tu handbook contents 2wk 2012-13

7/31/2019 TU Handbook Contents 2wk 2012-13

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Tulane/University HospitalNew Orleans

2-Week EmergencyMedicine Rotation

Student Handbook 2012-13


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Table of Contents

1. Contact information

2. Orientation handout and course details

3. Campus map


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Contact information

Clerkship Director:

Jennifer Avegno, MD

Clerkship [email protected]; [email protected](504) 903-3594 (office)(504) 301-5058 (cell)

Office: 6th Floor, Learning Center room 622

2020 Gravier Street

Mailing Address: Section of Emergency MedicineLSUHSC New Orleans

1542 Tulane Avenue Room 542Box T4 M2New Orleans, LA 70112

Emergency Medicine Clerkship and Residency Office:

Shanel Sede, Clerkship CoordinatorKathy Whittington, Residency CoordinatorUniversity Hospital room 5462021 Perdido Street

New Orleans, LA 70112(504) 903-3594 (phone)(504) 903-4569 (fax)

Website:

http://www.medschool.lsuhsc.edu/emergency_medicine/core_em_rotation.aspx

Emergency Department:

Main Emergency Room (MER):(504) 903-3144Urgent Care (UC): (504) 903-0564Rapid Triage Area (RTA): (504) 903-3215
mailto:[email protected]:[email protected]


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Tulane/University Hospital New Orleans EmergencyMedicine ClerkshipRotation Guidelines

Welcome to University Hospital and New Orleans

Emergency Medicine! We are pleased that you havechosen to rotate with us. Historically, this has been one ofthe most popular EM rotations in the country, and we willcontinue to work hard at providing you with an excellenteducational experience. Please read the followinginformation carefully and do not hesitate to contact us atany time with suggestions or questions.

Course Objectives:

To obtain insight into the principles and practice of

emergency medicine and trauma care in theEmergency Department (ED)

To perform a targeted history & physical of theundifferentiated patient, and generate a differentialdiagnosis addressing possible urgent and emergentconditions

To understand the usual course of care/disposition

for patients presenting with common medical

conditions

To obtain skills in such common emergency

procedures as:

airway

oxygenation (nasal cannula, mask, BVM, pulse

oximetry, ABG)

venipuncture/IV access/fluid administration

NG tube, Foley catheterization

wound care

eye examinations, gynecological exams, and

other common procedures

To observe and learn coordinated, efficient, and

expert management of seriously ill medical and

trauma patients


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Emergency Medicine (EM) is a broad, complex disciplinewith a wealth of patient encounters unmatched by mostother specialties. Regardless of your future career choice,you will face unexpected acute medical emergencies inyour professional or personal lives. Evaluation of the

undifferentiated patient that is, figuring out who is trulysick or not sick is one of the most elusive yetimportant skills for any physician. Through this rotation,we aim to teach you basic skills in acute medical care,including simple and common procedures, and provide youwith an evidence-based foundation for approaching patientcare. Furthermore, by one-on-one interactions with facultyand residents, we hope to illustrate to you that everypatient encounter can result in both formal and informalteaching and education. Evidence-based learning shouldoccur as often as possible during the course of your shift.

Finally, we intend to provide you with a healthyunderstanding of how a modern ED and trauma unitoperates.

You will be working in three locations at University Hospital(UH): the Main Emergency Room (MER), Rapid Triage Area(RTA) and Urgent Care Area (UC). In each location, you willbe supervised by board-certified EM faculty and have theopportunity to work with EM residents and interns as wellas off-service interns from both LSU and Tulane (in theMER). You will be responsible for seeing your own patients.

MER:YOU ARE CONSIDERED TO BE AN "ACTING INTERN" -that is, you will have direct patient care responsibilities foryour own patients, with significant supervision and backupfrom EM residents and staff. You are responsible for fulldocumentation in the patient record.

After performing an H&P, you may present the patienteither to an EM resident or directly to staff for guidance.All procedures must be directly supervised by an EMresident or staff, and EM staff must review the case and

sign the patients chart prior to discharge. At shift change,you must sign out and provide detailed information on anyactive patients to oncoming students or interns.

