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First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
First Aid for the Wards Presentation with Dr. Tao Le
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First Aid for the Wards Presentation with Dr. Tao Le

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  • You – 3 rd year student
  • Team dependent Holding the leg/ Overnight call Short call Institution/team/dependent
  • Team dependent Holding the leg/ Overnight call Short call Institution/team/dependent
  • ADCVAANDIMSL Handwrite Type Intern Med student
  • ADCVAANDIMSL Handwrite Type Intern Med student
  • ADCVAANDIMSL Handwrite Type Intern Med student
  • ADCVAANDIMSL Handwrite Type Intern Med student
  • BE on time
  • Transcript

    • 1. Tao T. Le, MD, MHS Assistant Clinical Professor Chief, Section of Allergy & Immunology University of Louisville Senior Editor First Aid Board Series USMLERx Test Bank Series First Aid for the Wards: The Really Short Version
    • 2. Overview <ul><li>Common Ward Mistakes </li></ul><ul><li>The Team </li></ul><ul><li>A Day on the Wards </li></ul><ul><li>The Admission </li></ul><ul><li>Key Tasks </li></ul><ul><li>Survival Tips </li></ul><ul><li>Getting Off to a Fast Start </li></ul><ul><li>Q&A </li></ul>
    • 3. NRMP: Charting Outcomes in the Match
    • 4. Common Mistakes <ul><li>Not understanding roles, responsibilities, expectations </li></ul><ul><li>Not seeking timely feedback </li></ul><ul><li>Not using appropriate texts and references </li></ul><ul><li>Not knowing how to be a team player </li></ul><ul><li>Inefficient organization and execution of daily work </li></ul>
    • 5. The Team <ul><li>Attending/Chief </li></ul><ul><li>Resident </li></ul><ul><li>Intern </li></ul><ul><li>Sub-intern </li></ul><ul><li>Nurse </li></ul><ul><li>Ward clerk </li></ul><ul><li>Pharmacist </li></ul><ul><li>Other staff </li></ul><ul><li>You </li></ul>
    • 6. Typical Inpatient Medicine Day <ul><li>Prerounds: 7-8 am </li></ul><ul><li>Work rounds: 8-9:30 am </li></ul><ul><li>Work time: 9:30-11 am </li></ul><ul><li>Attending rounds: 11-noon </li></ul><ul><li>Conference: noon-1 </li></ul><ul><li>Afternoon work: 1-? </li></ul><ul><li>Signing out </li></ul>
    • 7. Typical Inpatient Surgery Day <ul><li>Prerounds: 5-6 am </li></ul><ul><li>Work rounds: 6-7:30 am </li></ul><ul><li>Preop prep: 7:30-8 am </li></ul><ul><li>Surgery/floor work: 8-5 </li></ul><ul><li>Conference: noon-1 </li></ul><ul><li>“ Afternoon” rounds: 4-5:30 </li></ul><ul><li>Postrounds work: 5:30+? </li></ul>
    • 8. Taking Call <ul><li>Overnight call </li></ul><ul><li>Short call </li></ul><ul><li>Typically Q4 </li></ul>
    • 9. The Admission <ul><li>The “Call” </li></ul><ul><li>Reviewing objective data </li></ul><ul><li>Medical record review </li></ul><ul><li>Interviewing the patient </li></ul><ul><li>Physical exam </li></ul><ul><li>Putting it all together </li></ul><ul><li>Reviewing case with the resident/intern </li></ul>
    • 10. Key Notes and Orders <ul><li>Admit orders </li></ul><ul><ul><li>A dmit to </li></ul></ul><ul><ul><li>D iagnosis </li></ul></ul><ul><ul><li>C ondition </li></ul></ul><ul><ul><li>V itals </li></ul></ul><ul><ul><li>A llergies </li></ul></ul><ul><ul><li>A ctivity </li></ul></ul><ul><ul><li>N ursing orders </li></ul></ul><ul><ul><li>D iet </li></ul></ul><ul><ul><li>I V fluids </li></ul></ul><ul><ul><li>M edications </li></ul></ul><ul><ul><li>S pecial studies </li></ul></ul><ul><ul><li>L abs </li></ul></ul>
