© 2014 Nile Chang
2018 David Burkholder
2018 David Burkholder
The second year emphasizes the development of clinical skills necessary to evaluate and treat patients in the emergency department setting. You will work closely with EM faculty to effectively investigate the chief complaint, consider diagnoses “not to miss,” and discern which diagnostic tests or studies are necessary to either identify or exclude emergency conditions. You will be the team leader in resuscitations and learn to approach patients with life, limb, or reproductive threats in an organized and prioritized manner. You will multitask and work to maintain patient flow as you gain confidence in your clinical decisions and enhance your ability to disposition patients effectively and safely. There will be one full EM block (4 weeks) based at Huron Valley-Sinai Hospital in order to obtain community medicine experience. All EM blocks will have shifts at DRH, CHM, and Harper University Hospital, with DRH being your main site. Shifts at Huron-Valley Sinai Hospital will be added into the assortment after the completion of your dedicated HVSH month.
Quite unique to DRH is the ED Critical Care block, during which you will spend a month in the DRH ED garnering concentrated bedside experience managing critically ill ED patients. You will spend 100% of your time participating in, learning from, and gaining perspective about critical care management in the emergency department. This is not an ICU-based rotation. With built-in faculty support, you will be responsible for participating in all medical and trauma codes and function as an adjunct “floating” resident for critical patients throughout the ED. During downtime, you will receive focused didactic training in areas such as sepsis, oxygen delivery, shock, therapeutic hypothermia, mechanical ventilation, difficult airway management, pharmacology, and pre-hospital critical care. You will also assist the intern ultrasound resident with procedural education by overseeing their procedures as well as ultrasounds scans until they are competent to perform these procedures on their own. By the end of the block, you can expect to have been involved in the care of approximately 80 critical patients and have performed dozens of critical care procedures, all within the emergency department.
We also provide a unique pediatric rotation associated with CHM — the Pediatric Intensive Care Unit. You will work out of Children’s Hospital of Michigan in their newly-renovated PICU. This is one of the few and one of the busiest PICUs in the state and you will care for patients who are transferred in from across the region. You will work as a member of an integrative team comprised of pediatric residents, EM residents, PICU fellows, Pediatric Intensivists, as well as Pediatric Cardiothoracic Surgeons. You will help manage rare pediatric conditions, congenital cardiac conditions, as well as post- cardiac or transplant surgical patients. You will receive thorough didactic education during this rotation, especially during your time spent on the cardiac team. You will learn essentials of pediatric resuscitation and pediatric critical care. You will care for pediatric patients of all ages, and rarely some adults admitted for known congenital issues.
In the Harper MICU, you will have senior resident responsibilities for managing critically-ill patients with complex malignancies, organ transplants, and end-stage medical conditions at this tertiary care center.