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IUEM Clerkship

The Indiana University School of Medicine requires Emergency Medicine as a fourth year clerkship. Emergency Medicine became a required clerkship in the academic year 2003-2004. The Emergency Medicine Clerkship has received numerous awards as the best rotation elected by the graduating students since it's inception. We look forward to working with you!

CLICK HERE to download the entire syllabus

Contact Information

Assistant Professor of Clinical Emergency Medicine
Assistant Director, Residency
Co-Clerkship Director

 

Assistant Professor of Clinical Emergency Medicine
Associate Clerkship Director

 

Senior Clerkship Coordinator
Assistant Residency Coordinator

 

Description/Overview

The emergency medicine clerkship is a required fourth year clerkship at IUSM. Students must successfully complete all required third year clerkships as a prerequisite for the emergency medicine rotation. Following an initial didactic series, students will work approximately 15 nine-hour shifts where they will be supervised by board-certified emergency medicine faculty and senior emergency medicine residents. We believe that autonomy and responsibility are essential for the student to learn the fundamental approach to the patient with undifferentiated urgent or emergent conditions. On our clerkship, students function as the primary caregiver for their patients, working closely with supervising faculty to develop and implement management plans. There is ample opportunity for the performance of procedures.

Clerkship Goals and Objectives

Clerkship Goals

The student will learn the fundamental approach to caring for the undifferentiated patient with urgent or emergent conditions. The student will be required to identify the patient’s problem with a focused history and physical examination, taking into consideration not only the patient’s medical condition, but also the psychosocial aspects of the problem. The student will implement solutions to these problems under the direct supervision of the emergency medicine faculty. The student will also learn to consider unexpected circumstances that arise in the emergency department.

Clerkship Objectives

The IUSM endorses six core competencies. All of them are applicable to the Emergency Medicine Clerkship. The course objectives reflect the emphasis of the clerkship but are not an all-inclusive list of what you will learn in the emergency department.

Upon completion of the emergency medicine clerkship, learners will…

Maps to Institutional Learning Objective

Obtain an accurate problem-focused history and physical examination from a patient presenting to the emergency department with an undifferentiated complaint.

PC2

Interpret clinical data and be able to recognize immediately life-threatening conditions that present to the emergency department.

PC4

Formulate a differential diagnosis for their patient’s chief concern, prioritizing the likelihood of the diagnosis and considering worst-case diagnoses.

PC3

Develop a diagnostic and therapeutic plan, based on the differential diagnosis, for both an undifferentiated concern and specific disease processes.

PC3

Describe the underlying pathophysiology of common cardiovascular, neurologic, traumatic, and toxicologic emergencies and use this information in the development of a therapeutic plan for an acutely ill patient

MK2

Determine the appropriate care setting for management of patients presenting with an acute medical condition

PC7

Demonstrate appropriate communication during provider changes and transitions of care, using effective strategies to ensure patient safety

PC7

Demonstrate effective communications skills with patients, families, and other members of the health care team.

ISC2

Act in a professional manner, including being punctual, conscientious, responsible and honest.

PROF2

Recognize the role of emergency medicine in the health care system, including providing access to care at all hours to all patients.

SBP6

Identify health care challenges faced by underserved populations and deliver quality and equitable care to all patients presenting with an acute condition

PROF5

Consult the IUSM Competencies section for a description of each competency and the corresponding institutional learning objectives.


Clerkship Policies

Attendance

Consult the Required Clinical Clerkship Absence policy and the Adverse Weather policy prior to completing a request form.

Professionalism

What it means to be a professional in the Emergency Department.

  • As the patient's primary care giver you are an integral part of the ED team. You are expected to be present and on time for your clinical shifts. Please see the Clinical Shift Schedule Change and Illness Policy below. If an extraordinary circumstance occurs that precludes you from reporting for clinical duties, you must notify both the attending physician in your assigned department as well as the clerkship coordinator immediately.
  • Emergency medicine is a specialty with a fluctuating pace depending on patient flow. As such, being present in the department at all times during your clinical shifts is important to your education. Meals during a shift should be eaten on the go. If time permits you may have time to grab some food and bring back to the department, but extended absence from the department for meals is not permitted.
  • Appropriate attire for duty in the emergency department is scrubs. White coats may be worn but are not required.  For further information reference the IUSM Clinical Education Dress Code in the Student Handbook.
  • Students must respect patient confidentiality.

