ED/UCC Taster session for FY2 Trainees

Monday 09.00-11.00 11.00-13.00 13.30-17.00 Induction ED Majors ED Resus Tuesday 09.00-13.00 13.30-17.00 RUCC, Physio clinic RUCC Wednesday 09.00-13.00 13.30-17.00 ED Resus ED Majors

Thursday 09.00-10.00 10.00-13.00 13.30-17.00 Teaching RUCC RUCC

Friday 09.00-13.00 13.30-17.00 ED Majors ED Resus 13.00-13.30 – Lunch

Supervisor – Mr S Bhattacharyya, Consultant in Emergency Medicine

Other ED Consultants - Mr E A Bayton

Mr M Tan

Mr K S Haq

Dr C Thomson

Mrs G Robertson

Dr H Turner

Dr G Adaka

OBJECTIVES TO ACHIEVE

1. In ED

1.1. ED Majors –

1.1.1 – To gain an understanding of Triage

1.1.2 - To assess patients presenting acute illness in all systems using -

 The ABCDE approach

 A structured, focussed History

 Systemic (if non trauma)/systematic (if trauma) Examination using the correct methods

 Attempt clinical decision making

 Develop management plan

1 ED/UCC Taster session for FY2 Trainees

 Administer essential treatment including drugs

1.2. In the ED Resuscitation –

1.2.1 – To consolidate ABCDE assessment system

1.2.2 – To assess and manage under supervision –

 Cardiac arrest in adults and children

 Major trauma

 Severe sepsis

 COPD exacerbation with respiratory failure needing BIPAP

 Shocked patient

 Severe Head Injury

 Peri arrest Arrhythmia

2. In RBH UCC –

2.1 – To assess minor injuries and illness using the Look, Feel, Move technique

2.2 – To decide the need for X-ray request in injury

2.3 – To interpret X-ray under supervision

2.4 – To devise a management plan

2.5 – To see patients with the following emergencies –

 Eye

 ENT

 Maxillo-facial

3. Generic skills – To consolidate the following -

 Communication

 Consent

 Documentation

 Referral to specialty(orthopaedics, paediatrics) and handover using SBAR

2 ED/UCC Taster session for FY2 Trainees

 Referral to agencies ie – OT, Physio, Alcohol team, Age UK, RAT, Neurosurgeons at RPH

4. Procedural skills – To perform under supervision (US) & independently (IP) and to get SLE’s done in –

 IV access - IP

 Venepuncture - IP

 Blood culture - IP

 Blood tests incl. interpretation and action if abnormal - IP

 ABG incl. interpretation and action if abnormal - IP

 ECG interpretation - US

 Fascia Iliac Compartment Block (FICB) for # NOF patient – US

 Femoral nerve block for femoral shaft # patients – US

 Digital nerve block – US

 Chest drain – US

 CPR – IP

 Defibrillation – US

 Wound assessment, management including closure techniques - US

 Log roll a patient with spinal injury - US

 C-spine immobilisation – US

 Airway management using basic manoeuvres & adjuncts

 MUA of simple colles # in the elderly, Dislocation of Shoulder & Elbow, #-dislocation of ankle

5. To try and obtain exposure to and manage the following –

 Patients with Chest pain with diagnosis of – STEMI, NSTEMI, Unstable angina,

 Patients with Breathlessness with diagnosis of - Acute Asthma, COPD exacerbation, Pneumonia, ?PE

 Patients in Shock with diagnosis of - Haemorrhagic, anaphylactic, Septic, Hypovolemic, Cardiogenic

 Patients with Abdominal pain with diagnosis of – Acute Cholecystitis, Acute pancreatitis, Acute Appendicitis, Acute Intestinal Obstruction,

3 ED/UCC Taster session for FY2 Trainees

 Patients with Bleeding PV in early pregnancy

 Patients with Upper and Lower GI Haemorrhage

 Patients with Neurological emergencies with diagnosis of – Stroke, TIA, Cauda-Equina syndrome

 Patients with Collapse in the elderly

 Patients with DKA

 Patients with diagnosis of - #NOF

 To use care Bundles like – Sepsis, #NOF, Stroke, pneumonia, COPD, DKA

 To use NICE guidelines (CT scan in head Injury, COPD, GI Haemorrhage, DVT, PE), BTS guidelines(Asthma, Pneumonia)

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