Emergency Medicine

MEDICAL STUDENT PROGRAM

Fourth Year Emergency Medicine Rotation - ER 843 Syllabus

This four week fourth year course is designed so that after completion, the student will demonstrate:

1. Assessment, evaluation and treatment of common acute emergency problems
2. Assessment, evaluation, and treatment of the undifferentiated patient
3. Assessment and treatment of basic wounds including suturing techniques
4. Competency in presenting patient information to a group for discussion
5. Understanding of the Emergency Department’s relationship to the EMS system, hospital and community
6. Competency in the presentation of a patient care plan to a faculty or resident supervisor
7. Professional behavior and demeanor

Specific Goals and Objectives

1. Gather appropriate relevant patient historical information in a time sensitive manner
2. Demonstrate ability to access EMS and describe the relationship of pre-hospital care providers to the emergency department
3. Perform a directed, complete and appropriate physical examination of the emergency patient directed by the patient clinical presentation
4. Perform a basic mental status examination including GCS
5. Apply an appropriate splint for an injured extremity
6. Establish IV access
7. Perform NG and Foley catheter insertion
8. Demonstrate the ability to appropriately interact and discuss care with variety of patients
9. Demonstrate the ability to you succinctly relate a patient’s clinical findings to an appropriate consultant
10. Demonstrate the ability to appropriately complete the medical record in a timely fashion
11. Perform basic wound care and evaluation
12. Perform basic suturing of simple lacerations
13. Demonstrate knowledge of reasonable, competent evaluation and treatment of common ED emergencies

Experiences

ACLS training will be available four times the year. The current year’s schedule for ACLS training is available from Amy Salmons in the Department of Emergency Medicine.

The first two days of the rotation (usually a Monday and Tuesday) are spent at the University of Kentucky Department of Emergency Medicine in didactic and skill station labs. During this orientation period, students will be provided a comprehensive reading curriculum, a CD of all didactic materials and a general orientation to the environment of the emergency department. Students return weekly on a scheduled basis to participate in an instructional series specifically geared to the medical student. These include didactic presentations, skill sessions and case presentations during which the student will present a case for discussion by the group. Students are invited to attend the regularly scheduled curriculum provided for the emergency medicine residency program on Tuesdays and Thursdays. Oral examinations may be included as part of the evaluation process. On or near the final day of the rotation, the students will undertake a comprehensive examination covering didactic material and all readings.

Readings

Students will be given a notebook containing all required reading materials (except ACLS, which has its own separate text). These materials have been carefully selected to provide you with a core set of information that you may supplement with further reading if desired. The student is responsible for the manual and will be charged a fee of fifty dollars if it is lost or damaged. The examination will be drawn from these reading materials and information in the didactic lectures and skill station labs. Note: a significant portion of the exam is drawn from the reading material. Please make sure you plan your studying since there is a large volume of reading.

Case Conference

Each student will present a patient case in which they participated and cared for during the rotation to the entire group. The case should be one in which the student played a role in diagnosis and/or treatment and the student will have personally seen and examined the patient. The case will be presented in a 10-minute session for each student. The presentation will be as an “unknown case” that the group will work through and from this discussion, the group will develop a differential diagnosis and plan. The student should have all pertinent information available such as history findings, examination findings, lab, ECG and Radiographs. The student should know the eventual outcome for the patient and be prepared to discuss the disease process briefly for the group. Unusual cases are OK but true “bread and butter” typical cases of common complaints are good also. If you need help, speak with your preceptor or attending with which you saw the patient. Students will be graded on case selection, presentation style, and knowledge of the final disease process.

The General Format Is:

• Present a “teaser” for the case such as “I have a gentleman who is brought in by friends speaking out of his mind” or “This is a 22 year old roofer who fell 30 feet off a roof”
• Give a few pertinent facts including vital signs to the group
• Answer questions about the patient from the group
• Develop with the group a reasonable differential and plan of evaluation
• The group decides on a most likely diagnosis
• Discuss the actual outcome and diagnosis of the patient with a brief discussion of the Pathophysiology

EMS Shift

Students are expected to experience pre-hospital care by riding with a local EMS unit. Students in the Lexington area will be assigned to ride a 10-hour shift with the Fayette County EMS. To schedule (Lexington based students only) the EMS ride, contact Chief Chuck Fowlers at 231-5661, complete attached Request for Ride-A-Long Program, and fax it to 281-6136 to obtain his signature. He will then sign the form and fax it back. If you have any problems please see Amy. All students doing rotation at AHEC sites will be assigned through their preceptors to ride on one 10-hour shift with the local EMS services.

EMS Guidelines

• Wear your U.K. student identification badge
• Follow dress codes required by each EMS site
• You may bring your stethoscope and reference mat\erials that you use in the ER