Louisiana state university health science center new orleans emergency medicine residency program policies to supplement lsuhsc house officer manual



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TOXICOLOGY


Dr. ________, you are assigned to Toxicology for the month of _________.
Orientation: There is a mandatory orientation for this rotation. Dr. Tuckler is the director of the toxicology rotation. Contact him one week prior to starting the rotation. Orientation occurs on the first day of each month. Vacation and time off are not allowed during the rotation. There is an exit interview on the last day of the rotation that you must attend. All required materials are due at that time.
Scheduling: The majority of your time on this rotation will be spent performing consults, taking call, attending lectures, and giving lectures. When you meet with Dr. Tuckler, you will be given a list of lectures and persons giving you those lectures. It is your responsibility to contact each lecturer and schedule the date and time of each lecture.
Responsibilities:

  1. Daily rounds on all toxicology patients in the MER, ICUs and wards.

  2. Responding to all ED and in house toxicology consults.

  3. Giving intern and resident lectures.

  4. Giving one conference lecture.

  5. Attendance to the Trauma Conference.

  6. Presenting at M & M conference.

  7. Attending all emergency medicine conferences and journal club.

  8. Availability for Disaster call.

  9. Completing a "toxicology case of the month". Report due at the end of the month.

  10. Completing one toxicology oral board scenario case.

  11. Completing a set of “written board” toxicology questions.

  12. Attending an interactive review session of past toxicology cases.

  13. Goals, objectives and responsibilities will be given to you during orientation.

14. Meeting with Dr. Tuckler for toxicology teaching.
Conferences: You must attend all conferences.
Extras: All consults and required paper work must be turned in to Dr. Tuckler on the last day of the month.
Supervision: Per Dr. Tuckler
Evaluation: Compiled and pooled from all faculty and Dr. Tuckler.
LSU Emergency Medicine Residency Program

MCLANO

Toxicology Rotation
GOALS and OBJECTIVES
What follows are the goals and objectives for the MCLANO Toxicology rotation, that will range from a 2 week to 1 month rotation, as assigned by the Program Director. The rotation will take place at the MCLANO University Hospital. The year of training is assigned in the PGY4 year but may include PGY 1-5.
Toxicology is a core component of the Emergency Medicine curriculum mandated by the Residency Review Committee.

1. ROUNDS and CALL at MCLNO


The most important part of your rotation will be DAILY ROUNDS as a stimulus to further your education in emergency toxicology. You are expected to make rounds with the interns and emergency medicine residents caring for poisoned patients. These rounds should be geared to educate the residents and interns as to the appropriate evaluation, treatment, and disposition of the patient, as well as the pathophysiology of the agent or agents causing the overdose. You should be available to the residents to answer questions that may arise regarding treatment of overdoses and perform consults on those patients admitted. Document these rounds by having the ESU staff sign your daily round sheet. Also, document the date, patient's name, hospital number, type of overdose, and location of all patients seen.
In addition YOU WILL BE ON CALL (24 hour call). A schedule will be provided.

You will be required to round with the toxicology staff when they ask you to round with them. You will consult with the staff when you are called for a consult. You will be required to follow patients admitted to the hospital.


DAILY PROGRESS NOTES need to be written and placed in the patient’s chart.
You will also be made familiar with the HAZMAT disaster protocol and you and the staff will be called to come to the hospital in the event of a citywide HAZMAT incident. NO VACATION TIME SHOULD BE PLANNED DURING YOUR TOXICOLOGY MONTH.
YOU ARE REQUIRED TO ATTEND ALL RESIDENT CONFERENCES. NO EXCUSES!!!
You will be required to LECTURE TO THE INTERNS AND RESIDENTS IN THE ED. The subjects of these lectures will be given to you at the beginning of the month. You should also PREPARE A HANDOUT for the interns covering the lecture material. Please provide copies of the lectures to Dr. Tuckler when you check out at the end of the month. The date, time, and subject of these lectures should be documented on the toxicology rotation checklist provided with this packet. You will be REQUIRED TO HAVE A TOXICOLOGY LECTURE LOG SIGNED by all persons attending your lecture. ONE LOG SHEET PER LECTURE

2. MEETINGS:

Toxicology meetings will be held with members of the faculty who have a interest in toxicology, namely, Drs. Edward Halton, Keith Van Meter, and Victor Tuckler. You will be provided with a Topics Form, which will list the topics and designate which the faculty will discuss each topic with you. It is your responsibility to establish the time and place with each faculty member. Please do not wait till the end of the month to have these lectures. These meetings will provide one-on-one interaction and allow the discussion of varied issues in toxicology.
3. LECTURE:

Each resident is expected to give a hour long lecture to the Emergency Medicine residents. The lecture is to be given on the Last Wednesday of the month at 11:00 a.m. The topic of your lecture will be assigned on the first day of the month so that adequate preparation time is available. HANDOUTS AND SLIDES ARE REQUIRED FOR THIS LECTURE. FIVE BOARD TYPE QUESTIONS REGARDING YOUR LECTURE ARE REQUIRED. Please provide a copy of the handout in a floppy disk to Dr. Tuckler. A copy of the handout will be added to the toxicology file. Please meet with the toxicology staff prior to your presentation to review your presentation and discuss possible changes.


