Welcome to The Acute/Emergency Block

1. Dr Viviana Elliott Acute Block Lead Welcome to The Acute/Emergency Block

2. First day of the Acute Medicine BlockTuesday 15th September 2015

3. Clinical Teaching Fellows Teaching.fellows@uhcw.nhs.uk Ext 28727 CSB 2nd floor • Dr Hannah Blakey • Dr KavitkumarDasari • Dr Sarah Edwards • Dr Christina Tourville • Dr Hayder Hussein

4. Aim of this talk • Understand how the acute block works

5. Outline • Aim of the acute block • Rotation Areas • Teaching • Clinical kills • Assessments • Requirements for end of block 5

6. Acute Block Aims • 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 6

7. Challenges Teaching High Acuity Patient Safety Bed Pressure Personal Limitations

8. Rotation Areas UHCW Acute Medicine ITU Emergency Department Clinical Skill Department SWFT Acute Medicine Emergency Department Clinical Skill Department 8

9. UHCW-Acute Medicine Lead: Dr NihalAbosais Areas: • AMU/CDU/Ward • Morning ward round • Medical on call • GP assessment area/ Acute clinic • Short stay ward 9

10. 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

11. ITU Location 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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.

18. 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

19. 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.

20. SWFT Emergency Medicine Lead 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

21. Formal Teaching • Lectures • Tutorials (evidence based teaching) • Ethics 21

22. Lectures Thursday morning Location CSB Time 9-13 Most common presentations ATLS 1st week 22

23. 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

24. Ethics Tuesday tutorial 2 Location CSB Dates (see timetable) Time 08:00 – 12:00 Preparation needed

25. Clinical Skills • Ophthalmology teaching • Simulation • T Doc ( according to needs)

26. Ophthalmology Teaching Lead Dr Fiona Dean CSB room 2nd Thursday 14:00 h Practice Fundoscopy T Doc coming soon!

27. Simulation UHCW Introduction to simulation High fidelity simulation SWFT Simulation Different approach to UHCW

28. UHCW Simulation High fidelity simulation Timetable CSB 0005 Time 09:00-12:30 or 01:30-17:00 Read before the session Dress code Stethoscope Http://www.youtube.com/watch?v=u-Nryz7nPRE Sim Man Medical Students training-You tube

29. 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”

30. SWFT Simulation SWFT Medical School Leads Dr RathinavelShanmugam Timetable Wednesday Room E Medical School

31. Assessments • Formative MCQ pre and post block • Clinical Assessment • Portfolio • OSLER (Objective Structured Long Examination Record) two assessments for the block

32. Requirements for End of Block • Attendance (clinical areas only) • Portfolio x1 • Clinical Assessment • Osler x 2 • MCQ formative • Block feedback

33. Feedback

34. ANY QUESTIONS

35. “You get out what you put in” Enjoy yourself!