Emergency Medicine RotationIntroduction
These differences result in a work environment that some will find challenging and exhilarating, but which others find stressful. The key to how individuals respond to this environment is in large part dependent on how comfortable they are seeing patients with problems outside of their prior experience, their ability to make prompt appropriate decisions based on limited data, and their ability to prioritize and organize multiple tasks simultaneously. hile effective decision-making, prioritization, organization, and realization of one’s limitations are the keys to the successful practice of Emergency Medicine, these skills are applicable to all areas of medicine. Therefore, enhancing these skills during the ED rotation will be of general benefit to ALL rotators. WELCOME to your Emergency Medicine rotation.
Rotation Reference Guide Duration 4 weeks or 1 calender month Clinical: You will work approximately 110-130 hours in 8 or 10 hour shifts in the Emergency Department. You must work all your scheduled shifts to receive credit for this course. Be sure to complete your shift worksheet and turn it in at the end of your rotation. Any missed shifts will result in an incomplete or failing grade for the entire month. Schedule change requests must be given to Mary Blanks prior to orientation. Schedules will be finalized prior to orientation and no further changes will be made. If an emergency arises prior to or during a scheduled shift, you must inform the on duty attending at x54301 and contact Mary Blanks to reschedule your missed shift. Grading: The final course grade will be calculated based on the rubric below with the following additional requirements. The conferences held on Wednesdays are mandatory. Any unexcused absence from conference will result in an incomplete or failing grade for the rotation regardless of other performance. Clinical evaluation forms (included) must be given to the supervising attending or senior resident each shift. Interim evaluations will be completed mid-month. The Clerkship director will also hold individual meetings at the end of the rotation. Final grades are completed the week following the rotation. Grading Rubric is as follows: Clinical evaluations: 40% Pre-test: 15% Skill and simulation completion: 5% Patient and procedure logs: 5% Case presentation: 10% Post Test: 25% Please fill out the Emergency Medicine Rotation Evaluation at the end of the rotation and submit with: your shift worksheet, patient & procedure logs, and skills/simulation log. Failure to submit any of these will result in a grade of incomplete. Didactics: Student didactics are held every Wednesday, generally from 9-12 and 1-3 pm in the T20 conference room. Some didactics are held at different times and locations; these will be made clear ahead of time. Late arrival, regardless of reason will not be tolerated. Attendance is recorded on a sign-in sheet. Signing another students name is considered a violation of the honor code and will result in failure of the course and reporting to the school of medicine. Some didactics are held in the Simulation lab in the new Classroom Building. Departmental conferences are held in Room 4A and begin on Tuesday and Thursday mornings at 7:30 am. Attendance at these conferences is optional, but encouraged. If you are scheduled for a shift in the ED during conference time, you are excused to go (and expected to go) to the departmental conference. References: Please make use of the references available on the internet and intranet through the library links. On the web site http://emergencymedicine.umc.edu/liblinks.html you will find access to Rosen & Barkin’s 5 Minute Emergency Medicine Consult, Goldfrank’s Toxicologic Emergencies, Rosen’s, Tintinalli’s, and many other reference guides and online textbooks. These links will be invaluable to you while working in the emergency department.
Patient care: Place the notation “MSIV” on the tracking board prior to going to see patients. You are expected to provide complete care for your patients – all necessary procedures, follow-up of laboratory and diagnostic studies, and appropriate dispositions. You are expected to function at an intern level. All documentation is electronic. This record goes into the patient’s medical record. All patients must be reviewed with the attending prior to beginning management of the patient. You are encouraged to discuss patient care with senior EM residents as needed, but ultimately you and the attending will manage your patients. If you have any concern that a patient has an emergent condition or requires immediate intervention, contact the nearest EM resident or attending immediately. If your patient’s disposition cannot be completed at the end of your shift, you are to transition care for the patient out to an EM resident. Do not transition care to another student or a non-EM resident. Record information from all of your patient encounters on your patient log sheet, which will be turned in at the end of the rotation. Obtaining patient stickers is an efficient way to accomplish this. Procedures: All procedures must be documented on the patient’s chart. You must make the attending aware of any procedure prior to starting that procedure. The procedure note should include: indication, type of consent, location, preparation, type and amount of anesthetic, amount of irrigation if needed, the number and type of sutures if needed, amount of purulent material expressed, dressing type, and complications if needed. All procedures attempted and completed by you need to be included in your procedure log sheet which must be turned in at the end of the rotation. Disposition: Write all discharge instructions in legible layman’s terms. All instructions should include what the patient needs to do for the identified problem(s), what the patient needs to look for which indicates that a return to the ED is necessary, and what arranged follow-up has been made for the patient with appropriate telephone numbers and physician names listed. Consults: Always clear the need for consultation with your supervising attending. Be prepared prior to calling with your reason for consultation. Call the intake specialist at x44004 to page the consultant. Let the intake specialist know your name, the patient’s name and room, your telephone extension and whether or not your consult requires an admission. Give a concise and complete report to the consultant. If there are any problems, refer the consultant to the supervising attending or resident. Professionalism: Be professional at all times. There is no eating or drinking except in designated areas. Respect patient confidentiality is critically important. Students, residents and staff have all been fired because of breaches of patient confidentiality. Appropriate attire is required and includes either professional dress or scrubs. Additionally your white coat and ID badge should always be available. Communications: While you are on this rotation, there will be a mailbox in the communication center of the ED with your name. Please check this box on a regular basis for correspondence. If you have additional questions or problems, please contact Mary Blanks in the department office at x45584 or Dr. Jonathan Jones at x56067.
|
