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Archive for the ‘Residents’ Category

Resident Composite 2010-2011

Written by reuben

January 7th, 2011 at 5:20 am

Posted in Residents

EHC Cardiac Room Eval

In our continued quest to get more evaluations from the cardiac room, Weingart has created an online form at http://eval.ehced.org.  It is basically identical to the new innovations eval (and the paper forms in the cardiac room).


Attendings: sometime during your cardiac shift, please go to http://eval.ehced.org and complete an eval of the resident you’re working with. No username/password required.  Should be super fast.  Your input is invaluable and the residents deserve it.  Alternatively, you can log on to New Innov or complete a paper form.

Residents: sometime during your cardiac shift (don’t wait until the attending is wrapping up to go home), pull up the evaluation on http://eval.ehced.org, complete the general info (your name, attending name and date) and then ask the attending to complete the evaluation.  This is probably the best way to ensure you get an evaluation and feedback.

The web address is also posted on the wall next to the attending computer in the Elmhurst cardiac room.

As always, feel free to email/call with questions/concerns. Thanks,
Kaush

Written by phil

July 24th, 2010 at 4:16 pm

Posted in Residents

Fourth Year Medical Students interested in EM

Raphael Falk                  Mount Sinai
Joseph Freedman        Mount Sinai
Daniel Chien                   Mount Sinai
Jessica Murphy            New York Med
Sammy Yu                      Chicago Medical School
Kevin Tierney               UMDNJ – New Jersey Med

Written by phil

July 14th, 2010 at 5:30 pm

Posted in Residents

2009-2010 Resident Composite

Written by reuben

October 21st, 2009 at 7:53 pm

Posted in Residents

Fourth Year Role

Start of shift:

1. Check airway equipment, including diffcicult airway supplies
2. Check difficult airway stock list (list near airway supply) against current inventory- ask tech or Resus Nurse to restock missing items
3. North zone signout
4. Confer with charge nurse, IBEX Pulsecheck, and BedBoard Overview- introduce yourself, touch base on ED bed situation, # admitted patients, # available ICU beds, etc.
5. How many patients are in for a stress test today?

During shift:

Supervise all junior residents, meaning hear cases primarily when you can, otherwise just get a bullet (assessment and plan) from the resident on cases they’ve presented to attending

When you start falling behind in hearing about cases or seeing patients you’ve heard about, defer presentations to the attending, catch up with attending afterwards

Know all North Resus pts- well enough that you would be able to speak to a MICU consult about them

Know the bare bones of the South Resus patients- who’s really sick, who could leave the Resus area if a bed is needed

• When the junior residents become saturated with patients, and the department gets busy:
1. Board round with them on their patients (have them click “My patients” in IBEX); help them determine the next few critical actions they need to perform
2. Cherry pick patients to pick up primarily- clear admissions, call-ins who need orders entered, etc.
3. Confer with attending if other options would improve department flow

Board round with attending a few times per shift (just for a few minutes each time) to get on the same page about eval and dispo for each patient- this is a good way to get the gist of patients you were previously unaware of and see the departmental ‘big picture’

At Signout:

• -Sign out to incoming senior
• -Take part in attending change of shift as needed

Notes on Resus:

• -Know the North Resus patients well- the EM-4 should be actively supervising their care (bring junior residents in to the case), or care for them primarily if no juniors are available
• -Know key issues/dispo status for South patients

Charting:

Reiterating the attending assessment and plan may not be useful; however, Seniors should write a brief progress note in the Doctors Notes section on patients they are supervising/following (ie. Response to treatment, PCP contacted, etc.)

Codes:

The EM-4 should run the codes, assigning other roles according to staffing and need (airway, central line, etc.). If an EM-3 is primarily caring for a coding patient, the EM-3 could then take on the role of running the code and assigning roles (leaving the EM-4 to assist with airway, or whatever is needed).

Night Shifts:

Depending on staffing and volume, several options are possible:

1. EM-4 supervises the North Zone, attendings focus on hearing South Zone cases directly from South junior residents and EM-4 supervises North juniors
2. EM-4 sees patients primarily, but periodically round the board with attending to keep abreast of overall department flow and cases

Know This

The fourth year should know the answers to these questions (or know how to find out quickly) on any given shift:

1. Who can come out of Resus?
2. If CT can take a patient right now, who goes next?
a. -Or- How many patients are waiting on CT and Ultrasound? In what order should they go?
3. How many admitted patients are boarding in the ED right now?
4. Which patients have been in the ED the longest without a disposition, and what are they waiting on?

Written by phil

July 27th, 2009 at 5:52 pm

Posted in Residents

Patient Flow as of March 30, 2009

few clarification to the revised flow:

Pt flow:

The attempt to improve pt flow taught us many lessons, but for now leadership has decided to return to pt distribution the “old way”: esi 2’s and 3’s will be distributed in rotation to all 6 primary rn’s evenly.  We will no longer be “cohorting” admitted pts.

Resus Pts will rotate to north and south teams for care.  (if no resus resident is scheduled)
Pts coming out of the resus room will be distributed to the appropriate zone.

When a resus resident is working:   all resus pts will go to the resus resident.  pts coming from the resus room, will be evenly distributed to the north and south zone geography and rn staff.

Physician staffing:

If staffing permits, an EM resident will be assigned primarily to care for  pts in the resus room.   Post stabilization resus pts will be distributed to both the north and south zone– they will continue to be monitored by the resus resident and resus attending.

It is possible that the south zone may be staffed by 2 interns and an attending.  This staffing poses risk, especially if esi2 pts are assigned to the south zone.  Attending physicians are encouraged to adjust staffing in the ED on a shift by shift basis, and they are encouraged to discuss staffing with the charge nurse to ensure the safety of our pts at all times.

Kevin M Baumlin, MD

Written by reuben

March 31st, 2009 at 4:36 am

Posted in ED Flow,Residents

2009 Intern Composite

Written by phil

March 20th, 2009 at 2:21 am

Posted in Residents

Emergency Resident Composites

Written by phil

September 24th, 2008 at 5:40 pm

Posted in Residents

Composite

Written by phil

June 1st, 2006 at 11:49 pm

Posted in Residents