Weekly Update – 7 June 2021 – NewYork-Presbyterian Emergency Medicine

June 14, 2021

Reminder for Seniors about Morning Report

Please remember to check the morning report schedule and e-mail your assigned mentor 2-3 days before hand with what you are planning on discussing. Please also ask if they will be joining in-person or via Zoom.

If you are running late, please try to e-mail/text your mentor, especially if the attending is joining via Zoom.

BLS and ACLS courses available for residents

NYP EMS has availability for AHA training (BLS & ACLS) for house staff. For each date listed below you can sign up for either the Cornell campus or Columbia campus they are not offered simultaneously (The trainer will go to the site you pick). The training room at Columbia can host 20 participants. The training room at Cornell can host 25 participants. If you have house staff that need to take AHA training, please reach out to Pricilla Adams at pra9012@nyp.org or 212-746-7877.

June 6
June 19
June 26
July 10
July 17
July 24
July 31

Documentation Update from Cornell, forwarded from Dr. Curato:

Every pateint with your name on it needs a progress note.
1. Every chart must contain closure:
For Admitted Patients: Open a “handoff” note which contains the ED-PASS document.
For Discharged Patients: Open a progress note and use the “.RESDISPO” smartphrase, which is now live. (The only possible exception would be in area D if the patient is immediately discharged and the disposition is clear in the provider note, such as a suture removal).

2. Every patient who is signed-out must have progress notes containing the smartphrase “.RESHANDOFF1” from the offgoing resident and “.RESHANDOFF2” from the oncoming resident.
Seniors: Please remind off-service residents, especially on their first day, about documentation expectations.

Campus Announcements

From Dr. Betty Chang: Trauma Activation Guidelines and Roles at Columbia.

Notice the similarities between criteria for a Columbia Trauma Code and a Cornell Level I Trauma; Columbia Trauma Alert Criteria are similar to Cornell Level II Trauma Activations. Both Trauma Codes and Alerts go to the DART room but surgery is only activated for Trauma Codes. Please see the attachments for details on resident roles and responsibilites AND for case examples.

Trauma Activation Guidelines -Milstein Final. May 2021

Milstein Trauma

From Dr. Lauren Titone: Third Year Medical Students in the ED

Below are some class specific reminders that are relevant to the MCY (third year) clerkship students we have. This is particularly important for the rising PGY-3s who these students will be shadowing many times throughout the year.

These are “third year” Columbia Medical students that rotate with us for two weeks, they are not Sub-Is. Many of these students have never rotated or shadowed in the ED (or ANY clinical area) before.
PGY4s: These students may be presenting to you, as any junior resident would, in Area Green. At the end of every shift, the student will hand you a feedback card with a QR code. Scan the QR code with your smartphone and it will take you to a 4 question Qualtrics survey. Please, please, please fill these out in real time. Then sign the card and hand back to the student. Please also provide as much verbal and direct feedback as possible throughout their shift.
PGY3s: The students will be shadowing you during some of your shifts from 3p-8p (if you are singing out at 4p please also have them shadow your relief form 4p-8p, do not dismiss them early). They will not be seeing these patients primarily on this shift so should not be writing notes. Please encourage and involve them in the resuscitation process for patients that you see and try to share your thought process with them. This will be the most exciting part for them! At the end of their shift, the student will hand you a feedback card with a QR code. Scan the QR code with your smartphone and it will take you to a 2 question Qualtrics survey mostly asking if they were on time and professional. Please, please, please fill these out in real time. Then sign the card and hand back to the student.

PGY1s/PGY2s: The students should not be presenting to you directly on any patients. However, please feel free to involve them in any case, imaging study, procedure, etc. that you think may be interesting. Remember, a lot of these students have never been in the clinical arena, so everything is new and exciting for them!

The students are expected to work directly with the attending (or PGY4 if working in Area Green) and see patients independently (about 2-3 per shift). This is not a shadowing experience (except for the PGY-3 shift). Please do not have them move to a different clinical area. There may be two students on shift at a given time but never two students per attending. If any issues arise regarding staffing of the MCY students, please reach out to us directly.

We wanted to thank each and every one of you for the incredible work that you do for our medical students. They look to you for guidance both medically and career wise so please share your experiences and knowledge with them as much as possible. Here is a link to a great resource that your colleagues have put together with class specific tips for teaching medical students. These students will see and listen to everything you do and say, so please show them how great it is to be an EM physician!

From Dr. Marc Probst: New NIH-funded Syncope study – PACES.

Dear EM Residents,

We are very excited for the upcoming launch of a new ED clinical research study called PACES.

Here is a brief summary of the study:

Study Design: Prospective, observational study.
Inclusion Criteria: ED patient with syncope OR pre-syncope. Adults aged 40 and over.
Exclusion Criteria: AMS, unstable, lacking capacity, NEW serious ED diagnosis (e.g MI, PE, GI bleed.)

The research coordinators will first approach you to check whether the patient is stable, has capacity, and truly had syncope/presyncope. If yes, they will do all the screening and consent. Then they will ask you a couple of clinical questions (e.g. vasovagal vs cardiac syncope vs unclear). Later they will ask you to interpret the EKG and about any serious ED diagnoses (e.g. MI, PE, GI bleed).

Please do NOT hesitate to contact me if you have any questions or comments:

My contact information:

Cell: 310-666-3834 (Any day, any time.)

Email: mprobst@gmail.com.

Thank you in advance!!

-Marc

From Dr. Garg: New ED/IM/Endoscopy workflow

GI confirms that an ED patient needs to go to the endoscopy suite
ED Team clearly states in their Transfer of Care note “Working ED Diagnosis / Reason for Admission” that the patient is being admitted for food impaction/endoscopy
ED places Bed Request to Medicine
PPOC prioritizes these endoscopy patients for a Medicine team
PPOC initiates the admission secure chat with Internal Medicine + ED + GI consult “WC GI Consult”
–>> Allows for all parties to discuss case details & anticipated discharge timeline

From Dr. Shah: Mattu EKG Competition

Amal Mattu is sharing his 9th Annual ECG Competition to all programs that would like to test their ability to interpret ECGs. Answers will be posted on www.ECGWeekly.com and will be FREE open access.

To get a copy of this years questions please download them from https://spaces.hightail.com/receive/wRJKi5sQoJ

From Dr. Shah: EMRA Awards / Grants

Please consider applying for an EMRA award/grant. Deadline is July 15.

https://www.emra.org/be-involved/awards/