beachdude

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Hey guys,

Question - how the heck can anyone retain all that knowledge for their ER elective?

I know im not stupid, but given the nature of ER, you basically have to know a little about everything...which is why I love ER...

But its tuff remembering everything when your not using it! So my question is this...what do you guys do during your ER rotation when you have to recall things which you forget and you want to impress your attending?

Read up on it on your PDA before talkin to your attendin?

help please!
 

Powder

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:) Relax, no one expects you to rember everything. Keys to doing well. Get a good focused H&P done quickly and be able to present it quickly. Have a good differential (1st things that could kill the patient and then the most likely diagnoses.) eg. Chest pain - AMI, PE, anxiety, etc. Have a plan for your patients. Follow-up labs and xrays you want to know what they are before the attending looks at them. Be interested and ask relevent questions. Don't be afraid to say I don't know, but look it up and know it for next time. Have fun, EM rotations are great. Be nice to everyone, MDs, RNs, and Techs. :)
 

WilcoWorld

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Be on time, be respectfull, be enthusiastic.

I didn't get an Honors for either EM rotation, so I can't tell you how to do it, but I can guess.

I was told near the end of my rotations that students should take on fewer patients. Of course you want to show your stuff by carrying three yto five charts around, but I'm told the attendings would much rather see you do a bang-up job on one patient then appear frazzled by five. So don't bite off more than you can chew.

To address your stated question: I think that the Five Minute EM Consult is a great resource for rotators when they have the time. Or, if you can read 1st Aid for EM before your rotation you'll be in GREAT shape knowledge-wise.
 

willlynilly

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the book i liked the best was the washington manuel for emergency medicine. appearantly it's sort of hard to find, but it broke it down really well, even giving pretty extensive differentials, and initial workups...
 

Doczilla

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You don't need to know everything, nor do you need to know exactly what's wrong with the patient. You do need to have a plan for how you will work the patient up in the differential. It never hurts to look at the patient, then skim the 5 Minute Emergency Consult or 5 minute Clinical Consult (both available for PDA) before talking to the attending. In fact, you should almost always do that. This only takes a couple of minutes and can help you with the major differential diagnoses and the right tests to get. The exception being if the patient looks unstable in any way.

As far as aceing the elective, Wilco's go it right. Be on time, hardworking, enthusiastic, and respectful of everyone. Talk to the clerkship coordinator or senior resident early and ask them what is expected of you. Ask what students have done in the past to do well in the rotation. Take on slightly fewer patients than you can handle, so nothing gets lost. Be available and express interest in procedures. (tell the senior resident at the beginning of each shift that you want to do some procedures, and they will come get you for lines, suturing, etc.) A good attitude goes a very long way, perhaps further than outright clinical knowledge.

'zilla
 
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beachdude

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Thanks for the tips guys...I downloaded 5 MCC, plus 5 minute rosesn's emerg (got the keygen ;) and they're awesome...

I last question...how do you get good letters of references?
I did surgery as my electives in the past, and although I hated surgery to a passion (thank God I did them, as I completely ruled them out as I thought I'd like it), since I worked with a surgeron most of the time, I was able to get a letter of reference should I desire one.

But in Emerg, it seems a bit different. Every shift Im working with someone different. Moreover, I'll only be doing a 2 week elective, and there's only 8, 8hr shifts given.

The way the school works is that at the end of every shift, the attending writes the evaluation. Then at the very end of the rotation, there is a co-ordinator attending that summarizes all your evaluations, into one big ass evaluation...

Any tips on how to get a letter of reference in this situation??

Thanks guys
 

Doczilla

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Hmmm... You may find that you work with one attending more than the others. They may need to get some input from the residents, but may pull it off for you. Otherwise you may ask the coordinator, who will use comments from your evaluation forms.

This begs the question: are you planning on going into ER? If so, then why so little ER time? If not, you may be better off getting your recommendations from a preceptor in your chosen field.


'zilla