How to Crush Your SLOE (Tips 26-30)
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 14 April 2019
⏱️ 15 minutes
🧾️ Download transcript
Summary
Tip #26
Update your attending when the nurse is having difficulty with your patient’s IV or drawing blood.
Tip #27
Get the urine sample from your patient (there is no greater delay in patient flow than waiting on urine)
Tip #28
Round on your patients and repeat your initial scripting.
* “It’s Zack the medical student again”* “Anything I can do to make you more comfortable?”* “Do you have any questions?”* “I’m doing my best to keep things moving fast for you, here’s an update”
Tip #29
Perform one of the 4 most important reexamination protocols.
* The ambulation trial* Best for patients with low oxygen on arrival or geriatric patients with weakness/dizziness/etc* The repeat physical exam* Best for patients with abdominal pain or respiratory complaints* The repeat vital signs* Best for patients with multiple abnormal vitals documented in triage, hypertension, fever, etc* The PO Challenge* Best for patients with nausea and vomiting or pediatric patients
Tip #30
Update your attending the MOMENT everything is back (and choose one of 3 dispositions)
* Admit them* Best when you have confirmed a specific, bad diagnosis* Discharge them * If everything is normal, including your reexamination* Recommend follow up in 1-2 days* Observe them* Best for patients with concerning symptoms, risk factors, or red flags but reassuring testing or no clear diagnosis
Transcript
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| 0:00.0 | Hello, med students. My name is Zach Olson and thank you for downloading this week's |
| 0:06.5 | episode of the EM Clerkship Podcast. It's the final week, at least with our first attempt |
| 0:15.5 | at coming up with a list of specific actionable tips that you can use to impress your |
| 0:20.7 | attendings and your |
| 0:21.5 | residents and get a really good slow. |
| 0:24.2 | Last week was really, really important. |
| 0:27.5 | All this stuff has been important. |
| 0:29.0 | You've spent so much energy up to this point. |
| 0:30.7 | I'm just going to recap the tips so far. |
| 0:34.2 | Introduce yourself to your team. |
| 0:36.8 | Stay humble and confident. Stay focused. Do your learning, |
| 0:41.2 | your core learning before your rotation. And then remember, it's all about teamwork. Find ways that |
| 0:46.5 | you can contribute to your team. Repeat your name over and over to the patient. Explain every little thing to your patient. |
| 0:56.0 | Keep them comfortable. |
| 0:57.5 | Try to keep things moving quickly for them. |
| 1:00.3 | Use the language line. |
| 1:02.9 | Get four descriptors for each complaint. |
| 1:07.2 | Find out why the patient is in the department today and what their biggest concerns are. |
| 1:13.6 | Make sure you hit every single red flag, jot down the name of their doctors, |
| 1:20.6 | and then at least have an organized medical history for when you're attending asks for more detail. |
| 1:25.6 | Maybe put the three biggest things in |
| 1:28.1 | your presentation. Recheck that heart rate and that respiratory rate. Do a thorough exam of |
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