4. QUESTIONS:

One hundred well documented questions of a national board type are required to be handed in at the end of the rotation. These questions will be discussed at the end of the month with Dr. Tuckler during your check out meeting.


5. PATIENT LOG:

YOU WILL NEED TO KEEP A LOG OF ALL PATIENTS SEEN DURING THIS ROTATION. PLEASE LIST THEM ON THE PROVIDED CHECKLIST. Use extra sheet if needed. At the end of the rotation please place all materials to Dr. Tuckler.


6. TOXICOLOGY ORAL BOARD SESSION AND WRITTEN EXAM REVIEW:

You will have one oral board scenario practice session with Dr. Tuckler. Please arrange the date and time with Dr. Tuckler. You will also have a review session with Dr. Tuckler over written exam topics and questions.


7. TOXICOLOGY CASE OF THE MONTH

You will have one toxicology case to solve during the month. The case will be provided to you at the beginning of the month by Dr. Tuckler. Please answer all the questions, provide a diagnosis, and explain why you reached the diagnosis that you did.


8. TOXICOLOGY CASES REVIEW:

You will review toxicology cases with Dr. Tuckler and will be asked to discuss and answer questions regarding toxidromes and pathophysiology.

10. HAZMAT/DISASTER MEDICINE

Please contact Dr. Aiken and Dr. Hardy to help with teaching Hazmat and attending Hazmat drills.


11. MONTHLY EVALUATIONS:

A final evaluation of your performance and completion of all the above requirements are submitted to Dr. Haydel/Avegno to be put in your file. You are required to turn in to Kathy a copy of your lecture, case of the month answers, a copy of the one hundred questions, patient log, sign in sheets, and lectures attended.

For any concerns or questions call Dr. Tuckler at 664-5383.

TRAUMA SURGERY




Emergency Medicine

Trauma Surgery Rotation
Dr. _______________, you are assigned to Trauma Surgery at LSU Interim Hospital for the month of __________________.
You are scheduled for LSU Surgery for the month:
Schedule: Contact the LSU Surgery chief resident 2-3 weeks prior to your rotation to receive your schedule and /or submit a schedule request. All schedule requests should be directed to the Chief Residents.
Responsibilities: Care of University Hospital TICU/Surgery Patients.
Conference: You must attend conference.  Dr. Hunt will facilitate this.  Please notify your team and the rounding faculty in advance of each conference day, so that you may present your patients first and then come to conference.

 

Learning Modules:  The following two module must be completed with a score of  >80% on the open book post-tests within 2 weeks of completing the rotation.  The post-test is located in residency partner.


Blunt Trauma Evaluation                        Trauma Resuscitation

 

Extras: All procedures must be recorded in residency partner. Please see the section of Procedure and Patient Experience Documentation for ACGME procedure targets. You should document every “room 4” as either an adult or pediatric trauma resuscitation.


Supervision: Provided by LSU Surgery faculty and senior level residents.
Evaluations: Compiled by LSU faculty and senior level residents at the completion of the rotation. The resident is responsible for delivering the evaluation forms to the appropriate faculty or chief resident at the completion of the rotation.
Meals: available at University Hospital.

LSU Emergency Medicine Residency Program

MCLANO Surgery Rotation
GOALS and OBJECTIVES
What follows are the goals and objectives for the MCLANO Surgery rotation, that will range from a 2 week to 1 month rotation, as assigned by the Program Director. The rotation will take place at the MCLANO University Hospital. The year of training is assigned in the PGY1 year but may include PGY 1-5.
OBJECTIVES:

Gain expertise in the management of surgical emergencies. Learn the priorities and procedures of trauma resuscitation. Become an integral part of the trauma team and respond to all trauma resuscitations along with junior, senior and staff surgeons. Gain exposure to OR sterile techniques and surgical techniques.