Major trauma resuscitations will be done by the upper-levelEM resident with staff backup. The EM resident serves asteam leader and will assign you a role in the management


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and care of trauma patients, and you are expected toobserve and participate in each resuscitation.

On most shifts, there will be a dedicated EM teachingresident. This resident will conduct regular student and

intern-only rounds, guide you through patient cases, andinstruct and supervise your procedures.

UC: The Urgent Care (UC) is a fast-paced, walk-in minorcare area. You will be responsible for seeing your ownpatients; presenting directly to EM faculty; performing allneeded procedures (under supervision); and developing amanagement plan at discharge.

RTA: The Rapid Treatment Area (RTA) is a busy andflexible area of the ED that is designed to primarily see

level 4 and 5 (less acutely ill) patients but also beginevaluation and workup of sicker patients when the Main EDis full. This allows you to understand how modern EDscope with issues of resource and space constraints whileproviding efficient, safe, effective patient care. Prioritizingof patients and managing patient flow are two of the maingoals of care in this area. You will work alongside EMresidents but primarily present your patients directly to EMfaculty.

Course Requirements:

5-6 shifts divided between the MER, RTA andUC. MER shifts are from 7 am 7 pm and 7 pm 7am. UCC and RTA shifts are from 7 am - 3 pm("day") and 3 pm - 11 pm ("evening"). A scheduletemplate will be provided prior to and duringorientation. Please look over the template carefullyand pick out a few schedule choices prior to comingto orientation. All students will pick a number, andyou will choose your schedule in that order. AllTulane school holidays are considered rotation

holidays as well, but you may work them if youchoose.

o ATTENDANCE AT YOUR SHIFTS IS MANDATORY.If you are ill or have an emergency, you musteither call the course director or the ED and letthe attending staff know you will not be there.Students who fail to show up for a scheduled


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shift will be assigned an extra penalty shift.NO EXCEPTIONS!

o Much thought has gone into the schedulingprocess. To optimize patient and ED flow, thelevel of student staffing is as consistent as

possible.o Any special circumstances regarding shift

scheduling must be discussed with the coursedirector as far in advance as possible.

o The master schedule will be available online atall times.

Faculty lectures and EM curriculum. OnThursdays from 7:30-9:30 am you will receivelectures from EM faculty and residents on a variety ofcore EM topics. These lectures are informal and

frequently interactive, and have been very popular inthe past. These are mandatory lectures; if youforesee any problems with attending a certainlecture, please let the course coordinator knowahead of time. If you miss a lecture, you will beexpected to read a selection of core articles on thetopics missed.

Available on the website are several articles on coreconcepts in EM developed by national leaders in EMstudent education:

http://www.medschool.lsuhsc.edu/emergency_medicine/core_em_rotation.aspx

(See "Required Course Reading" links to the right ofthe page.)

These should serve as a starting point for your studyof management of the acutely ill and/orundifferentiated patient. Evidence-based medicine isas important in EM as it is in other disciplines and

should serve as the basis for evaluating, diagnosing,and managing patients in the ED. The end-of-rotation exam questions will be taken directly fromthese articles and the student lecture material.

In addition to traditional didactic lectures, there willoccasionally also be sessions that include hands-on


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simulation and procedure labs, as well as ultrasoundinstruction.

Lectures will be held either in the basement conferencerooms of the hospital, in the ED conference room on the

1st floor, or in one of the LSU medical school buildings;you will be notified of the location ahead of time.

The learning objectives and curricula for all EM rotationscan also be found on the website. Please read thesecarefully and target your on- and off-shift learning andstudy to these objectives.

Daily evaluations. Students will be evaluated dailyby faculty and/or residents during each ED shift. At

the end of each shift, simply hand your shift card forthat day to the appropriate staff or upper-levelresident. Please do not give your evaluationcard to an EM or off-service intern. The staff orupper-level resident will fill it out and drop it in theappropriate box. Please feel free to discuss yourevaluation with staff at any time.

We know that feedback is important to

you! Your charge resident and/or staff shouldgive you informal and sometimes formal tips

with every patient you present - listen forthese, and ask for more if you feel you needmore guidance or instruction. Your shift cardsare kept in a secure location in the EM office,and you may view them at any time during orafter the rotation. DO NOT BE AFRAID TO ASKFOR FEEDBACK - either on shift, or formally tothe course director. We welcome your activeparticipation in your own education.

