Faculty Coordinator: Ben Davis, MD

Contacts: 

Cherry Hill ED: Kristine (Krissey) Tucker, MD Kristine.Tucker@swedish.org
First Hill ED: Mike Pirri, MD (206) 386-2573 email: michael.pirri@swedish.org 

Brian Livingston, MD, Mike Pirri, MD



Prior to starting your rotation: 

Review schedule and clinic, and determine details of elective with advisor. 


Location/Other notes: 

First Hill ED and Cherry Hill ED. 

Harborview ED. 206.744.8334. uwemapps@uw.edu Susan A. Stern, M.D. 


RCR Curriculum link: https://www.fammedrcr.com/access-curriculum/PGY1/emergency-medicine-and-urgent-care


Readings: 

Please review CURRENT Diagnosis & Treatment Emergency Medicine (UW Log in required) 


GOALS:
1. The resident will learn how to provide acute care services to patients in the Emergency Department.
2. The resident will develop an understanding of criteria for hospitalization versus outpatient therapy of patients with non-life threatening diseases.
3. The resident will gain an understanding of when to consult specialist to assist with emergency patient management.
4. The resident will learn to order appropriate, cost-effective diagnostic tests for acute medical conditions.

OBJECTIVES:

Family Physicians provide ER and Urgent Care in many communities across the US.  A deep familiarity with presentation, evaluation and treatment of the acutely ill and injured patient is essential to Family Medicine. By the end of the ED rotations, residents will be able to demonstrate competence in the diagnosis and treatment of emergency conditions as follows:

Patient Care
    1.    Residents will be able to provide initial assessment and triage of patients presenting to the Emergency Department.
    2.   Residents will be able to assist in resuscitation of a patient in acute respiratory failure and/or cardiovascular arrest.
    3.    Residents will be able to evaluate and manage a comatose patient.
    4.    Residents will be able to identify and assist in the management of the following life-threatening conditions:
        a.    Shock
        b.    Myocardial Infarction        c.    Toxic Exposure        d.    Aortic Aneurism e. Hypertensive Crisis f. Cardiac Arrhythmias g. Meningitis h. Ectopic Pregnancy i. Meningitis j. Acute Abdomen k. Seizures / Status Epilepticus. l.                         Acute  Stroke     5. Residents will be able to independently manage the following acute conditions:          a. Acute Headache b. Vaginal Bleeding / Discharge c. Pelvic Pain d. Simple and Complex Lacerations e. Skin Abscess f. Pneumonia g. RAD exacerbation h. CHF exacerbation i.          Chest Pain (without evidence of acute MI) j. Infant with Fever k. Dislocated Shoulder l. Care of Muscular Strains/Sprains m. GI Bleeding n. Threatened / Missed Abortion o.             Joint Effusions p. Non-displaced fractures q. Pleural Effusion r. Ascites s. Psychiatric Emergencies t. Allergic Reactions u. Sexual Assault v. Emergency Contraception w.                 Epistaxis x. DVT / PE 
Medical Knowledge
    1.   Technical Skills for Life-Threatening Medical Emergencies
        a.    Residents will understand when intubation of a patient is required.
        b.    Residents will understand when placement of a central line is needed.
        c.    Residents will demonstrate knowledge of ACLS protocols.
 
    2.    Technical Skills for Non-life threatening emergencies. Residents should be able to perform the following:
        a.    Laceration Repair
        b.    Joints Aspiration
        c.    X-ray Interpretation
        d.    I&D of abscess
        e.    Lumbar Puncture
        f.     Minor surgical procedures (i.e. nail removal)
        g.    Joint Immobilization
        h.    Thoracentesis
        i.      Paracentesis
        j.     EKG Interpretation
        k.    Control of Epistaxis
 
Practice-based Learning and Improvement
    1.    Understand the resources, providers, and systems necessary to provide optimal emergency care.
    2.    Advocate for and facilitate patients’ advancement through the health care system.
    3.    Practice cost-effective health care and resource allocation that does not compromise quality of care.
 
Interpersonal and Communication Skills
    1.    Residents will demonstrate sensitivity to patients from diverse backgrounds
    2.    Residents will demonstrate the ability to show compassion to individuals with social challenges
 
Professionalism
    1.    During the ED rotations, residents will exhibit characteristics of a professional health care provider by:
        a.    Dressing appropriately based upon standards present for attending physicians in the ED.
        b.    Demonstrate sensitivity and responsiveness to patients’ perception of illness, and include these perceptions and patient preferences in formulation of management plan.
 
Systems-based Practice
    1.    At the completion of the ED rotations, residents will be able to:
        a.    When presented with a patient in the ED, describe several ways in which the primary care provider and emergency room physician can work as an interdisciplinary                 healthcare team in providing effective emergency management.
        b.    When presented with an acutely or chronically ill patient, describe the financial implications of ED health care evaluation and treatment decisions.

Supplemental readings/resources:
CDEM Medical Student ED Curriculum 

AAFP Critical Care Curriculum 


Reviewed and Updated: 7/2018, Ben Davis