Consult the IUSM Mission and Vision and IUSM Honor Code that provide the foundation for the culture of professionalism expected at IUSM

Student Evaluation of the Clerkship

Students will have an opportunity to evaluate the Emergency Medicine Clerkship after taking the final exam.

Each student is provided access to a survey about the rotation and its different elements. Suggestions on improving the course are welcome. The evaluation is done through E-value. This should be done within 30 days of the end of the rotation.

Learner Accommodations

Any student at any IUSM campus requesting accommodations for a disability must apply to the Indiana University School of Medicine Disabilities Accommodations Committee and must register with the adaptive educational services office at the host campus.  Guidelines for applying along with a list of the adaptive services offices on each campus are available in the Student Handbook under the heading IUSM Disability Accommodation Policy.

IUSM Honor Code & Policies

 

Learning Experiences

Clinical Learning Experiences

  • Students will work fifteen nine-hour shifts or equivalent during their rotation, divided between day, evening, and night shifts. The schedule will be distributed at the beginning of the month (or posted on Canvas as soon as it becomes available). Any schedule requests should be directed to the Senior Clerkship Coordinator (Jim Graber- jamgrabe@iu.edu) at least one month prior to the beginning of the rotation. Students will be scheduled for shifts through the last day of the month. If any scheduling conflicts arise, please refer to the Clinical Shift Schedule Change and Illness Policy below.
  • During the clinical shifts, the student will be the primary caregiver for his/her assigned patients. He/she will be responsible for evaluating the patient and with the faculty or senior resident’s guidance, will develop and implement a focused diagnostic and treatment plan. A guide to presenting patients in the emergency medicine style can be found here: http://prezi.com/hlv11z7fyfzw/?utm_campaign=share&utm_medium=copy
  • Students perform (or assist with) procedures on their patients as needed, including suturing, arterial puncture and/or line placement, central venous access, and airway management. They will also interpret radiographs and ECGs.

Clinical Shift Schedule Change and Illness Policy

Each student is scheduled for approximately fifteen clinical shifts. The schedules are posted on the Canvas website as soon as they become available and are included in the orientation folder. The schedules have been thoughtfully constructed to accomplish the following:

  • Exposure to a wide variety of emergency department patients. The types of patients and problems encountered, and the types of resources available to care for these patients, vary by the time of day and the day of the week. Each student is therefore scheduled for both weekend and weekday shifts, which are distributed among days, evenings, and nights.

  • Ample time for reading and independent study.

  • Exposure to faculty at the off-campus venues with a special interest in teaching.

  • Maintenance of an optimal faculty to student ratio.

  • Facilitation of learning by respecting circadian physiology and avoiding long stretches of clinical shifts with no interposed days off.

Accordingly, changes to your assigned schedule are not permitted. Exceptions will be made on a case-by-case basis for extraordinary circumstances, such as a death or illness in the family. Schedule changes are not granted for personal reasons. However, you may trade a maximum of two shifts with other students rotating at your clinical venue. Any such trade must be submitted to Jim Graber for approval by the clerkship site coordinator and must conform to duty hour guidelines.

In the case of illness, you should not work if your illness poses a threat to patients or if you are physically incapacitated. You must contact Jim Graber (by email), and the attending physician on duty in the emergency department where you are scheduled to work, prior to the beginning of the shift for which you are scheduled. You are expected to seek medical evaluation from your personal physician or in the emergency department if your illness lasts more than one day.  Each department's phone number is listed in the Clinical Venues section below. IUSM policy also states that students must submit a Time Away Request Form (http://medicine.iu.edu/ume/index.php/download_file/view/222/768/166/) for any missed shifts. See the above policy on Required Clinical Clerkship Absence for further information.

Student Patient Encounter Tracking

It is required that each student sees a variety of patients with different patient presentations to meet the educational objectives of the clerkship. The purpose of this is to ensure that every student gets a minimum exposure to different patient types and problems. Every student’s experience will vary, but we require that they experience the following patient chief complaints. The conditions in parentheses are examples, but not an all-inclusive list, of conditions that would qualify for each chief complaint.

