ROTATION Details pgy-1

AnesthesiaUltrasoundEmergency MedicineMedical Intensive Care UnitObstetricsOrthopedicsTrauma ICU

 

Orthopedics

 

OBJECTIVES:

1.      To learn the basic approach to the evaluation of orthopedic injuries (Practice-based learning, medical knowledge, and patient care).

2.      To evaluate multiple fractures, dislocations, and other orthopedic problems (Practice-based learning, patient care).

3.      To become familiar with splinting and casting (Practice-based learning, patient care).

4.      To learn which injuries require emergent or urgent orthopedic referral (System-based practice, practice-based learning).

5.      To understand and be able to predict complications of various injuries (Practice-based learning and improvement, medical knowledge, patient care).

6.      To reduce dislocated shoulders, hips, elbows, knees, and digits (Practice-based learning).

7.      To be able to recognize x-ray findings in a wide variety of orthopedic injuries (Medical knowledge, practice-based learning and improvement, patient care).

8.      Specific orthopedic entities with which the resident should become familiar include: necrosis of the hip; osteogenesis imperfecta; osteomyelitis; bone tumors; Paget's disease; septic arthritis; osteochondritis dessicans; spondylolysis/spondylolisthesis; disc herniation; discitis; sacroilitis; sciatica overuse syndromes; myositis ossificans; slipped capital femoral epiphysis; Legg-Calve-Perthes disease; synovitis; spine injuries; compartment syndromes; tendon injuries; amputations/reimplantation; open joints; crush injury; and high-pressure injection injury (Medical knowledge, practice-based learning, Patient care).

9.      To learn what special tests are available and when to use them (Practice-based learning, system-based practice)

10.  To learn how to describe an injury (Communication skills, practice-based learning). Specific orthopedic injuries include: supracondylar humerus fracture; forearm fracture; Colle's fracture; acromioclavicular separation; nursemaid's elbow; radial head fracture; lunate/perilunate dislocation; calcaneus fracture; proximal femur (hip) fracture; Lisfranc fracture; dislocations (hip, ankle, shoulder, knee); and pelvic fractures (Medical knowledge, practice-based learning, patient care).

11.  To learn the post operative complications of orthopedic procedures, how to prevent them, and when to follow-up on injuries (System-based practice, practice-based care).

DESCRIPTION OF CLINICAL EXPERIENCE

·         Each resident will spend one month in the first year on orthopedics. The resident will be based in the ED and will function under the auspices of an upper-level consulting orthopedics resident and an EM faculty member. The resident will be the first call responder to the ED for all Orthopedic consults while he/she is in the ED. 

The resident has the opportunity to go to the operating room, but should view the OR as a selective enhancement of the ED experience and not a primary responsibility. The Resident will spend time daily (Monday –Friday) in the radiology reading room reading x-rays with the attending EM Radiologists.

 

DESCRIPTION OF DIDACTIC EXPERIENCE

·         The resident will read a syllabus and text prepared by the Department of Emergency Medicine. The resident will present one case per week at Case Conference with supporting X-rays.

 

 

EVALUATION PROCESS

·         Written evaluation by the Course Director with input from Orthopedic Faculty and residents

FEEDBACK MECHANISM

·         Direct bedside feedback from faculty and residents, written formatted rotation evaluations.

 

 

This rotation has been agreed to and approved by the Chairman and the Residency Director of the Department of Emergency Medicine. Residents are given copies of all rotation summaries at the beginning of their PGY-1 year. Residents should use rotation summaries, formatted written rotation evaluations, and their performance on the In-service Examination to assess the rotation’s effectiveness.