Emergency Medicine

Methodist Hospital's emergency center is the fifth busiest in the state. Residents on emergency medicine rotation are allowed a great deal of responsibility managing ER patients. There is opportunity for procedural experience including laceration repair, closed fracture and joint dislocation reduction, and, for those residents with interest, intubation and central line placement, among others.

Emergency Medicine Rotation Teaching Module

Rotational Goal
Residents will gain an understanding of conditions that frequently present to the emergency room setting, and will learn how these both overlap with and differ from conditions presenting to the family practice center.

Rotational Objectives
By the end of the emergency medicine rotation, residents will be able to demonstrate mastery in the diagnosis and treatment of the acutely ill patient as follows: 

(A) Patient Care
Through patient care experience gained as part of the emergency medicine rotation, when further presented with the acutely ill patient in the family medicine clinic or inpatient setting, residents will be able to:

• Accurately demonstrate taking an appropriate and efficient history to include assessment of current complaints, relevant past history, and significant co-morbidities
• Formulate appropriate management plans for emergency room patients, including appropriate use of diagnostic laboratory and radiographic testing, consultants, and medication.
• Accurately recognize and initiate management of acute life threatening conditions, including those with pulmonary, cardiac, infectious, and toxicologic causes
• Manage several patients concurrently in an efficient manner.
• Competently repair minor lacerations
• Determine appropriate patient dispositions following conclusion of treatment

(B) Medical Knowledge
At the completion of the emergency medicine rotation, residents will be able to demonstrate medical knowledge of common diseases and scenarios in the emergency department, and “best practice treatment plans” suitable for the family physician, to include being able to:

• Describe the principles of triage, the process of pre-hospital emergency care, the standard protocols for resuscitation and stabilization, and indications and mechanisms for patient transport to higher levels of care
• Describe how to assess a trauma victim
• Describe the evaluation for a patient with acute change in neurologic status
• Discuss the psychiatric conditions which may lead to emergency hospitalization, including indications for involuntary “holds”
• Describe the initial management of drug overdoses
• Recognize presenting symptoms and signs, and discuss management of, acute respiratory distress
• Recognize presenting symptoms and signs, and discuss management of, acute cardiovascular disorders

(C) Practice-based Learning and Improvement
At the completion of the emergency medicine rotation, and subsequently in the family medicine clinic and inpatient setting, when presented with the acutely ill patient, residents will be able to:

• Critically evaluate evidence basis for diagnosis and treatment, such as the use of D-dimer to assess for likelihood of thrombotic disease.
• Interpret and apply treatment guidelines, such as ATLS protocols and code 68 and code 99 guidelines.
• Modify patient treatment plans on an ongoing basis based on patient response to therapy

(D) Interpersonal and Communication Skills
At the completion of the emergency medicine rotation, and subsequently in the family medicine clinic and inpatient setting, when presented with the acutely ill patient, residents will be able to:

• Obtain a relevant and complete history using effective communication skills with patients and their families/care takers
• Provide appropriate patient education on diagnosis and treatment as part of a management plan based upon the literacy level of patients and their families/care takers.
• Coordinate care with patient and other team members for followup outpatient care or admission

(E) Professionalism
During the emergency medicine rotation, residents will exhibit characteristics of a professional health care provider by:

• Dressing appropriately based upon standards present for attending physicians in the emergency department; scrubs are appropriate attire for this rotation
• Demonstrate sensitivity and responsiveness to patients’ perception of illness, and include these perceptions and patient preferences in formulation of management plan

(F) Systems-based Practice
At the completion of the emergency medicine rotation, residents will be able to:

• When presented with a patient in the emergency department, describe several ways in which the primary care provider can work with the emergency department as a healthcare team in providing effective treatment
• When presented with either a patient in the emergency department, provide a verbal and/or written estimate of cost of care
• Describe formulary implications for medication selection based upon insurance coverage (or lack of coverage) for the emergency department patient