Emerging emergency medicine - Copy

Information about Emerging emergency medicine - Copy

Published on August 7, 2014

Author: drvenugopalpp

Source: authorstream.com

Content

Emerging emergency medicine : Turning points and Burning points : Emerging emergency medicine : Turning points and Burning points Dr. Venugopalan.P.P Chief, Institute of emergency medicine MIMS Calicut Objectives: Objectives E M background in India What others think about EM Turning points during emergence Burning points Lesson learnt Scenario: Scenario Dr.Eqbal is fresh graduate scored excellent rank in NEET exam and he is very much interested to join MD EM . He seeks a second opinion with his role model professors. Medicine professor advised him “Don’t take such dirty specialty”. Microbiology professor “ What is it…I am not aware of such specialty “ 1# Concept : 1# Concept What is emergency medicine Where exactly the boundaries Know your strength and weakness Name of the specialty Casualty E M E R G E C Y M E D I C I N E Emergency Medicine : Emergency Medicine Initial evaluation, treatment and disposition of any person at any time for any symptom, event or disorder deemed by the person or someone acting on his or her behalf to require expeditious medical, surgical or psychiatric attention . ACEM Scenario: Scenario Dr.Vineetha knows about the speciality of Emergency medicine . She also knows some courses are available. She was so much worried about the placement , job responsibilities payments ,recognition etc… 2# Emergency Physician : 2# Emergency Physician Qualification Academics and visibility Faculty from other specialties Involve as much as Emergency Physician : Emergency Physician A specialist who has been trained to engage in the immediate initial recognition, evaluation and disposition of patient with acute illness and injury.. Emergency Physician: Emergency Physician ER Physicians do not usually provide long term or continuous care but they diagnose a wide range of diseases and perform interventions to stabilize the patient Emergency Physician: Emergency Physician Attitude Aptitude Alertness Aggressiveness Adaptability Awareness Accomplishment Qualifications: Qualifications MD[EM &MCI recognized other specialties ] DNB MEM MCEM;FCEM Fellowships PGDEM Quality More Demand Less people Scenario: Scenario 55years gentle man presented to emergency department with giddiness and tachypnea at 2 AM. Known case of CAD and APD, had stent and on anticoagulant P A to state transport minister and he was not even willing to do initial evaluation. He want to see his cardiologist . Cardiologist is not taking phone More than 10 bystanders around 3# People : 3# People They are not much bothered about who you are ! 1000 people… more than 10,000 ideas Competency and care up to their expectations Quality and professionalism Ethics , Transparency and Truthfulness Passionate always Scenario: Scenario 23yr old female brought to ED following RTA. Had suspected C-spine injury , # Humerus and # Femur Attending did Primary survey and Secondary survey as per ATLS protocols Later new bystanders started agitation and abusive language for tearing dresses and bills #4 Patients : #4 Patients Have a problem and sometimes many …. Distress Rewards are …how fast you make them comfortable Need physical , physiological and psychological resuscitation Culture ,Race and Religion Be Systematic…. #5Premise : #5Premise ER is the front office Good reception lead good care lead to comfort and confidence Plan ,Performance and Perfection Implement what exactly you want Be live …save lives … PowerPoint Presentation: Pediatric Emergency Medicine Scenario: Scenario 5 bedded rural casualty, 1 OT, No CT facility 3 doctors, 6 Nurses ,One ambulance and 2 ambulance assistants 8 patients brought to casualty following a collision of Jeep versus Autorickshaw 5 Walking patients , 1 case with fracture femur of Hypotension, 1 case with facio -maxillary injury with obstructed airway and one case fracture dislocation of shoulder #6 Team: #6 Team Doctors, Nurses, Paramedics , Ambulance assistants ,Security …. Training, modulation and empowerment Team work is the success You can win…..: You can win….. When resources are exhausted …: When resources are exhausted … Scenario: Scenario 78 year old lady ,Known case of DM, CKD,CAD and COPD presented to ED with SOB and Signs of Sepsis Attending EP initiated early stabilization and contacted different consultants Medical ICU beds are full except crash bed Consultants are not very keen to take case #7 Destination: #7 Destination When destination is not clear … Overcrowding Dumping No man area Multisystem cases and Poly trauma Protocol based practice Scenario: Scenario 37 year old gentleman brought to Ed with shortness of breath , palpitation and dizziness Vital Pulse 210 / mt reg. BP 110 ,SpO2 94 RA ECG – supra ventricular Tachy Not responding to Vagal maneuver and responds to one dose of adenosine and called cardiologist for expert opinion He shouted to EP like anything and asked to do the rest of the management as well #8 Consultants: #8 Consultants Supportive Incompatible Lazy Egoistic Money Over work /Burn out Evidence based Medicine Do for the best interest of patient Scenario: Scenario 25 year old male presented with Tachypnea and pleuritic chest pain. He was just travelled from Washington yesterday. PGY2 order D- Dimer . PGY 3 objected and they are in Arguments #9 Academics : #9 Academics Regular academics Multiple levels Different modalities Teaching is the best way to learn Scenario: Scenario A corporate Emergency department claimed to do good works . They reported the they treated 65,000 cases per year. Resuscitated many cases. NABH auditors visited in the department declared that department is non complaints to standards #10 Quality assurance : #10 Quality assurance Regular follow up Documentation Know about the errors and its chances Fix measurable Parameters , process and protocol Errors Audit Only way to get into next level PowerPoint Presentation: Assessment-Diagnosis-Treatment-Management-Disposition Triage Admit Discharge EMS Patient Presentation ED Design Triage Cueing Over crowding Information Gap Lab errors Report Delay Authority Gradient Orphaned Pt Team work problem Transition of Care Resource Constrain Sense Making Affective state Radiology Error Fatigue & Shift work Cognitive properties of the mind Violation producing factors Procedural factors Medication errors Inadequate Discharge Plan Long waiting time For Bed Follow up failures Sources of Failures and Errors in ED PowerPoint Presentation: Communication Communication Communication Communication PowerPoint Presentation: E M E R G I N G E M E R G E N C Y MEDICINE Thank you so much

