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Procedures (including IV's, blood draws)
The most important procedure in all of medicine is the IV. You must be
expert at placing an IV, and the only way to be expert is to practice. Doing
the IV on your patients is the best way. It is not scut work! There are few
procedures which are as life saving as establishing IV access. Don’t wait
until you are trying to save a life in the stabilization (stab) room to
practice. The nurses will be glad to help you with your first few IVs and to
give you tips on particularly difficult patients. The ED supervisors will advise
you on and demonstrate other procedures such as laceration repair and I and Ds
(incision and drainage). (* see Wound Care/Lacerations in this packet and ED
Wound Care and Basic Laceration Repair in Additional Reading Materials)
Whatever the procedure remember the associated clean up (especially
"sharps") and documentation.
Example of simple laceration repair note:
2 cm lt. eye brow laceration, cleaned with normal saline, anesthetized with
1% Lido plain/Bicarb, irrigated with NS, draped, explored without FB or bony
involvement, sutured with 5-0 Vicryl subcuticular and 6-0 Nylon simple sutures. There
is a specialized function on EPIC for documenting procedures: use it!
On the inside of student evaluation
cards there is an area to record those procedures you
perform during any given shift. I encourage you to fill these out
and you will receive a record of all your procedures with your written
evaluation. Students should not under any circumstances
perform bedside Ultrasound or pelvic examinations without a faculty member
or senior resident present.
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