Faculty Coordinator: Ben Davis, MD
ED Clinic Contact: Michael Pirri, MD
Prior to starting your rotation:
Prior to beginning the rotation, an orientation to the department will be given by Dr. Pirri.
Location/Other notes:
Swedish First Hill ED
1st Floor, Southwest Wing
Contact:
Mike Pirri, MD
(206) 386-2573
RCR Curriculum link: Emergency Medicine Core Topics
Required readings: See RCR Link above
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:
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. AcuteStroke
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: - Check with ED Attendings for any additional readings.
Reviewed and Updated 3/23/17, Jorge Garcia
Effective 6/25/2016 - 6/25/2018