Welcome to The Acute/Emergency Block

Dr Viviana Elliott

Acute Block Lead

First day of the Acute Medicine BlockTuesday 15th September 2015

0800–

0845

Welcome and Acute Block inductionViviana Elliot & Teaching fellows

0845 –

1000MCQ Paper

1000-1020 Coffee Break

1020-

1100

 ABCDE approach to the acutely unwell patientDr Hannah Blakey

1100-

1130

 ABCDE DemonstrationTeaching fellows

1130-

1200Meet with teaching fellows

Clinical Teaching Fellows

Teaching.fellows@uhcw.nhs.uk Ext 28727

CSB 2nd floor

•Dr Hannah Blakey

•Dr Kavitkumar Dasari

•Dr Sarah Edwards

•Dr Christina Tourville

•Dr Hayder Hussein

Aim of this talk

• Understand how the acute block works

Outline

• Aim of the acute block

• Rotation Areas

• Teaching

• Clinical kills

• Assessments

• Requirements for end of block

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Acute Block Aims

6

• To gain confidence in the initial assessment of acutely ill patients

•To help you develop initial management plans for acutely ill patients

• To gain confidence in practical skills

• To have exposure to most common Emergency and Acute Medical presentations

Curriculum- Learning Objectives

Challenges

Teaching High Acuity Patient Safety Bed Pressure Personal Limitations

Rotation AreasUHCW

Acute Medicine

ITU

Emergency Department

Clinical Skill Department

SWFT

Acute Medicine

Emergency Department

Clinical Skill Department8

UHCW-Acute Medicine

Lead: Dr Nihal Abosais

Areas:

1.AMU/CDU/Ward Morning ward round Medical on call

2.GP assessment area/ Acute clinic

3.Short stay ward

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What do I do?

• Introduce yourself

• Read a case to concentrate on

• Attach to doctors in area 1, 2 and 3

• Liaise with doctors in each area in the

morning and with the on call team in the

afternoon (registrar)

• Clerk only under senior supervision

ITULocation 1st floor opposite CDU/Ward 12

Lead Dr Vadim Iakimov

Shift starts at 0800 h with the handover, don’t

be late! Go to the seminar room on the

General Critical Care Unit. The seminar room

is located at the end of the admin corridor.11

ITU• The unit is divided into three bays and

eight side-rooms.

• The team will be divided between the areas, attach yourself to one of these teams

• Microbiology variable times

• Attach to nurses in the afternoon

• Read introduction to ITU in website

Emergency Medicine

• Location: Emergency Department• Lead Dr Marius Holmes ( Scott Carrington)• Areas of rotation:

Minors

Majors

Resus

Obs ward• On arrival introduce to sister in charge and senior

doctor 13

Emergency Medicine

• Attach to SHO/ staff grades in the area

• Before shift think about learning objectives

• Share cases, cases and interesting patients

• Obs ward alcohol, suicidal and mental health patients

• Allocated bedside teaching

SWFT Acute Medicine

Lead Dr Viviana Eliott

Location Fairfax ward AMU

Areas for rotation

• AMU/Fairfax

• Ambulatory Emergency Care

• ED/Fairfax medical on call

• Frailty

SWFT AMU/Fairfax

• Starts at 08:00 hs with a post take ward round with the night and day team

• There are 2 teams attach to one each

• 09:30 h night team leave and ward round continues until 12:00 hs

• 12:00 hs handover to nurse in charge

What do I do in the Acute Medicine Unit?

• Join the ward round.

• Concentrate how the senior doctors make differential diagnosis, determine scores and make decision to admit or discharge.

• Look at the Care Bundles.

What do I do in the Acute Medicine Unit?

• In the afternoon– Go to Ambulatory Emergency Care– Attach to the Medical Nurse Practitioner

(MNP) Paul or Abbey to see how to do a comprehensive geriatric assessment (CGA)

– Join the respiratory pull– Help with jobs

What do I do when I am on call?

Morning team 09:00-21:30h

• Reg ( most clinical teaching fellows!)

• SHO

• FY1 in AEC

• FY1 in AMU

Twilight SHO 12:00-24:00h

Attach to one member of the team and review patients with them.

SWFT Emergency MedicineLead Dr Martin Smyth

Location Major and See and Treat

Time Timetable

Introduce to senior staff in the area

Attach to SHO/ registrar in the area.

Teaching sessions on Wednesday morning 09:00-12:00 h (Burns, Allergies, Epistaxis

and Head Injury) IN ED SEMINAR ROOM

Formal Teaching

• Lectures

• Tutorials (evidence based teaching)

• Ethics

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Lectures

Thursday morning

Location CSB

Time 9-13

Most common presentations

ATLS 1st week

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Tutorials: Evidence based teaching sessions

Tuesday (see timetable)

Location CSB

Time Tutorial 1 - See Timetable

Tutorial 2 - See Timetable

Tutorial 3 - See Timetable

Outstanding feedback

Ethics

Tuesday tutorial 2

Location CSB

Dates (see timetable)

Time 08:00 – 12:00

Preparation needed

Clinical Skills

• Ophthalmology teaching

• Simulation

• T Doc ( according to needs)

Ophthalmology Teaching

Lead Dr Fiona Dean

CSB room

2nd Thursday 14:00 h

Practice Fundoscopy

T Doc coming soon!

Simulation

UHCW

Introduction to simulation

High fidelity simulation

SWFT

Simulation

Different approach to UHCW

UHCW SimulationHigh fidelity simulation

Timetable

CSB 0005

Time 09:00-12:30 or 01:30-17:00

Read before the session

Dress code

StethoscopeHttp://www.youtube.com/watch?v=u-Nryz7nPRESim Man Medical Students training-You tube

Feedback

“Really good practical experience in a realistic but safe situation”“SimMan was excellent, good confidence builder”“Good learning experience and it is good to practice "team working”“Great experience I could do it all week! Fantastic and probably the most useful thing I have done this year”

SWFT Simulation

SWFT Medical School

Leads Dr Rathinavel Shanmugam

Timetable Wednesday

Room E Medical School

Assessments

• Formative MCQ pre and post block

• Clinical Assessment

• Portfolio

• OSLER (Objective Structured Long Examination Record) two assessments for the block

Requirements for End of Block

• Attendance (clinical areas only)

• Portfolio x1

• Clinical Assessment

• Osler x 2

• MCQ formative

• Block feedback

Feedback

ANY QUESTIONS

Enjoy yourself!

“You get out what you put in”