L1: Role of PA in ED Flashcards

Question

Common chief complaints in Intermediate care/ acute care/ high acuity care

Answer 1

``` *more advanced illnesses or serious injury* Deformed extremities Age <3 months or Elderly Temperature > 103 F Abnormal vital signs O2 saturation <90% on room air Chest pain Difficulty breathing Neuro changes Abdominal pain/ pelvic pain Vaginal bleeding ```

Answer 2

May work alone with satellite physician supervision May be only resource for healthcare in region May cover ED alone without consultants available Might not have skilled help for minor procedures Stabilize + transfer critical patients to facility with higher level of care

Answer 3

``` Education, teaching and administrative functions pertaining to emergency medicine Scheduling Hiring and interview of new PAs Discuss PA issues at board meetings Can be partners in ED physician groups Leadership roles in clinical initiatives ```

Answer 4

``` Teaching residents Precepting PA students “on-boarding” new PAs Research Lectures ```

Answer 5

Care for patients at scene of call and during transport Care for patients during transport from one facility to another Care at events: concerts, sporting Part of EMS team in rural areas where transport times to ED are longer Military: transport to medical facilities in combat situations

Answer 6

ED note is the ONLY defense

Answer 7

Think of the worst possible scenario and rule it out

Answer 8

+/- exact diagnosis (not always possible/necessary) Sick or not sick? Where are they going? Home with follow up vs admission + workup or monitoring? Discharge, leaving against medical advice To OR, to observation (24 hours non-cardiac chest pain or asthma) Admit to med/surg, telemetry, or ICU Transfer to skilled nursing facility or hospice

Answer 9

``` Name, DOB, Date/time Indication, Consent Description of procedure Estimated blood loss (EBL) Complications (if any) ```

Answer 10

Support patients to make a decision give lots of information offer guidance in weighing goals and possible outcomes allow autonomous authorization→ patient consent or refusal

Answer 11

``` unconscious patient incapable of consenting imminent harm from non-treatment no surrogate available in timely way → make sure there is no evidence patient would refuse a specific tx ```

Answer 12

Admit: floor, ICU, telemetry Diagnosis: primary diagnosis at time of admission Condition: stable vs unstable Vitals: frequency, continuous pulse ox? when to call? Allergies: foods and medications Nursing: pressure dressings, neuro checks, etc Diet: normal, low sodium, NPO? IV fluids: maintenance, bolus Specials: DVT prophylaxis Meds: pre-hospital AND new medications Activity: ad lib, fall risk, etc Labs: CBC, CMP, q am

Answer 13

Review: current medical condition, specific risks and benefits of treatments and alternatives, specific consequences of leaving Assess mental capacity of patient: understands proposed tx, understands consequences, reasoning for refusal of tx/admission Follow-up: advise when to seek medical attention, arrangement with social services, family members, etc.

Answer 14

Discharge diagnosis: cannot be a sign or symptom Secondary diagnosis: regardless of when diagnosed Discharge medications: all meds, doses, route, frequency Discharge instructions: activity level, diet, wound care, return to ER Follow-up: name of doctor, specialty, appointment location and time. Include timeframe if the patient is scheduling the appointment.