Sep 28, 2023
SELECT SIEMA - Acting Internship Emergency Medicine
Director Fourth Year Department Courses: Stephen Baker, M.D.
Director(s): Stephen Baker, M.D., Phone: 626-2325 Room: XG-5; Dept. of Emergency Medicine
Administrative Contact: Belinda Kennedy, Administrative Assistant Phone: 626-2325 Room: XG-5; Dept. of Emergency Medicine
Number of Students Per 4 Week Block: 4
Location: Academic Medical Center at Ochsner LSU Health Shreveport
Selective Available During Blocks: Blocks 1-9
Course Code: SIEMA
The primary goal of this rotation is to teach medical students how to recognize and manage acute life-threatening conditions. Our secondary goal is to develop the diagnostic skills necessary to evaluate patients with common symptoms such as chest pain or abdominal pain. Other goals of this four-week elective in Emergency Medicine are to enhance the student’s:
- Knowledge of the fundamental principles of medicine
- Understanding of the fundamental concepts and skills learned in the 3rd year clerkships
- Basic knowledge of the pathophysiology, clinical presentation, assessment and treatment and interpretation of diagnostic tests of major and common disease problems presenting to the emergency department
- Skills of medical history taking and general physical examination
- Foundation for continuing education and lifelong learning skills
These objectives will be accomplished by having the student participate as a member of the health-care team under the direct supervision of Emergency Department (ED) faculty. The student will be expected to become familiar with the following skills:
- Initial evaluation (history and physical examination) of a patient presenting to the ED with undifferentiated non-urgent, urgent or emergent illness or injury.
- Basic steps of resuscitation and stabilization of patients
- Development of a differential diagnosis for common presenting complaints in the ED setting such as:
- Chest pain
- Shortness of Breath
- Abdominal pain
- Sore throat
- Minor trauma
- Altered mental status
- Students will provide primary contact with patients under direct faculty supervision.
- Students will be under the supervision of ED faculty who are always present in the Emergency Care Center
- The history, physical examination and differential diagnosis will be presented to the faculty at each patient encounter. This will establish a teaching dialogue between faculty and student.
- Medical history and physical examination skills will be improved.
- The opportunity for bedside teaching regarding history-taking and physical examination skills will be avail- able at each student/patient encounter.
- Students will learn to perform a focused history and physical examination pertinent to what is needed for their patients.
- The concept of a focused history and physical examination as it relates to the “Chief Complaint” is integral to the practice of Emergency Medicine and will be taught to all students.
- Students will be taught to perform a rapid but thorough physical examination.
- General medical knowledge and disease-specific information for common and major medical problems treated :
- Students will utilize a variety of resources including standard texts and computer-based resources to enhance their knowledge of specific disease processes as they are encountered.
- Hands-on workshops will be presented covering a variety of Emergency Medicine topics:
- “Wound care and suturing techniques”
- “Basic Splinting”
- “Intubation and Emergency Airway Skills”
- “Cervical Spine Evaluation”
- “Emergency Procedures”
- “Medical Record Documentation”
- Students will also attend the weekly department lecture series covering Core Emergency Medicine topics
- Altered Mental Status
- Approach to Poisoning
- Approach to Trauma
- Chest Pain
- Respiratory Failure
- Common Infections
- Emergency Psychiatry
- Abdominal Pain in the Emergency Department
- Gynecologic Disorders and Emergencies
- Medical-Legal Aspects of Emergency Medicine
- ENT & Dental Emergencies
- Urologic Disorders and Emergencies
- Pediatric Emergencies
- Dermatology in the Emergency Department
- Students will learn about aspects of preventative medical care.
- The student will be educated on follow-up instructions and patient education regarding their disease process at the conclusion of each patient encounter.
- The importance of immunization status and recommendations regarding rabies, tetanus and influenza will be emphasized during the rotation.
- Breaking the Cycle of Domestic Violence - awareness, recognition and prevention of intimate partner abuse, child abuse and elder neglect/abuse will be highlighted during this rotation
- Learn documentation requirements.
- In addition to the documentation workshop, each student chart will be reviewed by a faculty member prior to disposition of the patient from the Emergency Department.
- Exposure to effects of social, cultural and societal problems and issues on health.
- During the rotation the student will interact with various organizations:
- LSUHSC Social Services
- LSUHSC Pastoral Care
- Adult and Child Protective Services
- YWCA Spouse Abuse and Domestic Violence Program
- The Rape Crisis Center
- STEPS Chemical Dependency Detox Program
- Animal Control Center
- Louisiana Poison Control Center
- Shreveport/Bossier Rescue Mission
- Alcoholic’s Anonymous
- Emergency Department Clinical Area
- Small group workshops
- One-on-One Faculty Interaction
Resources for Learning:
- All Emergency Department Faculty Attendings
- Study Guide of Emergency Medicine- Judith Tintinalli.
- Emergency Medicine- Concepts and Clinical Practice- Peter Rosen.
- 5-Minute Emergency Medicine Consult.
- e-Medicine, web-based emergency medicine text- Adler and Plantz. (This peer reviewed, web-based text will be utilized at the bedside at the time of each patient encounter. This will foster the development of lifelong learning skills in the student.)
- “Wound care and suturing techniques” - will provide students with the basic skills required for management of routine wounds seen in the ED setting.
- “Basic Splinting” - will teach students how to apply splinting material and manage many common orthopedic injuries.
- “Intubation and Emergency Airway Skills” - this workshop will teach students to recognize situations of potential airway compromise and develop the motor skills required to obtain a secure airway in the emergent situation.
- “Cervical Spine Evaluation” - will explore physical examination findings, mechanisms of injury and radiographic evaluation of the cervical spine in the trauma setting.
- “Emergency Procedures” - will teach indications, contraindications, risks, complications, techniques and landmarks for several emergency procedures including central venous access, lumbar puncture, thoracostomy and arterial access.
- “Medical Record Documentation” - this workshop will introduce the student to the computerized documentation system utilized in the ED and emphasize important medical/legal aspects of ED charting.
- Lumbar puncture workshop
- Bedside supervision of physical examinations and simple procedures will be provided by the Faculty after the student has shown proficiency in the practice workshops.
- Emergency Medicine: A comprehensive Study Guide - Companion Handbook, David Cline (recommended)
- Each student will be required to demonstrate independent life-long learning skills by presenting a brief case-based, oral presentation to a faculty member prior to completion of the rotation.
- A skills completion form will be maintained and checked as the student masters each required skill in the workshops listed above.
- Subjective - a comprehensive faculty evaluation form will be completed for each student at the conclusion of the selective.