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Emergency Medicine at HCMC
One and only one G1, G2 or PA needs
to go in on each stab case. There is no formal assignment. Generally
the
intern or PA who is least busy responds when a stab case is called. It
is helpful to observe one case before you are expected to perform the
G1 functions. Those functions include; establishing an IV (in the case
of trauma, as large as possible – 14 gauge preferred), doing a
rectal exam (in the case of blunt trauma, to look esp. for gross blood
and displacement
of the prostate), and placing a Foley catheter (in blunt trauma, after
urethral injury is ruled out). The pit boss runs the case and he/she
will direct your activities in the stab room. Be familiar with the appropriate
dress, protective attire and necessary equipment before your first case.
Recording in the stab room
- The senior residents rely on your documentation
to dictate and write their chart. This blue paper is not an official
document but be thorough. Vital signs should be recorded every
2-5 min or as often as possible. Document all procedures, meds given,
IV
lines
placed, physical exam findings, and any history available.
- Ask
what is being done if the nurses or residents are not telling you.
They
should be talking to you, but you also need to talk to the people
caring for
the patient. Give the first vital signs out loud and any changes
or trends in the vital signs need to be communicated.
- Labs – when you are
handed the lab sheet tell the senior the results.
- Intubations – the
time from the blade in until the blade out needs to be recorded in seconds.
Once the paralytic is given by the nurses count out the time in 10 second
intervals.
Recording in the Stabilization Room
is a very important function of the HCMC Emergency Medicine student.
This function allows you to observe the most interesting cases during
your shift. It also frees up the Pit boss and RNs and Faculty to deliver
care without having to worry about documentation. All these individuals
will depend on your ability to record the events of the case for their
subsequent documentation.
The following is an exemplary example of a properly recorded stab case
and will be included in your orientation packet:
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For more information contact Richard
O. Gray MD.
Emergency
Medicine main page
Copyright © 2000 HCMC Emergency Medicine. All rights reserved.
Manual last modified: Wednesday May 07, 2003.
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