Procedure Requirements

[Dienekes]

Does anyone have a copy- or know where to find one- of the list of the numbers of procedures that an EM resident has to do during their residency (i.e., x thoracostomies, y intubations, etc)?

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[FoughtFyr]

Does anyone have a copy- or know where to find one- of the list of the numbers of procedures that an EM resident has to do during their residency (i.e., x thoracostomies, y intubations, etc)?

From: https://www.acgme.org/acWebsite/RRC_110/110_guidelines.asp#res

GUIDELINES FOR PROCEDURES AND RESUSCITATIONS


Numbers include both patient care and laboratory simulations
Adult medical resuscitation - 45
Adult trauma resuscitation - 35
ED Bedside ultrasound - *
Cardiac pacing - 6
Central venous access - 20
Chest tubes - 10
Procedural sedation - 15
Cricothyrotomy - 3
Disclocation reduction - 10
Intubations - 35
Lumbar Puncture - 15
Pediatric medical resuscitation - 15
Pediatric trauma resuscitation - 10
Pericardiocentesis - 3
Vaginal delivery - 10

* See Procedural Competency Guideline​

There you go.

- H

 

[USCDiver]

Understand also that those are the minimums required by the ACGME/RRC and your own individual program may require more or different procedures.

 

[Dienekes]

Understand also that those are the minimums required by the ACGME/RRC and your own individual program may require more or different procedures.

Thanks guys, I am just working on a project for work and needed the data to back up a point.

 

[laptop]

Does this mean that we will not be able to get qualified for graduation, exam, or license, if we do not reach the minimal numbers for each procedure?

 

[USCDiver]

The residency program certifies that you have completed all requirements for graduation, including procedures. When the RRC does their program review (every 5 years if no probation) the program must give them documentation of procedure numbers for the last several residency classes.

 

[FoughtFyr]

Does this mean that we will not be able to get qualified for graduation, exam, or license, if we do not reach the minimal numbers for each procedure?

No. In theory you could graduate with these numbers of procedures. These are the minimums suggested by the RRC. The residency must show that their residents, in general, will meet these numbers. If an individual resident has an unusual experience, there is "no harm, no foul".

But most of these numbers are low enough that it shouldn't be a problem.

- H

 

[USCDiver]

But most of these numbers are low enough that it should be a problem.

Hehe, it's always a problem, isn't it?

 

[FoughtFyr]

Hehe, it's always a problem, isn't it?

F'ing night shifts. Grumble. Grumble.

- H

 

[southerndoc]

I was under the impression that a program doesn't use absolute numbers to certify competency. The RRC uses them as an average for all residents in the program to determine if they are receiving adequate numbers of procedures.

Nevertheless, the only thing I'm short of is DPL's. I've done absolutely none. All others I have well over the minimums (except crics, which I only have 3 -- gotta start missing a few intubations!).

 

[EM_Rebuilder]

I am still a newbie, and most of these numbers sound more that doable except for Cricothyrotomy - 3


Thats lots of those if you figure 10 residents in a class.... theoretically 30 per year. I do not know the incidence of crics in the ED, but I would assume that is high.

 

[FoughtFyr]

I am still a newbie, and most of these numbers sound more that doable except for Cricothyrotomy - 3


Thats lots of those if you figure 10 residents in a class.... theoretically 30 per year. I do not know the incidence of crics in the ED, but I would assume that is high.

Read the fine print. Lab and sim count.

- H

 

[docB]

I'm in real trouble. I've never done a DPL and I'm very short on culdocenteses and burr holes too. Don't tell ACGME. I'm not sure what they'll do to me but I'm sure it won't be good.

 

[Dienekes]

Don't tell ACGME. I'm not sure what they'll do to me but I'm sure it won't be good.

Just be sure, whatever it is, to get it on tape.....chances are good someone, somewhere will pay good money to see it.

 

[Red Beard]

Just doing a search and dug up this thread....

As a side note, what are some of the most common procedures EM physicians perform? How about uncommon ones but still done once in a while?

 

[dchristismi]

Well, let's see now...

Numbers include both patient care and laboratory simulations
Adult medical resuscitation - 45
Adult trauma resuscitation - 35
ED Bedside ultrasound - *
Cardiac pacing - 6
Central venous access - 20
Chest tubes - 10
Procedural sedation - 15
Cricothyrotomy - 3
Disclocation reduction - 10
Intubations - 35
Lumbar Puncture - 15
Pediatric medical resuscitation - 15
Pediatric trauma resuscitation - 10
Pericardiocentesis - 3
Vaginal delivery - 10

Yep, that covers pretty much all of the big ones. So we do a lot of I&Ds - so many, in fact, I guess it wasn't important enough to make the list. And occasionally you read about the perimortem c-section. But that covers most of it. The numbers required should give you a vague idea of how frequently it's done.

 

[Jeff698]

As a side note, what are some of the most common procedures EM physicians perform?

Completely off the top of my head...

I&D would probably be the most common followed by (in no apparent order):

Central lines (my current fav is the IJ w/ US)
intubation/RSI
Procedural sedation
splinting
laceration repair
bedside ultrasound

I don't think a shift goes by without doing several of these.

Take care,
Jeff