GOALS:

  • Participate in daily teaching rounds

  • Evaluate Surgical patients in the Emergency Department

  • Participate in Surgical Procedures, both in the OR and on the floor

  • Participate in the routine care of Surgical patients

  • Participate in consults to the Surgical Service

  • Follow inpatient surgical patients through discharge, including discharge planning

The clinical and didactic experiences used to meet those objectives included daily patient care of the MCLANO Surgical Service Patients, along with bedside teaching. The rotating resident is encouraged to attend lectures available at MCLANO pertaining to the care of the surgery patient. This rotation experience is part of the greater emergency medicine curriculum, also including weekly didactics (part of the overall didactic curriculum).


The feedback mechanisms and methods used to evaluate the performance of the resident include an end of rotation global evaluation. Immediate feedback may also be given to the resident, and any significant problems will be discussed during the rotation with the LSU EM administration.
The resources and facilities in the institution that will be available to each resident include computer access to Up To Date and the LSU Library services, including current texts in surgery and emergency medicine. The residents will have access to the resources of the hospital including call rooms, the LSU Medical Library, Hospital medical texts, medical records and the cafeteria.
The clinical experiences, duties and responsibilities the resident will have on the rotation: Residents will act as a part of the Surgery team under the supervision of a staff physician. The residents will participate in the initial management of surgery patients, to include pediatric and adult trauma and general surgery patients.
The relationship that will exist between emergency medicine residents and faculty on the service: The overall goals of resident education and patient care will govern the relationship between faculty and residents. Residents will receive 24 hour supervision while on the rotation. All patient care and medical charts will be reviewed and signed by the Surgery faculty daily and prior to patient discharge.
Duty hours for this rotation will not exceed an average of 80hrs/week, call not longer than 24 consecutive hours and will include 1 in 7 days off.
This rotation summary has been reviewed and agreed to by the service director and LSU Program Director.

WEST JEFFERSON ED


Dr.______________________,
You are scheduled for West Jefferson ED from______________to _______________.
Schedule: Contact the director of the ED, Dr. Chugden (chugden@charter.net) 2-3 weeks prior to your rotation to submit a schedule. Send a copy of your schedule to Kathy Whittington. A resident will do 15 shifts a month; 12noon to 12midnight.  No more than one resident per shift.  Don't schedule more that half of your shifts on conference or journal club days.  Please make a schedule to be posted in their ER prior to the start of the month.  
Responsibilities: You will be responsible for the care of individual patients in the ED.
Conference: You must attend conference.
Extras: A patient list must be maintained and turned in with your procedure log at the end of the month.
Supervision: You will be supervised by board certified Emergency Medicine physicians.
Evaluations: Daily evaluations.
Meals: provided in the West Jefferson cafeteria and doctor’s lounge.

West Jefferson Medical Center Emergency Department Rotation

GOALS and OBJECTIVES 2007-08

The following are the goals and objectives for the West Jefferson ED rotation, which will range from a 2 week to 1 month rotation, as assigned by the Program Director. The rotation will take place at the West Jefferson ED. The year of training may include PGY 1-5.

The educational goals and objectives for the West Jefferson ED rotation are to provide residents with an opportunity to experience and learn about the initial evaluation and management of emergency patients in the community setting as well as the following:


  1. Prehospital emergency medical services

  1. Multicasualty incidents and disasters

  1. Legal aspects of emergency care

  1. Emergency procedures

  1. Emergency department consultation

  1. Billing

The clinical and didactic experiences used to meet those objectives included daily patient care in the West Jefferson ED, along with bedside teaching. This rotation experience is part of the greater emergency medicine curriculum, also including PALS/ACLS/ATLS provider and instructor certification and weekly didactics (part of the overall didactic curriculum).

The feedback mechanisms and methods used to evaluate the performance of the resident include an end of rotation global evaluation. Immediate feedback may also be given to the resident, and any significant problems will be discussed during the rotation with the LSU EM administration.

The resources and facilities in the institution that will be available to each resident include computer access to Up To Date and the LSU Library services, including current texts in emergency medicine. The residents will have access to the resources of the hospital including medical texts, medical records, doctor’s lounge and cafeteria.

The clinical experiences, duties and responsibilities the resident will have on the rotation: Residents will act as a part of the Emergency Medicine team in a community hospital under the supervision of a staff physician. The residents will participate in the initial management of emergency department patients, to include trauma, psychiatric, obgyn, pediatric and general medical patients.

The relationship that will exist between emergency medicine residents and faculty on the service:  The overall goals of resident education and patient care will govern the relationship between faculty and residents. Residents will receive 24 hour supervision while on the rotation. All patient care and medical charts will be reviewed and signed by the ED faculty prior to patient discharge.

Duty hours for this rotation will not exceed an average of 60hrs/week, and will include 1 in 7 days off.

This rotation summary has been reviewed and agreed to by the service director and LSU Program Director.

