ORTHO ROTATION

Past Resident Tips

 

The first day of your rotation, get your “list” from the  ortho PA by doing the following: 

  • You’ll be working a lot with the Ortho PA--it’s the same one for the entire calendar month, so depending on your rotation dates, you may have 2 different PAs over your rotation.

  • Use the PA as your resource for what orders to put in, etc.

  • You’ll meet either the PA, the attending, or both in the surgeons lounge at Hackley at 6:45-7ish everyday. You’ll be at Hackley through mid/late afternoon. You’ll “round” on patients between OR cases. Ortho progress notes are very easy and simple. If in doubt of what to do, just ask the PA.

  • If asked to do “Discharge Instructions” it usually includes the following: Ice, Elevate, non weight bearing, advance diet as tolerated, f/u with ortho in 2 weeks

  • Figure out what body part fracture conference is on this month and keep a list of fracture so you can be responsible for pulling those up during conference

  • You’ll need to put together a short, 5 minute presentation to give Dr. Ringler (and possibly the ER residents) towards the end of the block.

  • If asked to “Board a Case” call 4944 and give them patient name, procedure, etc.

  • If asked to do Discharge instructions it will usually be something like this:

             - Ice

             - Elevate

             - Non weight bearing

             - Keep dressing/splint on until seen by Dr.

             - See Dr. Anhalt in 2 weeks

Rotation Overview:

The ER-Ortho Trauma Rotation will provide an ER Resident Rotation specializing in the care of patients with musculoskeletal injuries and fractures.  This rotation will emphasize aspects of orthopaedic trauma care critical to the education of Emergency Medicine Resident training and give greater insight into the continuum of orthopaedic care initiated in the Emergency Room.

 

Scheduling:

Typically, you will meet Dr. Anhalt or Dr. Ringler in the surgeons lounge at 0645 each morning, Monday through Friday. Rotations are 4 weeks in length and based at Hackley Hospital. Anticipate a 50-60 hour work week. Residents must be available 5 days/week. You are excused from rotation for scheduled ED conference lectures.

Components of Service: 

    1. Rounds

    2. ER Consultations

    3. OR  Trauma Room Coverage

    4. OR (non-trauma) Coverage

    5. Office Coverage

    6. Call+/- ?

    7. Education (Morning X-Ray Teaching Rounds and Monthly Ortho Trauma ER Lecture)

Service Member Roles/Expectations/Responsibilities: 

    1. Ortho Trauma Physicians

              a. Provide Educational Environment for Resident Learning

              b. Interact One on One with ER Resident throughout all facets of care

              c. Available for Morning Xray rounds

                         i. Anticipated Rounds at 7am (maybe 630am)

                        ii. X-Ray Review of all Admissions over the past 24 Hours

                       iii. Review of interesting cases System wide over past 24 hours

              d. Oversee all Floor/ER consults performed by Resident

                         i. Ensure accuracy of diagnosis and treatment plan

                        ii. Provide educational foundation of differential diagnosis

                       iii. Provide Educational foundation of Treatment options

              h. Interact with Resident and PA in OR

                         i. Educational Discussion regarding patho-anatomy

                        ii. Educational Discussion regarding treatment options

                       iii. Opportunity for Skill Enhancement

                                 a. Wound Debridement

                                 b. Suturing skill

                                 c. Reduction skill

                      iv. Provide Opportunity to Participate in Orthopaedic Surgeries

    2. Ortho Physicians (Non-Trauma)

              a. Provide opportunity for OR Exposure when there’s no Trauma cases

              b. Ancillary opportunities for education outside of Ortho Trauma

                        i. Total Joint Reconstruction

                       ii. Sports Medicine

                      iii. Spine Exposure

    3. Ortho Trauma PA

              a. Represent critical component to the Ortho Trauma Service

                        i. Single PA on service for a month representing a consistent provider

                       ii. Generally functions at upper level resident

                      iii. Work in concert with Resident dividing the work load on the service

                      iv. Rounds

                                 a. Floor Calls

                                 b. OR

                                 c. Consults

    4. ER Resident

              a. Function as a significant component to the ortho trauma service

              b. Will work in concert with Physician and PA on Service

              c. Clinical Responsibilities

                        i. Morning Work Rounds on Ortho Trauma Patients

                       ii. OR Coverage

                      iii. Patient Consults and Admits

                      iv. ER Consultation

                       v. Office Coverage

              d. Educational Responsibilities

                        i. Morning X-Ray Rounds – Review all patients from past 24 hrs

                       ii. Monthly ER-Ortho Conference

                      iii. 5 Min Presentation on Topic of Their Choice

              e. Objectives of Rotation

                        i. Develop greater understanding of pathoanatomy of injuries

                       ii. Develop Greater Discrimination of injury patterns

                      iii. Increase comfort with initial (ER) fracture management

                      iv. Develop Greater understanding of injury and associated tx

                       v. Develop greater understanding of potential complications

                      vi. Increase ability to read and describe radiographs

                     vii. Increase ability to present and discuss patient injuries

Rotation Assessment:

    1. Resident Evaluation in line With ER Residency at the End of the Rotation

    2. Rotation Assessment at End of Each Rotation