medical_student:university_intern_guide
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| medical_student:university_intern_guide [2021/01/05 21:33] – elliot | medical_student:university_intern_guide [2023/06/13 19:22] (current) – taylor | ||
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| - | ====How to Rock Plastic Surgery - Intern Guide==== | + | =====How to Rock Plastic Surgery - Intern Guide===== |
| - | General Daily Flow\\ | + | ====INTERN PEARLS==== |
| + | {{ : | ||
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| + | ====General Daily Flow==== | ||
| * Prepare patient lists with pertinent vital signs, lab values, I's & O's, and imaging/ | * Prepare patient lists with pertinent vital signs, lab values, I's & O's, and imaging/ | ||
| * Sign-out starts anytime before 6AM and occurs on the 6th floor of AIP2 tower in the surgical resident workroom between the second and third nursing station. You are responsible for grabbing the plastic surgery floor pager. There may be instances where the hand team will ask that you grab the hand pager for them and place it in the plastic surgery call room. The hand team will inform you if that is the case | * Sign-out starts anytime before 6AM and occurs on the 6th floor of AIP2 tower in the surgical resident workroom between the second and third nursing station. You are responsible for grabbing the plastic surgery floor pager. There may be instances where the hand team will ask that you grab the hand pager for them and place it in the plastic surgery call room. The hand team will inform you if that is the case | ||
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| - | Detailed Daily Flow\\ | + | ====Detailed Daily Flow==== |
| - | Before rounds\\ | + | ===Before rounds=== |
| * Print patient list: Go to plastics patient list, | * Print patient list: Go to plastics patient list, | ||
| * Include Room, Name, Age, Attending, Handoff To do, Blank column for columns\\ | * Include Room, Name, Age, Attending, Handoff To do, Blank column for columns\\ | ||
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| - | Rounds\\ | + | ===Rounds=== |
| * Chief/ | * Chief/ | ||
| * Rounds are usually casual, very brief SOAP presentation with updates, overnight events, pertinent results, plans/ | * Rounds are usually casual, very brief SOAP presentation with updates, overnight events, pertinent results, plans/ | ||
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| * Run the list after rounds | * Run the list after rounds | ||
| - | After rounds\\ | + | ===After rounds=== |
| * Place orders and call consults first. Then replenish electrolytes as needed. | * Place orders and call consults first. Then replenish electrolytes as needed. | ||
| * Call Case Management at x34075 for phone rounds. Case manager usually answers their phone after 8:30AM. | * Call Case Management at x34075 for phone rounds. Case manager usually answers their phone after 8:30AM. | ||
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| * Most attendings at the University have a dedicated PA who will often assist with pre-op orders, consents and scripts. Double check these are complete before starting floor work | * Most attendings at the University have a dedicated PA who will often assist with pre-op orders, consents and scripts. Double check these are complete before starting floor work | ||
| - | After OR\\ | + | ===After OR=== |
| * After the case do post-op orders - pain meds, antibiotics, | * After the case do post-op orders - pain meds, antibiotics, | ||
| * Pro-tip - complete discharge orders for outpatient surgeries prior to starting case | * Pro-tip - complete discharge orders for outpatient surgeries prior to starting case | ||
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| - | Consults:\\ | + | ===Consults=== |
| * If you get a consult you should let the consult resident know immediately and go and see the consult as soon as you can. The senior resident will either meet you at the consult or ask you to take pictures and send it to them | * If you get a consult you should let the consult resident know immediately and go and see the consult as soon as you can. The senior resident will either meet you at the consult or ask you to take pictures and send it to them | ||
| * Take pictures of consults and show the pics to the fellow even if they are scrubbed in. Residents are always willing to help with consults even if they are scrubbed in | * Take pictures of consults and show the pics to the fellow even if they are scrubbed in. Residents are always willing to help with consults even if they are scrubbed in | ||
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| - | Discharges:\\ | + | ===Discharges=== |
| * Ensure patient has appropriate prescriptions and wound care orders prior to discharge. This includes home health if required for wound vac changes or dressing changes. | * Ensure patient has appropriate prescriptions and wound care orders prior to discharge. This includes home health if required for wound vac changes or dressing changes. | ||
| * For specific orders, check with the Wiki page first for various types of cases. If you have additional questions, ask your senior resident about discharge orders (i.e. antibiotics, | * For specific orders, check with the Wiki page first for various types of cases. If you have additional questions, ask your senior resident about discharge orders (i.e. antibiotics, | ||
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| * Create a discharge summary for each discharge - this needs to be completed and signed within 24 hours of discharge | * Create a discharge summary for each discharge - this needs to be completed and signed within 24 hours of discharge | ||
| - | End of day:\\ | + | ===End of day=== |
| * Update the handoff throughout the day based on new information or changes throughout the day. Include plans for the following day/week if applicable (e.g. change wound vac tomorrow)\\ | * Update the handoff throughout the day based on new information or changes throughout the day. Include plans for the following day/week if applicable (e.g. change wound vac tomorrow)\\ | ||
| * Run the list with the senior resident at least once prior to the end of the day. You are encouraged to run the list even while they are scrubbed in a case | * Run the list with the senior resident at least once prior to the end of the day. You are encouraged to run the list even while they are scrubbed in a case | ||
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| * Let them know which resident is on call for that night and if they will be on hand call. Put their names, pager and cell phone numbers at the top of the list. The resident on call is listed on the wiki front page in the calendar\\ | * Let them know which resident is on call for that night and if they will be on hand call. Put their names, pager and cell phone numbers at the top of the list. The resident on call is listed on the wiki front page in the calendar\\ | ||
| - | Weekend:\\ | + | ===Weekend=== |
| * You will often round on the day you are cross-covering other general surgery services. You are responsible for rounding on plastic surgery patients, writing notes, updating orders and plans, and performing routine floor work. In addition you will get signout about other services' | * You will often round on the day you are cross-covering other general surgery services. You are responsible for rounding on plastic surgery patients, writing notes, updating orders and plans, and performing routine floor work. In addition you will get signout about other services' | ||
| * On weekends you are not assigned to cross-cover, | * On weekends you are not assigned to cross-cover, | ||
| - | Tips and Tricks:\\ | + | ===Tips and Tricks=== |
| - | * Refer to the wiki for DIEP flap protocols. There is a specific sequence of orders and milestones for each post operative day that is to be followed | + | * Refer to the wiki for [[medical_student: |
| * Do not hesitate to ask the senior residents for help. This is especially so when you have a question about a flap during a flap check. If you notice any changes to the flap it is better to report it to the senior resident and ask if it needs to be addressed. Flaps are tenuous reconstructions that require attention and interventions are sometimes necessary | * Do not hesitate to ask the senior residents for help. This is especially so when you have a question about a flap during a flap check. If you notice any changes to the flap it is better to report it to the senior resident and ask if it needs to be addressed. Flaps are tenuous reconstructions that require attention and interventions are sometimes necessary | ||
| * Steal all the smartphrases! They are your best friend\\ | * Steal all the smartphrases! They are your best friend\\ | ||
| - | * ALWAYS put in specific wound care orders if needed, either in a nursing communication or in a wound care order. Be very specific it won't be done right.\\ | + | * ALWAYS put in specific wound care orders if needed, either in a nursing communication or in a wound care order. Be very specific it won't be done right. |
| + | * Refer to the wiki first for any questions. It has many resources including operative reports for different attendings' | ||
medical_student/university_intern_guide.1609900430.txt.gz · Last modified: 2021/01/05 21:33 by elliot