You are scheduled for West Jefferson Pediatric ED for the month:


Schedule: Two weeks prior to starting, contact Dr. Andrew Mayer (andrewmayer@cox.net)  and Kacy Petit in their GME office (kacy.petit@wjmc.org).   You will do 8-hour shifts monday-friday 7a3p, except on wednesdays, when you will attend EM conference 7a11am and then will report to the ED by 12noon and work 12 noon to 8pm.  

 

Responsibilities: You will be responsible for the care of individual patients in the Pediastric ED.


Conference: You must attend conference and Journal Club.
Extras: A patient list must be maintained and turned in with your procedure log at the end of the month.
Supervision: You will be supervised by board certified Emergency Medicine physicians.
Evaluations: Monthly evaluations.
Meals: provided in the West Jefferson cafeteria and doctor’s lounge.

     


   

            Learning Modules:  You must complete the following learning modules and take the post-test within 2 weeks of completing the rotation.  You may complete them as early as you like and the tests are open book.  You must achieve 80% to get credit for completing the modules.  The learning modules can be found under the Home Study link on the LSUEM residency page.  The tests will be available on ResidencyPartner, but you can also email your answers to Kathy Whittington (klwhit@lsuhsc.edu) if you have trouble accessing RP.



 

Modules:   1.   Pediatric Emergencies      2.  The Nightmare Neonate                                       

LSU Emergency Medicine Residency Program

West Jefferson Pediatric Emergency Department Rotation
GOALS and OBJECTIVES
What follows are the goals and objectives for the WJ Pediatric ED rotation, that will range from a 2 week to 1 month rotation, as assigned by the Program Director. The rotation will take place at the  West Jeff Hospital in the Pediatric ED. The year of training will typically include PGY 1 residents only.
The educational objectives of the West Jefferson Pediatric ED rotation are to:
1)      Gain expertise in the recognition and management of pediatric emergencies.
2)      Gain expertise in pediatric resuscitation, including Pediatric Advanced Life Support, emergent intubation, fluid administration, and drug dosages.
3)      Become familiar with the management of non-emergent pediatric conditions which commonly present to the Emergency Department.
4)      Gain expertise in the performance of routine procedures such as venipuncture and arterial puncture.
5)      Become familiar with pediatric medication dosages.
The clinical and didactic experiences used to meet those objectives included daily patient care in the Pediatric ED, along with bedside teaching. The rotating resident is encouraged to attend lectures available at West Jefferson pertaining to the care of the pediatric patient. This rotation experience is part of the greater pediatric emergency medicine curriculum, also including PALS provider and instructor certification and weekly didactics (part of the overall didactic curriculum).
The feedback mechanisms and methods used to evaluate the performance of the resident include an end of rotation global evaluation. Immediate feedback may also be given to the resident, and any significant problems will be discussed during the rotation with the LSU EM administration.
The resources and facilities in the institution that will be available to each resident include computer access to Up To Date and the LSU Library services, including current texts in pediatrics and emergency medicine. There is a rent free, secure apartment available during the rotation for resident use. The residents will have access to the resources of the hospital including medical texts, medical records and cafeteria.
The clinical experiences, duties and responsibilities the resident will have on the rotation: Residents will act as a part of the Emergency Medicine team in a community pediatric hospital under the supervision of a staff physician. The residents will participate in the initial management of emergency department patients, to include pediatric trauma and general medical patients.
The relationship that will exist between emergency medicine residents and faculty on the service: The overall goals of resident education and patient care will govern the relationship between faculty and residents. Residents will receive 24 hour supervision while on the rotation. All patient care and medical charts will be reviewed and signed by the ED faculty prior to patient discharge.
Duty hours for this rotation will not exceed an average of 60hrs/week, and will include 1 in 7 days off.
This rotation summary has been reviewed and agreed to by the service director and LSU Program Director.

ELECTIVE

Dr.__________________________________,


You are scheduled for Elective from ________________to_______________.
Schedule: As required by your rotation. The program director and program coordinator must be informed of your selected elective 2 weeks prior to starting the rotation.
Responsibilities: As required by the rotation. Obtain these from the director of the elective rotation you take.
Conference: You are expected to attend conference.
Extras: All procedures must be recorded and turned in at the end of the month.
Available Electives:

-Radiology -Critical Care -Pathology (autopsy)

-ENT -EMS -Toxicology

-Ophthal -Teaching -International EM

-OMFS -Dermatology

-Hyperbarics -Board Preparation



-Research
*Note, all electives must be approved by the residency program director, 2 weeks prior to start of the elective or you will default to University ED.
Evaluations: Responsibility of resident to identify supervising faculty for rotation and obtain summative evaluation sheet.


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