  • Trauma (MVC, fall, other blunt trauma, penetrating trauma) – 2 patients

  • Chest Pain (acute coronary syndrome, PE, aortic dissection, pneumothorax, pneumonia, idiopathic chest pain) – 3 patients

  • Dyspnea (asthma, COPD, PE, pneumonia, CHF, acute coronary syndrome, idiopathic dyspnea) – 2 patients

  • Neurologic emergency (acute weakness,/stroke/TIA, seizure, cauda equine) - 1 patient

  • Abdominal pain (appendicitis, cholecystitis, biliary colic, pancreatitis, gastritis, PUD, diverticulitis, SBP, small bowel obstruction, mesenteric ischemia, gastroenteritis, idiopathic abdominal pain) – 3 patients

  • Toxicology/intoxication (alcohol intoxication, sympathomimetic intoxication, opioid intoxication, sedative intoxication, anticholinergic intoxication, aspirin overdose, acetaminophen overdose) – 1 patient

  • Headache (SAH, ICH, meningitis, CO poisoning, temporal arteritis, migraine, idiopathic headache) - 1 patient

  • OB/gyn (pelvic pain, cervicitis, PID, ectopic pregnancy, ovarian torsion, vaginal bleeding) – 1 patient

  • Pediatric fever – 1 patient

  • Pain management (local anesthesia, narcotic analgesia, oral analgesia, IV analgesia, procedural sedation) – 2 patients

  • Orthopedic (fracture, joint dislocation, ankle sprain, osteomyelitis, septic arthritis) – 2 patients

  • Wound care (simple laceration, complex laceration, burn management) – 2 patients

  • Infectious disease (pneumonia, UTI, bacteremia, cellulitis, abscess, acute gastroenteritis, strep pharyngitis) – 2 patients

Required patient encounters should be logged in PxDx. in order to keep track of your progress. This is required to receive credit for the course. Please review your logs periodically to ensure that you are getting an appropriate range of clinical exposure. If you have difficulty finding a particular type of patient encounter, contact the clerkship director. Students that complete their clinical duties without logging their patient encounters will be required to remediate in order to pass the clerkship.

Non-Clinical Learning Experiences

Introduction to Clinical Emergency Medicine Didactic Series

At the beginning of the month there are a number of lectures, workshops, and clinical orientations over the first 3 days aimed at providing the student with the tools necessary to excel during their clinical duties.  Attendance at the initial lecture series is mandatory.

Students based at a Center for Medical Education will view the live lectures online, have a local clinical orientation and will meet with the statewide Clerkship Director and Clerkship Coordinator via Polycomm.

There are online Adobe Presentation lectures in addition to the live lecture series. Viewing all the lectures is mandatory for every student.  We recommend that you complete them prior to the end of the first week of the rotation. These can be found under Lecture Materials on Canvas entitled ‘Online Lectures’.  Flash Player is required to view so they will not work on an iPad or iPhone.

There are also a number of supplemental learning materials provided, including suggested readings, clinical reasoning modules and an online comprehensive study guide.  These can also be found on Canvas.


For detailed objectives about the content of the didactic offerings click here.

Day 1 

Orientation and Introduction

Approach to Emergency Medicine

Approach to Resuscitation in the Emergency Department

Approach to the Trauma Patient

Approach to the Febrile/Crying Child

Suture Lab

Day 2 (half day)

Approach to Common Outpatient Infections in the ED

Approach to the Patient with Acute Abdominal Pain

Approach to Neurologic Emergencies

Approach to the Patient with Dyspnea Small Group Session (timing varies)

Day 3 (half day)

Approach to Pain Management in the ED

Approach to the Poisoned Patient

Approach to Chest Pain

Approach to the Violent Patient

Required Online Lecture Content (found on Canvas)

Approach to Wound Management

Approach to Headache

Approach to OB/GYN Emergencies

Orthopedic Emergencies

Approach to the Septic Patient

Approach to Anaphylaxis

Approach to Syncope

Approach to Gastrointestinal Bleeding

Approach to Acute Scrotal Pain

Environmental Emergencies

Approach to Low Back Pain

Small Group Session

As part of the initial didactic series students will participate in one of three small group sessions. Students will be sent a case prior to the start of the month and will be given questions to consider prior to the session. Students should perform a self-assessment to identify comfort and knowledge gaps regarding the presented case and should seek out resources to review the assigned topic and correct any knowledge base deficiencies. At the small group session students will share their knowledge and feedback will be provided by the clerkship director.

