Being efficient with your time during an ED shift is an important skill to develop. Not only will this help you (and your staff) keep up with the demands of a busy emergency department, but as a learner this will also provide you with the opportunity to see more cases and have more time for teaching and feedback. This blog post will outline some tips and tricks for managing your time effectively throughout …
A Guide to Charting in the ED
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 …
A “Friends” Case Report – Joey’s Urolithiasis
Presentation Joey Tribbiani, a previously healthy 28-year-old male, presents to the ED with left-sided flank pain. In the past 12 hours, he has had four 20-minute episodes of sudden onset, severe left flank pain radiating to the groin. During these episodes he was unable to find a comfortable position. He felt nauseous and had one episode of emesis. He denies hematuria and any lower urinary tract, gastrointestinal, or respiratory symptoms. He reports no …
Disposition Decisions: What do we need to consider and why?
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 …
Identification of Emergency Department Patients for Referral to Rapid-Access Addiction Services
This month, CanadiEM is featuring an article from the Canadian Journal of Emergency Medicine that looks at substance-related ED presentations and the need for direct referral to a rapid-access addiction services. Recent national data shows that substance-related emergency department visits are rapidly increasing.1 Despite this finding, previous studies show that many EDs do not have referral protocols for rapid-access addiction services.2 A prospective cohort study was conducted by Hann et al. to better characterize substance-related …