VA URGENT CARE CENTER
Dr.__________________________,
You are assigned to the VA URGENT CARE CENTER from__________________ to
________________________.
Orientation: Email Dr. Campisi (Michele.Campisi@va.gov) at least one week prior to the
start of the rotation to obtain your schedule. Make sure you have your fingerprinting done at
least 1 month prior to your rotation; it is necessary in order for you to receive clearance (it
takes at least 2 weeks for processing before you can receive your ID or computer access).
Richell Richardson (Richell.richardson@va.gov) is your contact for your ID as well as your
computer access, her office number is 504-565-4940.
Responsibilities: Interns and Residents are expected to manage their individual patients
under the direct supervision of the Urgent Care faculty.
Conference: All resident are expected to attend EM conference and journal club.
Procedures: All procedures must be recorded in New Innovations.
Supervision: You will be supervised by board certified Emergency Medicine physicians.
Evaluations: Monthly evaluations via New Innovations.
Meals: Resident Responsibility.
What follows are the goals and objectives for the Urgent Care rotation, that will range from a 2
week to 1 month rotation, as assigned by the Program Director. The rotation will take place in
the VA Urgent Care Center. The year of training may include PGY 1-5.
LSU Emergency Medicine Residency Program
Southeast Louisiana Veterans Health Care System
Urgent Care Rotation
GOALS and OBJECTIVES
What follows are the goals and objectives for the VA Urgent Care rotation, that will be a 1
month rotation, as assigned by the Program Director. The rotation will take place at the SLVHCS
Urgent Care Clinic. The year of training may include PGY 1-5.
The educational goals and objectives for the VA Urgent Care rotation are to provide residents
with an opportunity to experience and learn about the initial evaluation and management of
walk-in veteran patients, including the following:
1) Perform basic assessment of patients with a variety of mild to moderate traumatic
conditions.
2) Formulate a differential diagnosis for patients with various kinds of traumatic conditions
and mechanisms of injury.
3) Order and interpret appropriate diagnostic laboratory and imaging studies for minor to
moderate trauma patients.
4) Competently perform minor procedures such as suturing of lacerations, incision and
drainage of the abscesses, insertion of nasogastric tubes and urinary catheters, lumbar
puncture, splinting of fractures and sprains, spinal immobilization.
5) Demonstrate basic understanding of the principles of ACLS and ATLS resuscitation as
applied to persons in cardio-respiratory arrest.
6) Achieve ability to perform an adequate history and physical exam, prioritize conditions,
and form a differential diagnosis in adults with acute and chronic medical problems of
varying severity presenting to the Urgent Care for care.
7) Learn proper methods for stabilization of patients prior to transfer to an emergency
department with life threatening conditions such as sepsis, respiratory failure, acute MI,
CHF, status epilepticus, status asthmaticus, cardiac arrhythmias, severe GI bleeds, and
overdose.
8) Learn to evaluate, diagnose and initiate any needed therapy for a variety of specific
medical problems such as asthma, seizures, anemia, stroke, GI disorders, urinary tract
infections, pneumonias, and other respiratory illness.
9) Learn to evaluate and appropriately manage a variety of patient complaints such as
chest pain, abdominal pain, dizziness, headache, syncope, etc.
10) Learn to perform an adequate history and physical exam in female patients with
gynecologic problems or problems related to early pregnancy including abdominal
bleeding, infection, threatened abortion, and ectopic pregnancy.
11) Learn appropriate use of diagnostic lab and imaging studies for emergency patients and
to have basic competence in their interpretations.
12) Learn to use the following diagnostic aids: pulse oximetry, arterial blood gases, EKG’s.
13) Perform the following procedures with basic competency and to know indications and
contraindications: insertion of a Foley catheter, thoracentesis, paracentesis, lumbar
puncture, wet prep of vaginal secretions.
14) Become familiar with common medico-legal problems which present in urgent care
practice such as: consent, desertion, AMA, restraints, impaired patients, adult abuse or
neglect.
15) Be able to arrange appropriate follow-up for discharged patients and give adequate
discharge instructions.
16) Learn and use the available contributions of the Social Services and Mental Health
Depts. to patient care in the ED and for discharge planning.
17) Learn appropriate medical evaluation of mentally disturbed patients including
techniques for restraint and control of violent patients.
18) Learn about billing as it pertains to VA patients.
19) Learn about transplant patients.
20) Learn about geriatric presenting complaints.
The clinical and didactic experiences used to meet those objectives included daily patient care
in the VA Urgent Care, along with bedside teaching. This rotation experience is part of the
greater emergency medicine curriculum, also including PALS/ACLS/ATLS provider and instructor
certification and weekly didactics (part of the overall didactic curriculum).
The feedback mechanisms and methods used to evaluate the performance of the resident
include an end of rotation global evaluation. Immediate feedback may also be given to the
resident, and any significant problems will be discussed during the rotation with the LSU EM
administration.
The resources and facilities in the institution that will be available to each resident include
computer access to Up To Date and the VA Library services, including current texts in emergency
medicine.
The clinical experiences, duties and responsibilities the resident will have on the rotation:
Residents will act as a part of the Urgent Care team under the supervision of a staff physician.
The residents will participate in the initial management of urgent care patients, to include
trauma, psychiatric, obgyn, and general medical patients.
The relationship that will exist between emergency medicine residents and faculty on the
service: The overall goals of resident education and patient care will govern the relationship
between faculty and residents. Residents will receive supervision while on the rotation. All
patient care and medical charts will be reviewed and signed by the VA Site Director or other
staff physician prior to patient discharge.
Duty hours for this rotation will be an average of 50hrs every two weeks. The VA Urgent Care is
open from 8a-8p Monday through Friday. It is closed on weekends and Federal holidays. The
residents will initially follow the monthly schedule of the VA Site Director until other emergency
medicine faculty are credentialed at the facility.
This rotation summary has been reviewed and agreed to by the service director and LSU
Program Director.