Being able to think patients through to their final disposition can be a challenging skill at the clerkship level. However, a good clinician should start thinking about a patient’s disposition as soon as they pick up the chart. Before you take a patient’s history, look at the triage note and start to think through your differential diagnosis, diagnostic workup, therapeutic management, and disposition plan. What are the “most common” and “cannot miss” diagnoses …
“Help us help you” – Soliciting Feedback in the ED
We’ve all heard the adage that practice makes perfect and to become an expert you must complete 10 000 hours of deliberate practice1. This involves motivated, goal oriented, purposeful practice with periodic feedback. Feedback is critical to allow for growth from where you currently are as a clinical clerk to where you want to be as future practicing physician2. Even with extensive deliberate practice, you will plateau without guidance and identification of areas …
Approach to Caring for Homeless Patients in the ED during the COVID-19 Pandemic
Introduction It’s a cliche that holds true now more than ever – the emergency department really is the front door to the medical system. Despite many health and social services shuttering or moving to virtual care during the COVID-19 pandemic, the emergency department remains open 24/7. Our EDs are still committed to seeing anyone who shows up, in communities of all sizes from coast-to-coast. And while we try to keep people at home …
Navigating Patient Handovers
06:50AM: You are heading towards the tail end of your night shift, swamped with traumas, resuscitations, and overall high volumes of patients. You look forward to heading back to the warm embrace of your bed. However, before you can leave, you run your list again with your supervising physician and realize that there are still a few patients that will likely need to be handed over to the morning shift physician. The incoming …
The RULES of Patient Reassessments
You have seen the patient, collected a thorough history of pertinent positives and negatives, completed a comprehensive physical, generated a differential diagnosis, presented the case to your attending and ordered all the appropriate investigations. The next step in providing the best care in the emergency department is reassessing, reassessing, and reassessing. The Emergency Department is unique in that there is minimal continuity of care. Once the patient is discharged from the department you …
HiQuiPs: Quality Improvement in the time of COVID-19
You are attending your monthly ED staff meeting where the main topic of discussion is the COVID-19 pandemic. Recent events around the world have compelled your hospital to make changes to better prepare for the expected increase in local respiratory cases. The ED staff meeting has a debrief about some changes that will be happening including personal protective equipment use changes, new COVID-19 swab testing, ED triage and flow changes and many other …