacility Transfers: A Cluster-Randomized Crossover Trial. JAMA network open, 2023.PMID 36780158
  6. [15]Marcin JP Telemedicine vs Telephone Consultations and Medication Prescribing Errors Among Referring Physicians: A Cluster Randomized Crossover Trial. JAMA network open, 2024.PMID 38421649
  7. [19]Haggerty JL Continuity of care: a multidisciplinary review. BMJ (Clinical research ed.), 2003.PMID 14630762
  8. [21]Christakis DA Association of lower continuity of care with greater risk of emergency department use and hospitalization in children. Pediatrics, 2001.PMID 11230593
  9. [22]Council on Children with Disabilities and Medical Home Implementation Project Advisory Committee Patient- and family-centered care coordination: a framework for integrating care for children and youth across multiple systems. Pediatrics, 2014.PMID 24777209
  10. [24]Bugeja L Drowning deaths of zero- to five-year-old children in Victorian dams, 1989-2001. The Australian journal of rural health, 2005.PMID 16171505
  11. [26]McCarron M A 10-year review of paediatric trauma inter-hospital retrieval patient outcomes in New South Wales (NSW), Australia. Injury, 2026.PMID 41887088
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