Procedure Log

[The White Coat Investor]

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I'm being blinded by the light at the end of the tunnel (only 30 shifts left) and was looking at my procedure log today. I'm curious as to how it compares to graduating senior residents in other 3 year programs. Looks like I'm a bit short on perimorten C-sections, thoracotomies, and surprisingly enough, cardiac pacing. Anyone else want to chime in?

Procedure Name Total Logged Required

*Bedside ultrasound (Emergency Medicine) 619 40
*Cardiac pacing (Emergency Medicine) 2 6
*cardioversion (Emergency Medicine) 12 10
*central venous access (Emergency Medicine) 58 20
*Chest tube (Emergency Medicine) 17 10
*Conscious sedation (Emergency Medicine) 32 15
*crico-surg (Emergency Medicine) 8 3
*Dislocation reduction (Emergency Medicine) 25 10
*Intubation (Emergency Medicine) 100 35
*laceration repair (Emergency Medicine) 261 50
*lumbar puncture (Emergency Medicine) 64 15
*medical resuscitation, adult (Emergency Medicine) 105 45
*medical resuscitation, pediatric (Emergency Medicine) 28 15
*peritoneal lavage (Emergency Medicine) 1 3
*splint (Emergency Medicine) 36 20
*trauma resuscitation, adult (Emergency Medicine) 277 35
*trauma resuscitation, pedi (Emergency Medicine) 50 10
*vaginal delivery (Emergency Medicine) 15 10
abscess ID (Emergency Medicine) 39 1
anoscopy (Emergency Medicine) 1 1
Anthrocentesis, knee (Emergency Medicine) 4 1
art line (Emergency Medicine) 48 1
Arthrocentesis (Emergency Medicine) 1 1
Cro Fab Administration (Emergency Medicine) 1 1
Dental block (Emergency Medicine) 14 1
Digital block (Emergency Medicine) 24 1
Drainage ear hematoma (Emergency Medicine) 2 1
FAST (Emergency Medicine) 1 1
fiberoptic (Emergency Medicine) 5 1
foreign body removal, skin (Emergency Medicine) 4 1
G-tube replacement (Emergency Medicine) 1 1
Intraoss line (Emergency Medicine) 2 1
Laryngeal mask airway (Emergency Medicine) 6 1
Light wand (Emergency Medicine) 1 1
nail removal (Emergency Medicine) 2 1
nasal pack (Emergency Medicine) 5 1
paracentesis (Emergency Medicine) 1 1
peritonsillar abscess aspiration (Emergency Medicine) 5 1
Regional block (Emergency Medicine) 4 1
Spinal anesthesia (Emergency Medicine) 2 1
sugungal hematoma drainage (Emergency Medicine) 1 1
swan-ganz cath placement (Emergency Medicine) 6 1
thoracentesis (Emergency Medicine) 1 1
thoracostomy, needle (Emergency Medicine) 1 1
thoracotomy (Emergency Medicine) 1 1
Toe nail removal (Emergency Medicine) 7 1
Total Logged: 1904

 

[bulgethetwine]

I'm being blinded by the light at the end of the tunnel (only 30 shifts left) and was looking at my procedure log today. I'm curious as to how it compares to graduating senior residents in other 3 year programs. Looks like I'm a bit short on perimorten C-sections, thoracotomies, and surprisingly enough, cardiac pacing. Anyone else want to chime in?

Procedure Name Total Logged Required

*Bedside ultrasound (Emergency Medicine) 619 40
*Cardiac pacing (Emergency Medicine) 2 6
*cardioversion (Emergency Medicine) 12 10
*central venous access (Emergency Medicine) 58 20
*Chest tube (Emergency Medicine) 17 10
*Conscious sedation (Emergency Medicine) 32 15
*crico-surg (Emergency Medicine) 8 3
*Dislocation reduction (Emergency Medicine) 25 10
*Intubation (Emergency Medicine) 100 35
*laceration repair (Emergency Medicine) 261 50
*lumbar puncture (Emergency Medicine) 64 15
*medical resuscitation, adult (Emergency Medicine) 105 45
*medical resuscitation, pediatric (Emergency Medicine) 28 15
*peritoneal lavage (Emergency Medicine) 1 3
*splint (Emergency Medicine) 36 20
*trauma resuscitation, adult (Emergency Medicine) 277 35
*trauma resuscitation, pedi (Emergency Medicine) 50 10
*vaginal delivery (Emergency Medicine) 15 10
abscess ID (Emergency Medicine) 39 1
anoscopy (Emergency Medicine) 1 1
Anthrocentesis, knee (Emergency Medicine) 4 1
art line (Emergency Medicine) 48 1
Arthrocentesis (Emergency Medicine) 1 1
Cro Fab Administration (Emergency Medicine) 1 1
Dental block (Emergency Medicine) 14 1
Digital block (Emergency Medicine) 24 1
Drainage ear hematoma (Emergency Medicine) 2 1
FAST (Emergency Medicine) 1 1
fiberoptic (Emergency Medicine) 5 1
foreign body removal, skin (Emergency Medicine) 4 1
G-tube replacement (Emergency Medicine) 1 1
Intraoss line (Emergency Medicine) 2 1
Laryngeal mask airway (Emergency Medicine) 6 1
Light wand (Emergency Medicine) 1 1
nail removal (Emergency Medicine) 2 1
nasal pack (Emergency Medicine) 5 1
paracentesis (Emergency Medicine) 1 1
peritonsillar abscess aspiration (Emergency Medicine) 5 1
Regional block (Emergency Medicine) 4 1
Spinal anesthesia (Emergency Medicine) 2 1
sugungal hematoma drainage (Emergency Medicine) 1 1
swan-ganz cath placement (Emergency Medicine) 6 1
thoracentesis (Emergency Medicine) 1 1
thoracostomy, needle (Emergency Medicine) 1 1
thoracotomy (Emergency Medicine) 1 1
Toe nail removal (Emergency Medicine) 7 1
Total Logged: 1904

