Transcript The Right Way…..

Emergency
Medicine
SURVIVAL GUIDE
For Medical
Students
By Nick Bell, EM Clerkship Coordinator
Always…….
• Introduce yourself to the attending, resident(s) and staff in
the ED
• Team up with senior residents (2nd and 3rd 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.
The End!!!!!