A Guide to Charting in the ED

In All Posts, Education & Quality Improvement by Stella TungLeave a Comment

It’s your first Emergency Medicine shift in clerkship. You’re asked to see a 25-year-old female with abdominal pain. What are things you want to make sure you ask about and examine, and how should you document your assessment without spending most of your shift on paperwork? Documenting patient encounters is a core skill in all medical specialties; in fact, it is a legal requirement of all physicians providing patient care. In the fast-paced …