Outpatient/Emergency Department (ED) Information

Scheduling Details

The Outpatient/ED block is split among three areas. when you make your schedule - use the following strategy:

• Call your mentor and arrange to spend at least 3 - half days per week at the office. Avoid Tuesday and Friday PM - as you will likely be in conference. You may spend more than 3 half days if your mentor can accomodate you.
   
• Schedule yourself to spend 2-3 mornings in the well baby nursery at the Allen Pavilion. Spend 3 mornings if your mentor only has you observe - and 2 if you are seeing your own patients with your mentor. Call the Allen the day before to find out what time to come. Try to schedule 2 mornings on consecutive days.
   
• Whenever possible, be present for Chief of Service rounds on Wednesday morning from 8-9 a.m. and Grand Rounds on Friday morning from 8-9 a.m.
   
• Fill in the rest of your shifts in the PED. The shifts are 8:00AM - 1PM and 1PM to 5PM. One person should be scheduled to follow the acute side resident (red charts) and everyone else should be seeing patients on the non - acute side (blue and green charts - You can see these patients on your own.).
   
• When you are post call - you should take a half a day off on the following day

1. PED Experience: The ED experience takes place mostly in the non-acute area. PED trained physicians and Primary care physicians from the surrounding community (Washington Heights, an inner city environment) and from neighboring suburban communities (mostly Westchester, Riverdale and New Jersey) will supervise you. (See Objectives Below)
2. PED Call: During your ED weeks you will also be on call two evenings (5:00 p.m. - 2:00 a.m.) and part of a weekend day. You may switch your weekend and weeknight calls with each other to create one full 12-hour shift instead of 2 six-hour shifts. When on call either on a weekday or weekend you are supposed to be on the acute side. You may work on the non-acute side if it is not busy - but only with the permission of the ED attendings.
3. Mentor in General Pediatrics: During your ER time you will spend at least three half days a week with your primary care mentor. (see objectives below) These sessions will take priority over the ED and the nursery.
4. Neonatology: Most students will spend three mornings on the newborn nursery at the Allen Pavilion during Outpatent/ED time. During this time you should practice your Outpatient/PED/Neonatology Objectives.

Neonatology Objectives:

1. Physical examination of newborns, including screening for congenital abnormalities (cardiac, abdomenal, genital, hip and HEENT).
2. These sessions also provide opportunities for you to counsel new parents about the anxiety of parenthood and educate new mothers about proper breast feeding technique.
3. Other specific subject matter to cover includes: the jaundiced infant, prematurity / RDS, meconium aspiration, gestational age assessment, and Apgar scoring.

PED Objectives:

Non Acute Side: Objectives

Skill:

1. Perform histories and physicals focused to the complaint.
2. Generate differentials
3. Recognize levels of illness
4. Provide pateint education
5. Provide effective communication.

Specifically in the non-acute ED, familiarize yourself with how to deal with the following chief complaints:

You should be able to discuss some of the more common diagnoses and some of the key decision points in the work up of each complaint.

Acute Side: Objectives

Skill: Recognizing an emergency and principles of supportive management (fluids and respiratory support) are the two critical skills to learn.

In the acute ED you should try to cover the following topics: