G2 EMERGENCY MEDICINE

Contact: Nate Bowler through the ED at 612-863-4233

Subspecialty clinic: Not applicable

Conference: Not applicable

Resident continuity clinic: Tuesday AM, a three-week minimum notice, given to Anne is required if you are planning on taking vacation time.

Schedule:

Monday, Wednesday, Thursday, and Friday: ED time will be determined in advance of each residents block and communicated to the resident by Lisa Callies and/or Nate Bowler, conference time is as usual

Tuesday: AM continuity clinic and PM reading time

Performance Expectations:

The resident is expected to be in the emergency department for the predetermined shift each day seeing new patients. All patients should be staffed with the appropriate emergency department MD and subsequently entered into Excellian. Starting about one hour before the end of the shift, the resident may avoid seeing new patients unless needed and follow up on already seen patients to allow for a timely departure. Sign-out patients to the appropriate emergency MD only if necessary.

The shift hours of this rotation may not be altered except when the resident is needed to cover the NIP clinic, or on the day of the annual picnic in June.  On NIP coverage days, the ER rotation goes from 8 am until noon, then NIP in the afternoon. You must sign-in each day and give advanced notice to Dr. Bowler if vacation time is planned.

Your commitment for moonlighting should not interfere with your rotation. You may take the beeper at 5 PM, but you cannot leave the ED to work up an admission before your shift is over. If your shift is ending after 7 PM, you should not be scheduled for moonlighting. Inform the medicine attending of this if you are contacted about an early admission when moonlighting of the circumstance. Wear a lab coat with an ID tag during this rotation.
Keep paper prescription pads in the physician’s area only.

Educational Goals and Objectives:

	Educational objectives	Assessment method
Patient Care	1) Emergency department visits will be performed, staffed, and documented in Excellian 2) Demonstrate understanding of how to triage and work up patients in this unique setting 3) Understand indications for admission, observation, and discharge 4) Demonstrate appropriate communication with primary care physicians and hospital attendings 5) Understand follow up instructions 6) Perform appropriate procedures as able	1) Global faculty assessment 2) Direct faculty bedside observation
Medical Knowledge	1) Review core topics noted below using patient care, and didactic opportunities, and supplement with independent reading 2) Understand how life-threatening medical problems present 3) Participate in tutorials by EM staff physicians (for list of important topics see below)	Global faculty assessment
Practice-Based Learning and Improvement	1) Demonstrate insight into knowledge deficiencies and limitations 2) Use information technology to answer clinical questions	Global faculty assessment
Interpersonal and Communication Skills	1) Refine the skills necessary to present patients and topics informally and formally to another physician or group 2) Maintain a team approach to patient care: discuss plans with nurses and keep them informed of new developments and orders 3) Maintain open communication with the patient and/or family: keep them informed of any delays and additional tests, report abnormal test results, and inform them that their comfort is a high priority	Global faculty assessment
Professionalism	1) Arrive on time and demonstrate time management skills to attempt to finish up patient care by the end of the shift with appropriate signouts as necessary 2) Sign in at the beginning of each shift and give advanced notice to Dr. Nate Bowler if vacation time is planned 3) Do not start any moonlighting duties (except for emergency house officer calls) to interfere with the rotation until after the ER shift is completed 4) Wear a white coat and appropriate identification	Global faculty assessment
Systems-Based Practice	1) Understand systems unique to this patient care setting 2) Demonstrate effective and safe patient care hand off to appropriate next setting	Global faculty assessment

Experience in evaluation, diagnosis, treatment and/or triage of multiple emergency syndromes such as

Ophthalmologic problems
Red eye
Eye pain
Visual loss
Trauma to the eye
ENT emergencies
Otalgia
Otorrhea
Epistaxis
Sore throat
Difficulty breathing
Abscesses
Toxicology
Principles of toxicology1
Toxidromes
Common toxicology problems and treatments
Toxicology pearls
Orthopedic topics
General approach to orthopedic injuries
Most common fractures and dislocations
Splinting principles
Orthopedic referral and consultation
Emergency trauma care
General approach to the trauma patient
Primary and secondary survey
Chest trauma
Pelvic fractures
Headache in the emergency department
Goals of management
Ominous headaches
Evaluation and treatment principles
Other topics
Chest pain
Dyspnea
Decreased level of consciousness
Abdominal pain
Psychosis and acute or severe depression
Gastrointestinal bleeding
Low back pain
Alcohol abuse and withdrawal
Sepsis

There are tutorials that EM staff will present to the resident.

 Procedures: (Central venous catheters, chest tube)

 Past resident recommendations: On Tuesday after AM continuity clinic, the resident may take a half-day vacation and not attend to the EM shift. All other days, only a full day off may be taken.