Site Evaluation

Over the course of this rotation I had two site evaluations, for which I prepared three H&Ps and one journal article. Both of the site evaluations were held over zoom with two other students present. The two other students were completing their rotation at another hospital’s emergency room. I appreciated having the meeting with them present because I was able to see how the culture of different hospitals plays into patient care and treatment plans. We were able to discuss how each hospital deals with different issues and learn from each other.

For the first site evaluation I presented a patient who presented to the fast track area complaining of pain in her great toe. She was diagnosed with gout. The reason I chose to discuss this patient was because I was really fascinated that people really do present as we learn in class, sometimes. I went to speak with the patient on my own and when I came to discuss her with the provider I was certain she had gout. It felt really cool to finally see this diagnosis in real life, complete with many of the details we had learned about. For example, the pain was on her great toe and she also admitted to having a diet rich with red meat and seafood. The other patient I wrote about, but did not present, had a cecal volvulus. One of the feedbacks I got was that I should have presented this patient because it had more to discuss and more teaching points. For my next site evaluation I was determined to find and present a patient with more to discuss.

For my last evaluation I presented a patient going through alcohol withdrawal. This patient had a lot going on being that he also had the flu. We were able to discuss many points including the CIWA score (the score used to assess for alcohol withdrawal syndrome) and the treatment of alcohol withdrawal syndrome. Noting the importance of proper dosing of benzodiazepines in order to prevent worse outcomes with alcohol withdrawal, being that it can be fatal. I also presented a journal article discussing the benefits of adding a single dose of phenobarbital to the regimen of benzodiazepines for alcohol withdrawal.