Emergent Presentation Session

Rationale and relation to clerkship goal: 

In the Emergency Medicine Clerkship, students learn an approach to patients with undifferentiated urgent and emergent complaints. Opportunities for students to independently evaluate and manage emergent presentations are limited in an actual patient care setting. These sessions provide students with an opportunity to independently evaluate and manage critical clinical scenarios in a controlled setting and to receive formative feedback on their performance in a debriefing session.

Session Objectives:

  •  During the scenarios, students will collect the clinical data from available sources necessary to make clinical decisions.

  •  Students will interpret the appropriate clinical data and identify potentially critical diagnoses and conditions that are present.

  • Students will develop and implement a management plan for the initial care of the patient including initiating appropriate therapy and arranging disposition as necessary for each scenario. 

Format: 

The Emergent Presentation Session is presented to students in one of two ways. The cases are presented monthly to students at the Fairbanks Simulation Center as high fidelity scenarios that students work through in groups of 4-6, with two students taking the lead on each of three cases. The 15-minute scenario is viewed by all the students in the group and a 15 minute debriefing session follows where formative feedback is provided on the case. Students based at a center that are unable to attend the session at Fairbanks are provided with similar patient presentations in an oral boards format via polycom. Students will gather data from the case moderator and use this information to work through the patient presentation. 

 

Learning Assessment

Clinical Shift Evaluations

Description:

The majority of student assessment, both in terms of summative evaluation and formative feedback, comes through clinical shift evaluations. For each shift the student should submit an E-value evaluation to faculty and resident preceptors with whom he or she had meaningful contact (at least one and possibly multiple per shift). Students will be evaluated based on their performance in seven areas: professionalism, communication, data gathering, data interpretation/integration, medical knowledge, clinical judgment, and procedural skills. They will also be given an overall performance score.

Suggestions for preparation:

Students should prepare by viewing the demonstration videos on the proper emergency medicine style oral presentation, actively participating in the initial didactic component of the course, preparing themselves to formulate wide differential diagnoses for multiple common complaints, and working to capture case-based reading and actively incorporate feedback throughout the month.

NBME Shelf Exam

Description:

Students will take the NBME shelf exam at the end of the month. Students who have previously taken this exam in emergency medicine will alternatively be given the CDEM multiple choice exam.

Suggestions for preparation:

Students should view all required lectures, review suggested readings found on the course website to fill in knowledge gaps, and work to capture case-based reading after each shift.

Mid Rotation Feedback

Self-assessment, feedback and improvement should happen throughout your rotation. Faculty responses to each patient you staff is an excellent example of real-time feedback. We encourage you to frequently ask your preceptors for feedback at the end of your shifts and to contact the clerkship director any time if you have concerns. Additionally, however, you will be provided with more formal feedback close to the middle of the month.

On the 12th of the month you will receive an e-mail message from E-value asking you to complete a mid-month self-assessment. Complete this form including review of your procedure log by the 14th and forward to Dr. Turner (or Dr. Besinger if you are at Methodist). You will receive an electronic reply from the clerkship directors providing additional feedback via the E-value system. If you do not receive a message about this by the 17th of the month or if you have trouble accessing the information in E-value, please contact the clerkship coordinator. Much of this feedback will come directly from comments made by your preceptors. If you would like to meet in person please contact the clerkship director or your local site director to arrange a time. 


Grading

The grade for this rotation will be derived primarily from the clinical shift evaluations. The student should generate an evaluation for each shift in E-value and submit to the faculty member or resident with whom he/she worked most closely during each shift. It is expected that the student will generate this evaluation prior to leaving the emergency department, and failure to generate these evaluations for each shift could negatively impact the student's grade and even result in failure of the course. These evaluations are compiled at the end of the rotation and the clerkship leadership team compares student performance in each of the competencies, as well as overall performance, with that of their peers. This composes 80% of the grade. The NBME exam at the end of the rotation will count for 10% of the grade.   Attendance at the lecture series, completion of the online modules and participation in the dyspnea small group session and Emergent Presentation session will make up the remainder of the grade. Participation credit is given for all of these sessions and formative feedback will also be provided during the Emergent Presentation session. The grade distribution will be approximately 10% Honors, 30-50% High Pass, 40-60% Pass.

