HPI

Lectures

Procedures

Stab room Recording

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.

• 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: