Welcome to the Temple Emergency Medicine Rotation!
Temple University Hospital is a special place, congratulations on the opportunity to be a part of the team!
Temple Emergency Department is considered high volume: between 2019-2020, Temple ED had ~100,000 patient visits!
Temple is located in an area of profound socioeconomic disadvantage; our average patient faces a daily struggle to to get access to basic resources. The majority of our patient population has been directly affected by gun-violence and the opioid epidemic. Remember to keep these things in mind on your rotation if you encounter a patient that appears angry, distrustful, or afraid.
On your rotation, there will be times where the Emergency Department appears to be pushed beyond the capabilities of its staff. Times like this are an opportunity for you to shine by giving your team a heads up at a key moment. You've probably heard it a million times, but if a patient looks sick and you're the only person who has seen them, let a senior resident or attending physician know as soon as possible (definitely before taking a social history).
- Ask an attending which patients would be appropriate for you to see, or if you are interested in something specific, let us know early so we can keep an eye out.
- You are here to learn; if a critically ill patient arrives or is being resuscitated, make your way over as soon as you can!
- If you ever have a question or concern, feel free to ask/tell a resident, nurse, or attending.
- If timing seems appropriate ask to help with procedures, you may even get to do it yourself! There is a copy of Roberts and Hedge's, a massive procedure book in the red zone. You can look up any procedures (nerve blocks, joint reduction techniques, you name it) and it provides a step-by-step guide with pictures.
- Please feel free to run ideas by senior residents before speaking with an attending if you have questions about your patients, we are more than happy to help make you look good.
- Gown up during medical codes; you might be asked to help with CPR.
Temple is a high-volume level 1 trauma center located near an area where traumatic injuries of all kinds are unfortunately quite common. A Level 1 trauma center has all the resources and capabilities to handle any patient with any injury who comes through the door. At Temple, you may notice that our level 1 status is often put to the test several times a day, 24/7. Our Emergency Medicine team works closely with the trauma surgery service to rapidly assess and provide stabilizing treatment to critically ill and injured patients.
Medical students are almost always welcome to observe trauma care and there will be opportunities to help out as well. The exception is when the trauma bay becomes crowded with too many medical providers. If you are ever asked to leave the room, don't take it personally, they kick out other medical staff all the time; trauma surgery is all about efficiency, sometimes less is more when you have enough staff.
Try to stand in the back of the room when observing, and ideally ask an ED resident or attending if there is anything you can do to help.
You may see some disturbing things, and it may further disturb you to see the ED staff seemingly move on to their next task as if nothing just happened. The last thing we want is for you to be struggling with what you just saw alone; you are not alone! If someone doesn't debrief with you on something you saw, approach an attending or senior resident and ask if they can take a moment to walk you through what just happened in the trauma bay (this also applies to anywhere else in the ED too!). We all grow as humans and as doctors in taking a few moments to talk about our experiences and debrief. As a general rule, we always try to take a moment of silence when a patient passes away.
Life as a medical student is tough, and the Emergency Department setting might be one of the tougher places to have the medical student role. Please know that we want you to feel welcome, and we want you to have a life-changing experience. Sometimes it might seem like a resident or attending doesn't have time to talk to you; we've probably just got temporary tunnel vision due to a critically ill patient, or are occupied by some temporary chaos. Always remember that we are here to help you succeed as doctors!
Temple Emergency Ultrasound
We love ultrasound at Temple and we have a robust ultrasound program including a fellowship, a medical student rotation, and several Emergency Medicine ultrasound-trained instructors on faculty.
If you are on a shift with an ultrasound faculty member, take advantage of their knowledge. 9 times out of 10, the answer to whatever question they have about your patient is, "we should use the ultrasound".
Click the Temple Owl logo to head over to the Temple EM Ultrasound home page to learn more!
Photo credit Eric Curran, MD