Students who receive Honors or High Pass are generally those who are motivated and work hard, exhibit professional behavior, have comprehensive differential diagnosis and sound clinical plans on the majority of their patients, and do well on the final examination.

Student Remediation Policy

It is anticipated that students who have met the required prerequisites, maintain professional behavior, and put forth an appropriate effort will pass the emergency medicine clerkship. Specific expectations will be explained to the students at the beginning of the rotation and are outlined in this syllabus. Occasionally, students may fail to meet these expectations. Our goal is to identify these students and work with them to remediate any deficiencies. 

Identification of Deficient Students

The clinical activity of each student will be evaluated daily. Supervising faculty and/or residents will complete Clinical Shift Evaluation forms after each emergency department shift. The clerkship director will review these forms on a regular basis to facilitate early identification of any deficiencies. Unprofessional behavior is to be reported immediately to the clerkship director. In addition, the clerkship director will review any complaints from patients, nurses, or ancillary staff. 

Remediation

The clerkship director and appropriate site coordinator will work with the student to identify specific areas for improvement and to develop a specific plan for remediation. Remediation may include additional clinical shifts, one on one instruction with faculty, or focused reading. Any plan for remediation will be tailored to the individual needs of the student. A student may be required to repeat the course if he/she fails to meet expectations established in a remediation plan. Students may be removed from the rotation immediately and receive a failing grade for any unprofessional behavior. Examples of unprofessional behavior include academic dishonesty, unethical behavior, and neglect of clinical responsibilities.

Academic Dishonesty

The emergency medicine clerkship team take academic dishonesty very seriously. Any academic dishonesty could results in immediate removal from the rotation and a failing grade for unprofessional behavior. More about the IUSM policy on academic dishonest can be found here:

http://msa.medicine.iu.edu/studenthandbook/cheatingplagiarism/

Grade Appeal

Students who receive a failing grade and would like to appeal should follow the school's official procedure:

http://msa.medicine.iu.edu/studenthandbook/studentevaluation/

 

Clinical Venues

Students will do the equivalent of 15 nine-hour shifts at one of the approved clinical sites for the IUSM emergency medicine clerkship listed below. Shift schedules are posted on the Canvas web site. Below is information about each of the sites including contact information for the site director.

Please be sure to report to site orientation on time and in appropriate attire. This is considered part of your professional responsibility for the course and failure to do so may mean you have to reschedule your rotation.

St. Francis: Report to Emergency Department at the start of your first shift. You will receive an orientation to the department at that time. Park in the Emergency Lot and bring ticket in with you.

St. Francis Site Director:

Adam Trammel, MD

Email:

adamtrammel2@gmail.com

Department Phone:

317-865-5261

St. Vincent (86th Street): Report to Emergency Department at the start of your first shift. An orientation will be scheduled with Dr. Orme before your first shift. Make sure to show up to this orientation on time and wearing appropriate attire. Park in the visitor’s lot. 

St. Vincent Site Directors:

Matt Orme, MD

 

Lou Profeta, MD

Email:

mattorme@rocketmail.com (Dr. Orme)

 

louermd@att.net (Dr. Profeta)

Department Phone:

317-338-2345

IU Health Methodist: Clinical orientation will be at the end of one of the lecture days. There is also a Cerner computer orientation session. Parking passes and maps for designated surface lots will be provided at orientation.  Alternatively, you may take the People Mover from the IU campus.

IU Health Methodist Site Director:

Bart Besinger, MD

Email:

bbesinger@iuhealth.org

Department Phone:

317-962-8355

Eskenazi: Clinical orientation will be at the end of the first day of lecture. Park in the IU student parking lot.

Eskenazi Site Director:

Joe Turner, MD

Email:

turnjose@iupui.edu

Department Phone:

317-880-9291

IU Health North: Clinical orientation details will be provided. Parking is available in the hospital lot.

IU Health North Director

Sean Trivedi, MD

Email:

strivedi@iuhealth.org

Department Phone:

317-688-3139

IU Health West: Park in the Emergency Department Parking lot but away from the building and patient parking.

