Pediatric advanced life support (PALS) training is critical for pediatric residents. It is unclear how well PALS skills are developed during this course or maintained overtime. This study evaluated PALS skills of pediatric interns using a validated PALS performance score following their initial PALS certification. All pediatric interns were invited to a 45-minute rapid cycle deliberate practice (RCDP) training session following their initial PALS certification from July 2017 to June 2019. The PALS score and times for key events were recorded for participants prior to RCDP training. We then compared performance scores for those who took PALS ≥3 months, between 3 days to 3 months and 3 days after PALS. There were 72 participants, 30 (of 30) in 3 days, 18 in 3 days to 3 months, and 24 in ≥3 months groups (42 total of 52 residents, 81%). The average PALS performance score was 53 ± 20%. There was no significant difference between the groups (3 days, 53 ± 15%; 3 days–3 months, 51 ± 19%; ≥3 months, 54 ± 26%, p = 0.922). Chest compressions started later in the ≥3 months groups compared with the 3 days or ≤3 months groups (p = 0.036). Time to defibrillation was longer in the 3 days group than the other groups (p = 0.008). Defibrillation was asked for in 3 days group at 97%, 73% in 3 days to 3 months and 68% in ≥3 months groups. PALS performance skills were poor in pediatric interns after PALS certification and was unchanged regardless of when training occurred. Our study supports the importance of supplemental resuscitation training in addition to the traditional PALS course.

This chapter aims to describe the role of the pediatric healthcare system in the prevention and identification of children and youth who are trafficked, and what the pediatric healthcare response should entail. To help providers understand the relevance of this work, the authors provide a detailed context for trafficking in children, specifically with regards to risk factors, special populations, vulnerabilities, and healthcare interactions, and then delve into an exploration of the evidence base describing pediatric health care provider knowledge, studied interventions, screening tools and strategies, and the pediatric provider response. Summary tables and case vignettes are included to provide the reader with helpful quick references.