Emergency Medicine

Competencies covered in this module:

• Understand medical history taking and physical examination.
• Recognize immediate life-threatening conditions .
• Know patient management skills.
• Understand health promotion for the patient.

Learning Objectives

• Obtain an accurate, focused history based on the patient’s chief complaint.
• Perform a focused physical examination based on the patient’s chief complaint.

Learning Objectives

• Identify sick patients that need immediate management in the ED.
• Understand the initial management steps in any critically ill patient.

Learning Objectives

• Develop an evaluation and treatment plan.
• Monitor the response to therapeutic interventions.
• Develop appropriate disposition and follow-up plans.

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Learning Objectives:

• Educate patients on safety and provide anticipatory guidance as necessary related to the patient’s chief complaint.
• Educate patients to ensure comprehension of discharge plan.

Competencies covered in this module:

• Learn humanistic qualities
  
• Know presentation skills
  
• Understand medical record documentation
  
• Effectively use information technology
  
• Establish a work ethic
  
• Practice ethical decision-making
  
• Practice professional behavior
  

Learning Objectives:

• Effectively communicate with patients, family members, and other members of the health care team.
• Demonstrate a compassionate and non-judgmental approach when caring for patients.

Learning Objectives:

Learning Objective:

• Be able to provide accurate and organized documentation in the medical record where appropriate.

Learning Objectives:

• Understand how to use medical record retrieval systems.
• Understand how to use information technology educational resources to optimize patient care and to improve your knowledge base.

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Learning Objective:

• Learn the importance of conscientious behavior, honesty, and integrity.

Learning Objectives:

• Understand the basic principles of medical ethics.
• The required activities will help you to understand the competency and achieve the learning objectives.

Learning Objectives:

• Exercise accountability.
• Maintain a professional appearance.
• Be sensitive to cultural issues (age, sex, culture, disability, etc.)
• Work in a collegial manner with other members of the health care team.

Competencies covered in this module:

• Students should develop a differential diagnosis that is prioritized on potential life-threatening conditions and the likelihood of disease. Students should demonstrate a knowledge (or understanding) of basic diagnostic modalities and interpretation of results. Most importantly, students should cultivate an appreciation of risk stratification and pretest probabilities for selected conditions.

Learning objectives

• Identify cardiac arrest on ECG/monitor, describe its initial treatment, and list its most common causes.
  
• Discuss the role of adequate chest compressions. 
• Interpret electrocardiogram findings and the initial management of acute coronary syndrome.
• Describe common symptoms, diagnostic tests, and ED management of abdominal aortic aneurysm.
  
• Describe the presentation, diagnostic tests, and management of acute coronary syndrome.
• Describe the pathophysiology, presentation, and ED management of acute heart failure.
• Describe the presentation, ED management, and diagnostic tests of aortic dissection.
• Describe the presentation, diagnostic procedures, and ED management of DVT/PE.

Learning objectives

• Demonstrate the ability to identify a surgical abdomen.
  
• Discuss/explain the role of analgesia in patient management.
• Recognize hemodynamic instability and identify the probable source of bleeding.
  
• Understand the presentation, diagnostic tests, and ED management of appendicitis.
  
• Describe the presentation, diagnostic procedures, and ED management of common biliary diseases.
• Understand the pathophysiology, presentation, diagnostic tests, and ED management of bowel obstruction.
• Describe the presentation, causes, and ED management of massive GI bleeding.
• Describe the causes, presentation, diagnostic tests, and ED management of mesenteric ischemia.
• Describe the presentation, diagnostic tests, and ED management of a perforated viscus.

Learning objectives

• Describe common toxidromes and commonly available antidotes or treatments.
  
• Understand the pathophysiology of burns.
• Describe the initial assessment, classification, and ED management principles for burns.
• Describe the presentation and potential complications of inhalation injuries.
• Describe the presentation and ED management for envenomations.
• Understand the indications for antivenom.
• Describe the presentation and differences in diagnosis and ED management of classic and exertional heatstroke.
• Understand the difference between hypothermia, frostbite, and trench foot.
• Describe the clinical and ECG findings associated with hypothermia, and its ED management.
• Describe the presentation and ED management of a drowning incident.
• Understand investigations that may be used in drowning incidents.

Learning objectives

• Recognize the breadth of the differential for altered mental status.
  
• List emergent causes for altered mental status.
• Describe the initial assessment and management options for an agitated patient.
  
• Describe the risk factors, psychiatric evaluation, and ED management of patients with suicidal ideation.

Learning Objectives:

• Recognize emergent causes and identify diagnostic modalities and management.

Learning objectives

• Describe life-threatening causes, clinical manifestations, and the role of arterial blood gas in respiratory distress.
  
• Understand the presentation, diagnostic tests, and ED management for an acute asthma exacerbation.
• Describe the presentation and ED management of a COPD exacerbation.
• Understand the use of non-invasive positive pressure ventilation and intubation in severe COPD exacerbation.
• Describe the presentation, microbiology, diagnostic tests, and ED management of pneumonia.
• Describe the presentation, imaging tests, and ED management of pneumothorax.

Learning objectives

• Describe the causes(classifications) and clinical manifestations of shock.
  