IU Health West Director

Karen Crevier, MD

Email:

kcrevier@iuhealth.org

Department Phone:

317-217-3500

South Bend/Elkhart General Hospital:

South Bend/Elkhart Director

Dave VanRyn, MD

Email:

DVanRyn@egh.org

Department Phone:

574-523-3315

South Bend/St. Joseph Hospital:

South Bend/St. Joseph Director

Mark Kricheff, MD

Email:

kricheff@gmail.com

Department Phone:

574-335-1110 

Fort Wayne/Lutheran Hospital:

Fort Wayne/Lutheran Director

Andy McCanna, MD

Email:

andymccanna@yahoo.com

Department Phone:

260-435-7211

Northwest/Methodist Gary:

Northwest/Methodist Gary Director

Cynthia Galvan, MD

Email:

skyscoop@aol.com

Department Phone:

219-886-4710

Terre Haute/Reid Hospital (Richmond): Clinical and Hospital Orientation will be scheduled prior to your first shift in the department.

Terre Haute/Reid Director

Linda Hinkelman, MD

Email:

linda.hinkelman@gmail.com

Department Phone:

765-983-3144

 Lafayette/Arnett: Clinical and Hospital Orientation will be scheduled prior to your first shift in the department.

Lafayette Arnett Director

Jill Grant, MD

Email:

jill.a.grantmd@gmail.com

Department Phone:

765-838-5100 

IU Health Saxony:  

IU Saxony Director

Gaurav Aurora, MD

Email:

garora@iupui.edu

Department Phone:

317-678-1310 

Evansville Deaconess Gateway: 

Deaconess Director

Andrew Houseman, MD

 

Gina Huhnke, MD

Email:

housemaa@hotmail.com

 

gth0924@wowway.com

Department Phone:

812-450-7299  

Terre Haute Union:

Union Director

Anita Toussi, MD

Email:

atoussi@uhhg.org

Department Phone:

812-238-7523

Muncie IU Health Ball: 

IU Ball Director

Ryan Wallace, MD

Email:

rwallac2@IUHealth.org

Department Phone:

765-747-3241 

IU Health Bloomington: 

IU Bloomington Director

Andrew Watters, MD

Email:

wattersa@gmail.com

Department Phone:

 

Didactic Learning Objectives

Introduction: 

The Emergency Medicine clerkship takes place at several institutions throughout Indiana. Because of this structure, the learning experience for each student completing the Emergency Medicine (EM) rotation will be unique.  However, certain core concepts are essential for all students to grasp upon completing this rotation.  Listed below are objectives pertaining to the medical knowledge competency that all students completing the rotation are expected to achieve.

Delivery method:

The concepts relating to the objectives below are delivered to students through two primary modalities:  a 3 day live lecture series and online modules available in the Canvas platform and accessible to all students enrolled in the clerkship.  The method(s) by which each objective is delivered are listed following the objective.  (Key to abbreviation: LL-live lecture, OL-online lecture, SR-supplemental reading, SG-small group discussion, CL-clinical shift, SS- Emergent Presentations Session)

Assessment:

Mastery of the objectives below will be assessed by individual attendings completing a shift evaluation card.  These objectives will be assessed primarily in the “medical knowledge” and “data interpretation” subheadings.  In addition to this clinical assessment, the objectives will be assessed in the end of rotation examination.

Objectives: 

  1. Describe the approach and challenges associated with the undifferentiated patient presenting to the Emergency Department. (LL, OL, CS, SS)

  2. Identify the life threatening causes of chest pain. (LL,OL)

  3. Discuss the diagnostic evaluation and therapeutic options for a patient presenting to the Emergency Department with chest pain.  (LL, OL)

  4. Interpret electrocardiographic (ECG) findings of ST-elevation myocardial infarction, myocardial ischemia, and non ST elevation myocardial infarction. (LL, OL, CS)

  5. Differentiate between causes of acute dyspnea in Emergency Department patients (pulmonary embolism, anaphylaxis, pneumonia, asthma/COPD). (SG)

  6. Outline the potential treatment modalities for acutely dyspneic patients. (SG)

  7. Describe the approach to children presenting to the Emergency Department with fever of unknown origin, including how the approach varies with the age of the child. (LL, OL, CS)