#5premise presentations

Emerging emergency medicine
06. 08. 2014
0 views

Emerging emergency medicine

Related presentations


Other presentations created by drvenugopalpp

Emerging emergency medicine
06. 08. 2014
0 views

Emerging emergency medicine

Copy of Acute pain in ED
06. 08. 2014
0 views

Copy of Acute pain in ED

Pace 2014 Acute pain in ED
06. 08. 2014
0 views

Pace 2014 Acute pain in ED

Airway emergencies in oncology
20. 10. 2014
0 views

Airway emergencies in oncology

Niv in emergency department ebm
09. 11. 2014
0 views

Niv in emergency department ebm

Cricoid pressure : Yes or No
27. 03. 2015
0 views

Cricoid pressure : Yes or No

Pediatric BLS- Guidelines
19. 04. 2015
0 views

Pediatric BLS- Guidelines

FICB & Bier's block in ER
18. 03. 2016
0 views

FICB & Bier's block in ER

Poly trauma -initial evaluation
01. 08. 2017
0 views

Poly trauma -initial evaluation

Ima newsletter Volume 1
10. 07. 2017
0 views

Ima newsletter Volume 1

IMA News letter 2017
08. 07. 2017
0 views

IMA News letter 2017

Acute pain in ED NBE presenation
15. 08. 2017
0 views

Acute pain in ED NBE presenation

Emergency care mathrubhoomi
28. 09. 2017
0 views

Emergency care mathrubhoomi

Acute asthma  what is new?
11. 11. 2017
0 views

Acute asthma what is new?

Toxin and seizures
26. 11. 2017
0 views

Toxin and seizures

Poison intake and urgent care
14. 01. 2018
0 views

Poison intake and urgent care

End of Life Care -EoLC in ED
01. 02. 2018
0 views

End of Life Care -EoLC in ED