• Describe the initial evaluation of a trauma patient (primary and secondary survey).
• Promote injury control and prevention.
• Describe the screening for intimate partner violence.
• Describe the spectrum of sepsis syndromes and the use of Early Goal Directed Therapy in treating sepsis.
  

Learning objectives

• Describe the classic presentation, ED investigations, and ED management of diabetic ketoacidosis and hyperosmolar hyperglycemic state.
• Describe the presentation, ECG changes, and ED management of hyperkalemia.
• Describe the presentation and ED management of hypoglycemia.
• Understand the pathophysiology, presentation, diagnostic tests, and ED management of thyroid storm.

Learning objectives

• Describe the risk factors, diagnostic tests, and management options for ectopic pregnancy.
• Describe the risk factors, presentation, complications, diagnostic tests, and ED management of pelvic inflammatory disease/tubo-ovarian abscess.
• Describe the presentation, diagnostic tests, and ED management of ovarian torsion.
• Describe the presentation and initial ED management of testicular torsion.

Learning objectives

• Describe the clinical presentation, initial ED investigations, and ED management of acute ischemic stroke.
  
• Describe the indications and contraindications for the use of thrombolytic therapy.
• Describe the presentation and diagnostic tests for intracranial hemorrhage.
• Understand the differences between types of intracranial hemorrhage and the interpretation of lumbar puncture in its diagnosis.
• Describe the presentation, diagnostic tests, and ED management of meningitis and encephalitis.
• Describe the work-up and management of first time and recurrent seizures.
• Understand the definition and ED management of status epilepticus.

Competencies covered in this module:

• Perform the procedures listed in the Data supplement S2 of the Emergency Medicine Clerkship Curriculum. In addition to proper technique, the focus should be given to recognizing the indications, contraindications, and complications associated with each. The student should be able to discuss aftercare and reasons to return for further evaluation with the patient.

Learning objectives

• Demonstrate placement of an intravenous line.
  
• Demonstrate basic phlebotomy technique.
• List the indications for an intraosseous line.
• Describe intraosseous insertion technique.
• List the indications and complications of a central line.
• List the steps for the Seldinger technique.
• Describe relative advantages and disadvantages of different kinds of lines.

Learning objectives

• List the indications for emergency airway management.
  
• Demonstrate effective ventilation.
• List the factors that can make BVM difficult or impossible.
• Describe the roles and indications for various airway adjuncts.
• Demonstrate correct placement of a nasal and oral pharyngeal airway.
• List the indications for endotracheal intubation.
• List the steps in orotracheal intubation.
• Describe possible complications of intubation.
• Describe situations when rescue techniques may be used in a failed airway.

Learning objectives

• Correctly place the patient on a cardiac monitor.
• Demonstrate the ability to apply leads and obtain a 12-lead electrocardiogram.
• Demonstrate appropriate use of an AED.
• Recognize ventricular fibrillation and pulseless ventricular tachycardia.
• Demonstrate appropriate use of a defibrillator.
• Demonstrate effective chest compressions.

Learning Objectives:

• List the indications for placement of a nasogastric tube.
• Describe the proper technique for insertion of a nasogastric tube.
• Describe complications of nasogastric tube placement.

Learning Objectives:

• Demonstrate the correct placement of a Foley (male and female) catheter.

Learning objectives

• List the indications for emergency joint reduction.
  
• Describe the initial assessment of a suspected dislocated joint.
• List several types of extremity splints and their indications.
• Demonstrate the correct application of a splint.
• Describe complications associated with splints.

Learning Objectives:

• List the indications for an incision and drainage.
• Discuss the technique for an incision and drainage.
• List the indications for antibiotic therapy for an abscess/cellulitis.
• Describe complications of incision and drainage.

Learning objectives

• List the steps of primary survey in trauma.
• Demonstrate maintenance of C-spine stabilization.
• List the components of a FAST ultrasound examination.
• Recognize an abnormal FAST ultrasound examination.

Learning objectives

• List the factors that go into the decision to close a wound primarily.
  
• Describe the difference between a clean and dirty wound.
• Explain local and regional (digital) anesthetic techniques.
• Describe the maximum doses of lidocaine.
• Demonstrate the application of local anesthesia.
• Describe the role or sterility in wound irrigation and repair.
• Explain proper irrigation technique.
• Describe how to detect a retained foreign body.
• Describe different closure techniques (Steri-strips, Dermabond, suturing).
• List the various suture materials and their appropriate uses.
• Demonstrate proper closure of a wound (simple interrupted technique).
• Describe the number of days for suture removal.
• List the indications for tetanus prophylaxis.

Competencies covered in this module:

• Recognize when patients should be appropriately referred to the emergency department.
• Recognize the role of the emergency department in the community, including access to care and its impact on patient care
• Understand the indications, costs, risks, and evidence behind commonly performed emergency department diagnostic procedures
• Recognize the importance of arranging appropriate follow-up plans for patients being discharged from the emergency department

Learning Objectives:

• Recognize the importance of appropriate referrals to the Emergency Department.

Learning Objectives:

• Be aware of the resources available in your community.

Learning Objectives:

• Develop a basic understanding of the cost of diagnostic tests in the emergency department.

Learning Objectives:

• Develop appropriate disposition and follow-up plans.
• Educate patients on safety and provide anticipatory guidance as necessary related to the patient’s chief complaint.
• Educate patients to ensure comprehension of discharge plan.

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