  8. Demonstrate a broad differential diagnosis to the infant presenting to the Emergency Department with increased fussiness. (SR, CS)

  9. Identify the cardiac rhythm (VF, VT, PEA, asystole) in a patient presenting in cardiac arrest. (LL, OL, CS)

  10. Appreciate and apply the interventions necessary in a cardiac arrest with an appreciation of how the interventions may differ based upon the initial rhythm and clinical scenario. (LL, CS, SR)

  11. Describe the initial diagnostic and resuscitative approach of the trauma patient. (LL, OL)

  12.  Describe the procedures used in the resuscitation of the critically ill patient (endotracheal intubation, needle thoracotomy, central line placement, tube thoracotomy, and FAST examination). (LL, OL, SR)

  13. Discuss the differential diagnosis of a patient presenting to the Emergency Department with altered mental status.  (LL, CS)

  14. Identify the appropriate candidate for thrombolytic therapy in the Emergency Department. (LL)

  15. Discuss the diagnostic approach and develop a broad differential diagnosis in patients presenting to the Emergency Department with abdominal pain. (LL, OL, CS)

  16. Describe the indications for imaging studies and laboratory evaluations in a patient presenting with abdominal pain. (LL, OL)

  17. Appreciate the need to provide adequate analgesia in Emergency Department patients. (LL, CS)

  18. Identify toxidromes based upon clinical presentation of potentially poisoned patients—including cholinergic, anticholinergic, sympathomimetic, and opiate.  (LL, OL)

  19. Identify the appropriate antidote for specific toxins as well as the appropriate candidate for gastrointestinal decontamination. (LL, OL)

  20. Define the difference between SIRS, sepsis, and septic shock. (OL)

  21. Describe Early Goal Directed Therapy and its implementation in the septic patient. (OL)

  22. Describe the “red flag” ECG findings in patients presenting with syncope (dysrhythmia, prolonged QTc, WPW, and Brugada) (LL, OL, CS)

  23. Recognize the signs and symptoms of a compartment syndrome in a patient presenting with an acute fracture. (OL, SR)

  24. Demonstrate proper management of an acute fracture in the Emergency Department, including description of the fracture, analgesia, and appropriate splinting. (OL)

  25. Describe a systematic approach to the patient presenting to the Emergency Department with vaginal bleeding. (OL, CS)

  26. Discriminate accurately headache patients in need of further workup for subarachnoid hemorrhage, meningitis/encephalitis, temporal arteritis, acute angle closure glaucoma, or carbon monoxide poisoning. (OL, SR, CS)

  27. Differentiate upper gastrointestinal bleeding from lower gastrointestinal bleeding. (OL, CS)

  28. Describe the initial resuscitative approach to GI bleed patients in the Emergency Department. (LL, OL)

  29. Outline the diagnostic criteria for anaphylaxis and the initial treatment of patients presenting with this entity. (OL)

  30. Differentiate between testicular torsion and epididymitis. (OL)

  31. Discuss the role of compression only CPR in the out of hospital cardiac arrest patient. (SR).

  32. Identify a subset of trauma patients who may have their cervical spine cleared without radiographs using the NEXUS criteria. (OL, SR)

  33.  Describe the prevalence of and demonstrate an increased understanding of the challenges associated with the domestic violence patient presenting to the Emergency Department. (LL, SR)

  34. Discuss the approach to and acute treatment of epistaxis in the Emergency Department. (SR, CS)

  35.  Differentiate between disorders causing ocular emergencies and discuss their initial management. (SR, CS)

  36.  Discuss the approach to the actively seizing patient, new onset seizure patient, chronic seizure patient, and febrile seizure patient in the Emergency Department. (LL, SR, CS)

  37.  Demonstrate an understanding of the basic principles of wound management and associated procedures in the Emergency Department. (OL, SR, CS)

  38.  Describe the approach to skin and soft tissue infections presenting to the Emergency Department. (LL, SR, CS) 

  39. Identify red flags associated with lower back pain. (OL)

  40. Describe an approach to the management of the hypothermic or hyperthermic patient. (OL)

IU School of Medicine Resources

Please note that you have access to these and many other IUSM Resources via the IUSM Resources link found on the left side of your course page in Canvas.

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