Always……. Introduce yourself to the attending, resident(s) and staff in the ED Team up with senior residents (2 nd and 3 rd year EM) Have the residents and attendings fill out daily evals Obtain your patient assignments from the residents Be nice to patients and their family members EVEN if they are not so nice to you IMMEDIATELY advise the attending if a patient complains about their care or other problems
Be sure to…… Follow-up on the patients that you have seen until they are discharged from the ED Talk with the EM residents if you are interested in higher acuity patients (ICU, trauma, full arrest, etc.) Get with the nursing staff for simple procedures (IV’s, foley catheters, blood collection) Ask for help! Never put yourself or the patient at risk because you are in over your head
Charting….. Chart, chart, chart! Students should chart under HPI, ROS, and free text note. (Some attendings will tell you not to chart, however, if you see a patient you are REQUIRED TO CHART IT!!) Your history should be thorough and detailed BUT your presentation should be short and precise
Presentations….. Be prepared, presenting in the ED is different than floor presentations Use your HPI notepad When creating your presentation base it off of your chief complaint, pertinent positives and negatives and positive exam findings What is your diagnoses What is your treatment plan (include medications, labs, imaging and follow-up plan)
Presenting….(wrong and right way) The Wrong way….. Patient is a 29 year old male who presents to the ED with left sided chest pressure that started 2 days ago. Pain gets worse upon exertion and improves with relaxation. Upon physical exam his pupils are reactive to light, no lower extremity pain and denies any head trauma. I’m sorry….WHAT!?! The Right Way….. Patient is a 29 year old male who presents to the ED with left sided chest pressure that started 2 days ago. Pain gets worse upon exertion and improves with relaxation and denies personal and family hx of heart disease. Upon physical exam auscultation confirms bilateral rhonchi, patient confirms significant other and children had colds 1 week ago. I think that he has an upper respiratory infection and I would like to give him an albuterol treatment with pre and post peak-flow and get a chest x-ray to rule out pneumonia.