That's an impressive list!

Well done!

 

[basementbeastie]

nice work fulfilling the anoscopy req....

 

[anonymousEM]

you have inspired me to finally get out that gallon sized ziplock full of stickers and get going...it sure feels like I've done way more than 58 central lines, but maybe not that I can prove...we do so many procedures I've gotten pretty lax at keeping stickers since I still have so many to put in.

 

[Apollyon]

nice work fulfilling the anoscopy req....

I've stuck the ass bullet (the anoscope) at least 10 times, and I have pacing a bunch of times, but, otherwise, my procedure totals are anemic. The one place I've screwed myself is not documenting my ultrasounds. I'm short on them.

 

[WilcoWorld]

Procedures that should be added to RRC requirements:

Getting an HMO patient admited to a hospitalist for social reasons.

The 300+ lb pelvic exam.

Talking to the a$$hole consultant without blowing your top.

The 300+ lb hernia exam.

Convincing the 1st time parents that their playful child with a 100.1F temp does not have meningitis.

etc...

 

[Dr.Evil1]

Procedures that should be added to RRC requirements:

Getting an HMO patient admited to a hospitalist for social reasons.

The 300+ lb pelvic exam.

Talking to the a$$hole consultant without blowing your top.

The 300+ lb hernia exam.

Convincing the 1st time parents that their playful child with a 100.1F temp does not have meningitis.

etc...

Working in Detroit I don't think that I have ever done a pelvic exam on someone LESS than 300 lbs.

 

[turtle md]

Working in Detroit I don't think that I have ever done a pelvic exam on someone LESS than 300 lbs.

There not all that hard. In fact, it's kinda like surfing ... you just grap the speculum, slap the thigh, and ride the wave in. 😀

 

[Jeff698]

There not all that hard. In fact, it's kinda like surfing ... you just grap the speculum, slap the thigh, and ride the wave in.

Oh, I SO didn't need to read that. I still can't get the nasty smell outta my head from the last pelvic I had to do with panus retraction.

Speaking of smells that just won't go away, I was doing a procedural sedation for one of our othropods the other night. Push, push goes the propofol. Sniff, sniff, I go. Hmmmm, been in the cadavar lab, have you?

Take care,
Jeff

 

[The White Coat Investor]

Last time I checked 300lb pelvics were a team sport; I hold the speculum, two nurses hold pannus, and a medic on each side holds the leg flab out of the way. Even so, those little plastic lighted speculums we have don't have a chance of giving me a decent view of the vault. What I can't figure out is how the boyfriends of these ladies are getting in there. I've heard the broomstick method may have something to do with it (hold up the pannus with a broomstick, and work underneath.)

 

[WilcoWorld]

Whoops, I did not mean to turn this into another pelvic exam thread. Please believe me. I was just pointing out that there are a lot of skill sets less glamorous than, say, transvenous pacing, but that those are still necessary.

 

[DropkickMurphy]

Whoops, I did not mean to turn this into another pelvic exam thread. Please believe me. I was just pointing out that there are a lot of skill sets less glamorous than, say, transvenous pacing, but that those are still necessary.

I don't think TVP is very glamorous.....especially seeing as I had to talk my doc (FP doc) through doing one while on a critical care transport for the Air Force. Now thoracotomies and perimortem C-section....those are sweet 🙄

 

[EMIMG]

One of the "tricks" which I have used in the past is to cut the finger off of a glove and then cut the tip of the "finger" off. Put the speculum in this so that it forms a type of sleeve. This may make the speculum a little harder to open up; however, it can assist with keeping the "redundant tissue" from coming into the field of view of the speculum.