A daily log of patient encounters and

procedures is also required. All patientencounters and procedures observed, assistedwith, or performed should be logged intoE*Value. This must be completed by theend of the rotation in order to processyour grade.


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o Preventive medicine. Students areexpected to discuss preventive medicine issueswith their patients. Not only is this criticallyimportant for future health and well-being, butit is also becoming a critical evaluation tool by

medical governing bodies. Feel free to referyour patients to any available resources (i.e.,dietician, social work, etc.) during yourconversations.

o Teaching resident evaluation.You will alsobe asked to evaluate the EM teaching residentwhile in the MER. This helps us to provide youwith the best individualized educationalexperience.

End of rotation exam. All students must completea 23-question multiple-choice end of rotation onlineexam no later than the last day of the rotation.All questions in the test are taken directly from thecore reading material and lectures. You will receivea link to the exam within the last week of theclerkship. Rotation evaluation and grading will notbe complete until the test is submitted. You mustpass the exam in order to pass the course.

ACLS training. You must complete ACLS training in

order to receive a grade for the course. Classes areheld frequently and can be scheduled through theTulane Simulation Center. Any failure to completeACLS within 2 weeks of the rotation end may result ina grade of incomplete.

Other scholarly opportunities:

o EM resident weekly conferences are held onWednesdays from 7 am 11 am in the UHbasement conference room #103. Lecturesare given each week by EM faculty andresidents, as well as visiting guest speakers.You may attend these when not scheduled fora clinical shift; students working should remainin the ED while residents attend conference.

o Monthly EM Journal Club is held on the secondThursday of each month (usually at a


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restaurant). Students are invited but notrequired to attend.

Student Responsibilities

All students are expected to adhere to the same degree ofprofessionalism as in any other clinical setting. Towardsthat end, students are expected to be on time for everyshift. Any student arriving more than 10 minutes late onany occasion without good reason will be given a warning.As stated above, failure to show up for an assigned shiftwill result in an extra penalty shift. Repeated lateness willalso result in an extra penalty shift. Timeliness is part ofyour evaluation and contributes to your professionalismscore, which makes up 15% of your overall grade.

Students are allowed to make schedule switches as long asthey inform the course director. However, if you make aswitch with another student, and that student fails to showup for the shift, it is the original students responsibility.Repeated problems with switching must be brought to thecourse directors attention.

Proper hospital attire is required: either clean scrubs orprofessional dress. No t-shirts or open-toe shoes. Lab coatis optional. Your TU ID must be worn at all times. If you

need CLIQ (computer record) access, please call 568-HELPfor your ID and password.

Please keep running copies of your patient logs. Lostforms cannot be used in calculating your final grade.

Grades

Grades are based on the following:

1. Completing all shifts in the allotted rotation time.2. Submitting patient log and evaluation form with allshifts accounted for within one week of rotation end.3. Attendance (and timeliness) at all scheduled activitiesand lectures.4. End of rotation exam.5. Successful completion of ACLS.


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Grades are pass/fail.

Please do not hesitate to contact us at any time duringyour rotation.

Thank you,

Jennifer Avegno MDTU/LSU Medical Student Clerkship Director

EM Residency and Clerkship Office: University HospitalRoom [email protected](504) 301-5058 (Dr. Avegno cell)(504) 903-3594 (EM office)
mailto:[email protected]:[email protected]


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1. Medical Center of Louisiana at NewOrleans, Charity Hospital

2. Clinical Education Building3. L & M Building (Rehabilitation Center)4. Dibert Building5. Gravier Parking Garage6. Fitness Center and Student Residence

Hall7. Student Residence Hall8. Medical Education Building (MEB)

9. Allied Health & Nursing Building

10. South Roman Street ParkingGarage

11. Mervin L. Trail Clinical SciencesResearch Building (CSRB)

12. Learning Resource Center/LionsBuilding

13. Library, Administration andResource Center

14. University Hospital15. University Medical Office Building16. University Medical Parking Garage17. School of Dentistry

18. Tulane Medical Center19. V. A. Medical Center20. Delgado Nursing School

21. Saint Josephs Church

Campus Map


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tu handbook contents 2wk 2012-13

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