    • 11. Key Notes and Orders <ul><li>Admission notes </li></ul><ul><ul><li>O nset </li></ul></ul><ul><ul><li>P rogression </li></ul></ul><ul><ul><li>P rovocation </li></ul></ul><ul><ul><li>P alliation </li></ul></ul><ul><ul><li>Q uality </li></ul></ul><ul><ul><li>R egion </li></ul></ul><ul><ul><li>R adiation </li></ul></ul><ul><ul><li>S ymptoms </li></ul></ul><ul><ul><li>S everity </li></ul></ul><ul><ul><li>T ime course </li></ul></ul>
    • 12. Key Notes and Orders <ul><li>Progress notes </li></ul><ul><li>Procedure notes </li></ul><ul><li>Daily orders </li></ul><ul><li>Prescriptions/DC orders </li></ul>
    • 13. Documentation Tips <ul><li>Get everything co-signed </li></ul><ul><li>Date/sign all pages </li></ul><ul><li>No documentation = no reimbursement </li></ul><ul><li>Illegibility = no documentation </li></ul><ul><li>Use only appr. abbrev. </li></ul><ul><ul><li>“ q.d.&quot; vs. “q.i.d” vs. “once daily” </li></ul></ul><ul><ul><li>To CYA, never CYOA! </li></ul></ul>
    • 14. Oral Presentations <ul><li>Formal presentations </li></ul><ul><ul><li>5-7 minutes (surgery: 2-3 min.) </li></ul></ul><ul><ul><li>Should tell a story </li></ul></ul><ul><ul><li>CC/HPI/PE/Labs  sets the stage </li></ul></ul><ul><ul><li>A&P  delivers the climax </li></ul></ul><ul><li>Bullet presentations </li></ul><ul><ul><li>1 minute </li></ul></ul><ul><ul><li>15-20 facts </li></ul></ul>
    • 15. Daily Ward Activities <ul><li>Procedures </li></ul><ul><li>Patient/family communications </li></ul><ul><li>Consults </li></ul><ul><li>Data collection </li></ul><ul><li>Reading up on patients </li></ul><ul><li>“ Walking supply cart” </li></ul>
    • 16. Survival Tips
    • 17. Efficient Time and Patient Management <ul><li>Commit all tasks to a to-do list </li></ul><ul><li>Prioritize tasks </li></ul><ul><li>Organize tasks by location </li></ul><ul><li>Maximize hospital information system </li></ul><ul><li>Keep “scut” essentials on board </li></ul><ul><li>Always be early!! </li></ul>
    • 18. Organizational Aids (“Peripheral Brains”) <ul><li>Clipboard </li></ul><ul><li>Binders </li></ul><ul><li>Data sheets </li></ul><ul><li>Note cards </li></ul><ul><li>iPhone/iPad/Android </li></ul>
    • 19. Evaluations <ul><li>Critical for dean’s letter </li></ul><ul><li>Know the evaluation criteria </li></ul><ul><ul><li>Clinical performance </li></ul></ul><ul><ul><li>Shelf exam? </li></ul></ul><ul><li>Know who is evaluating you </li></ul><ul><li>Clarify expectations </li></ul><ul><li>Ask for feedback early on </li></ul>
    • 20. Difficult Situations <ul><li>Needlesticks </li></ul><ul><li>Abusive/inappropriate house officers </li></ul><ul><li>Inappropriate procedures </li></ul><ul><li>“ Gunner” classmates </li></ul><ul><li>Patient death </li></ul><ul><li>Sexual harassment </li></ul>
    • 21. Difficult Situations (cont.) <ul><li>Difficult/violent patients </li></ul><ul><li>Difficult family members </li></ul><ul><li>“ Narcolepsy” </li></ul><ul><li>Personal/family illness </li></ul>
    • 22. Getting Off to a Fast Start
    • 23. Scheduling Rotations <ul><li>Avoid most likely specialty in first/last block </li></ul><ul><li>Avoid back-to-back tough rotations </li></ul><ul><li>Do easy rotation before desired specialty rotations </li></ul>
    • 24. Choosing Rotation Sites <ul><li>County </li></ul><ul><li>VA </li></ul><ul><li>Academic/university center </li></ul><ul><li>Community/private hospital </li></ul><ul><li>Outpatient clinic </li></ul>
    • 25. Before the Rotation <ul><li>Classmates </li></ul><ul><li>FA Wards specialty chapter </li></ul><ul><li>FA USMLE Step 2CK </li></ul><ul><li>FA Step 1 relevant content </li></ul><ul><li>FA Wards recommended pocketbooks/texts/software </li></ul>
    • 26. Your “Secret Weapons” <ul><li>Enthusiasm/hustle </li></ul><ul><li>Time </li></ul><ul><li>Basic science knowledge </li></ul><ul><li>“ Low” expectations </li></ul>

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