Emergency Med

Can't say how excited I have been for this rotation! (and really nervous at the same time!) From my experience at Children's ED, I learned that I loved the busy-ness, chaos, pace of emergency medicine…the crazy hours, sleep deprivation, skipping meals, mixing up days of the week. I would not have originally imagined that I would like these things, and maybe I do complain about them some, but in the end, I love the thrill of the emergency department.

I started my rotation on Thursday. Arrived at 7AM only to find out my preceptor had told me the wrong day. So I played tag-along with other doc and then a PA-C. The structure of this ED is a bit different than that over at Children's. At CHP, I had a computer that I worked on. I used this station to sign up for patients, look through their history and triage, document, and discharge pts. Additionally, the docs used the computers to order labs/imaging, review results, order meds/fluids/etc. The computer told you where the patient was at, what was being done with them, what was coming up, and when diagnostics were ready. At Forbes, you triage on paper, document on paper, write orders on paper, review labs on paper. When you want to know what's being done with a pt or where they are, you ask. When you're ready to d/c a patient, you tell the nurse. Then the chart is dictated over phone to be typed up and entered into the pt's chart on the computer. But I'm slowly getting used to the system!

My first actual day with my preceptor was Sat, then I also worked Sun, and Mon from 4PM-12AM. A lot of geriatrics come in for various reasons. I have seen several falls, geriatric and adult, alike. One woman had fallen in a parking lot and sustained bilateral humeral neck fractures. Ouch. Then I've seen several older folks that had fallen and remained on the ground for several days, sustaining muscle injury, infection, fractures, and multiple abrasions. So far I've seen 2 STEMIs (heart attacks) and 1 stroke. Today I saw a case of appendicitis, a woman with a blood alcohol level of 490 (>80 is equivocal to a DUI), and a young girl that took 10 tabs of 325mg aspirin and 5 tabs of 550mg naproxen, among others.

Sun and Mon I was able to see pts on my own. After getting their histories and doing an exam, I then present to my preceptor and he may or may not ask what I think and what I want to do. Then we see the patient together, order labs, and review them when they're ready. My preceptor is very smart, and good humored. Really easy to get along with, as are the other docs and nurses. Compared to CHP, the ED at Forbes is much smaller and closer knit. One thing I do like is that there are not a lot of students, so I see more pts and have more opportunities to learn from the doc. There was a 4th yr med student there today, which as actually nice, so hopefully we'll get to work together a bit in the future.

I just got home from my shift a little after midnight and I'm still not exceptionally tired, which is why I'm writing this now. Working in the ED drastically messes with the body. Tomorrow (well today) I work 1-9PM, day off Wed, then 7AM-3PM shift on Thur and Fri. Almost tempted to ask the doc if I can work with the PA over the weekend, but we'll see! That's about all I have to say for now! Will post again with any exciting stories!