Diagnosing and Managing Common Genital Emergencies in Pediatric Girls (Trauma CME) is organized by EB Medicine.

Date of Original Release: October 1, 2018
Date of most recent review: September 15, 2018
Termination date: October 1, 2021.
CME Expiration Date: November 1, 2021

Target Audience:
This enduring material is designed for emergency medicine physicians, physician assistants, nurse practitioners, and residents.

CME Credits:
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits.

About this Issue:
The presentation of genital injuries and emergencies in pediatric girls can be misleading. While a straddle injury may present with excessive bleeding yet require only conservative management, an impalement injury may present with no external findings yet require extensive surgery. This issue describes the workup and management of common traumatic genital injuries and nontraumatic genital emergencies in pediatric girls. You will learn:
• Typical presentations of a straddle injury, hematoma, impalement/penetrating injury, imperforate hymen, and urethral prolapse in pediatric girls
• Key questions to ask during the history
• Recommended patient positions and examination techniques to use during the physical examination
• How to determine when interventions are needed and what types of interventions are recommended

Goals:
Upon completion of this activity, you should be able to:
• demonstrate medical decision-making based on the strongest clinical evidence;
• cost-effectively diagnose and treat the most critical ED presentations
• describe the most common medicolegal pitfalls for each topic covered.

CME Objectives:
Upon completion of this article, you should be able to:
• Differentiate concerning vaginal lacerations that require surgical consultation from benign vaginal lacerations.
• Discuss the signs, symptoms, and risk factors for hematocolpos.
• Determine the most appropriate imaging for children with impalement injuries.
• Identify and treat simple and chronic urethral prolapse.