Emergency Room


Dress: Scrubs

You work 11 shifts, 10 hours each. Must work 2 Fridays and 2 Saturdays.  You pick the days and shift times.  This can be tricky to arrange around call and clinic.  You are still required to attend noon conferences and answer clinic messages.

At the end of the day you may either finish working up the patients you saw or you may check-out the patients that still need to be followed. This is dependent on your personal preference and the ER docs on duty.

Current Docs: Dr. West, McCaig, Weber, Silver, Brooks, Torres & Weirman.

You will be asked to present 4 articles from a packet to Dr. Weber. Try to present them ASAP. It is very difficult to present all 4 in a month.

Try to see patients in order but feel free to select interesting and/or less seen complaints (patients). 

Fill out T-sheets. Check out patients with an ER attending. Present H&P and A/P. Check out labs & studies with attending before ordering.

Fill out triplicate with D/C instructions and Rx's. Ask nurse if he/she wishes to d/c patient or if you can do it.

Give patient education sheets. Nurse will provide them if you don't. They are also available on the computer (Ask the nurses).

You are welcome to participate or observe in acute/trauma presentations.

Psychiatry patients need a psych liasion to evaluate them in addition to your evaluation.

You frequently get to sew up lacerations in the ER.  If you are uncomfortable, always feel free to ask the ER doc for help.  See suture info.

Basic Suture Info

Nonabsorbable sutures: silk, Dacron, polypropylene (Prolene), and nylon.

Area

General type of suture

Removal Time (days)

Face

5-0 and 6-0 nylon or polypropylene

3 to 5

Neck

 

5 to 8

Scalp

3-0 nylon or polypropylene

7 to 9

Upper extremity

4-0 and 5-0 nylon or polypropylene

8 to 14

Trunk

4-0 and 5-0 nylon or polypropylene

10 to 14

Extensor surface of hands

 

14

Lower extremity

4-0 and 5-0 nylon or polypropylene

14 to 28

Absorbable sutures:

Type of Suture

Appoximate Duration in Tissue

Catgut (quick dissolving)

3-5 days

Catgut (chromic)

5-7 days

Polygycolic acid (Dexon/Vicryl)

30-45 days

Pollglecaprone 25 (Monocryl)

45-60 days

Polydioxanone (PDS)

3-6 months