ED - Finishing Week 1

5p-1a
The first week started a little slow but ended with some cool stuff. I got to help insert a Central line (IV in the neck) by holding the US and flushing the lines. I also got to remove an intraosseous IV (IV in the bone). We talked about intraosseous IV lines in school but I had never actually seen one. There was a little blood splatter on my white coat - I felt like I had been "anointed" into the ER! Thankfully it wasn't a big deal and I was able to roll my sleeves to cover it up.

I had another patient that complained of numbness and tingling in his fingers. We ended up doing a full stroke and heart check on him. Thankfully it all came up clean, but we didn't get any answers for the numbness and weakness in the hand.

Lots of chest pain. A patient with odd symptoms that ended up being a UTI. A young person who pulled some muscles in their back while moving furniture. AA lady who OD'd on narcotics. A woman in her 30's with chest pain that we had to do a full work up for MI.

End of Week 1 - I got to go home to be with my family for the weekend. Tomorrow we will finally celebrate my birthday - so nice to be with everyone to share the cake! One of my nephews is making me a special cake. I can't wait to see what they planned!

July - ED - Week 1

So I thought I would document some of the cool things I saw/did in the ED this month.

My first day, I only worked a few hours.

Chest Pain with a complete Heart Block

Kidney Stone - recurrent

Headache - new onset, sounded like a cluster headache, checked for acute narrow angle Glaucoma

Generalized Weakness, increasing confusion - unknown cause

Day 2 - 12p-10p

Headache - possible migraine, CT normal

Chest Pain - admit

Gallstone - non-unobstructed

Nothing else of note

Day 3

Attempted Suicide - cut neck with a buck knife extended from side to side. I got to go to the OR to see it repaired. Saw a laryngoscope as a trach tube was inserted.

Rollover Car Accident - Head Laceration that peeled the forehead back. Later found out she had a skull fracture

Threatened Abortion - 5 week pregnant woman with bleeding.

Dementia - Elderly lady that no longer swallows and doesn't eat or drink.

Seizures - elderly lady with seizures and DNR

Cellulitis - bilateral lower extremities with cellulitis, tense red skin and peeling skin. Bacterial infection with satellite lesions - called Infectious Disease

This may not be as interesting to you, but I know this will be a good resource when I graduate :-)

3rd Year has Begun

June was a busy month. I started my first rotation June 1st with Pediatric ortho at Children's Hospital. I worked 12-13 hours a day, 5 days a week. I learned a lot about Cerebral Palsy and other congenital disorders that cause limb and muscle deformity. I also learned a lot of surgical skills.

In my 3rd week, I was able to do a small surgical procedure by myself - from cut to close. It was a hardware removal of the distal tibia. I actually got to do almost 100% of the other leg too. It was so cool! Someday I will look back on this and wonder what I was so excited about but when you are just beginning, every little task is "cool".

I have also gotten to read a lot of x-rays, a hip US, and a hip MRI. I am getting better at finding fractures and classifying them. There is still so much to learn, it is almost daunting.

I spent many late nights in surgery and writing progress notes. All part of being a real PA, except I don't get paid. One morning I went in at 6am to do rounds on our patients. It was a really good experience to talk to families alone. I know I can't answer every question but it is fun trying.

My final eval was very encouraging. My preceptor commented that he felt I would be a great Orthopedic PA, which means a lot to me coming from him. It is what I really want to be and I pray God will provide a job in that specialty when I graduate!