20 Tips to be the best PEM physician By Dr Mohammed Almutairi Department of pediatric emergency -KASCH
1️⃣ We are in pediatric emergency, dealing with little angels. We try to reduce their pain, repair their wounds, splint their broken bones and alleviate parents’ anxiety and worries.
We are all proud about our Pediatric Emergency Medicine.
We are all proud about our Pediatric Emergency Medicine.
2️⃣ PEM physician is not only a healer. We are professional PEM physicians. Professionalism include knowledge, skills, ethics, communications, collaborations, scholarly skills, team work, collegiality, spirit of inquiry, managements and leadership
3️⃣ Do not forget that you are a human ... you are a bunch of values and emotions
4️⃣ ‘Patient safety first’. In order to avoid medical error, update your knowledge, check your patients, review the orders, do not use abbreviations, use references and endorse your patient well.
5️⃣ Remember that ED doctor makes a difference. We reduce the admission rate, help in hospital patients flow, prioritize actions, do most of the procedures under PSA in ED, reach most of patient diagnosis in ED and work as teams together.
We do the best for our patients
We do the best for our patients
6️⃣ If you want to learn safe way in Pediatric emergency, learn the high index of Suspicions.
7️⃣ Never think that your patients come for fun. No one likes your emergency area
8️⃣ Look to your patient from all aspects - “ physical , mental and psychosocial “. You must find a reason why the patient was brought at 0300 AM
9️⃣In resuscitation room - lead, stand well ,listen, observe,talk clearly, complete orders , summarize and control the situation. You need that sharp look and decision.
1️⃣0️⃣You must have a plan B for critical actions . your second trial is not going to be the best. Try to have the best look, best act and best decision from the start.
All PEM leaders are competent and highly qualified; they differ in who have got a plan B and who do not.
All PEM leaders are competent and highly qualified; they differ in who have got a plan B and who do not.
1️⃣1️⃣Sometimes, you may need to think loudly with your colleagues, present your case again and put everything together. It may help you reach the diagnosis and right decision
1️⃣2️⃣There is nothing called quit shift or nonteaching one in emergency department, you can fill it with many tasks, review the protocols, check the settings, visit the triage, observe the patients flow . Check the equipment and read about procedures.
1️⃣3️⃣"This is a common case, what I should learn?”- This is a negative question. You have to avoid this. You could present any case as a case of multiple problems and then analyze each problem and solve it .
1️⃣4️⃣If your patient stays uncomfortable, you must stay uncomfortable and stressed till you clarify why he has this kind of distress or misbehavior.
1️⃣5️⃣If you order any test or radiological assessment, you must take your time to review and analyze; do not wait for other to do it .Use others as a verification system
1️⃣6️⃣ Observation is a good assessment tool in pediatric emergency; the patient may give you hints with time.
1️⃣7️⃣ Try to absorb all anger from parents and patients’ relatives. This is most likely not their usual form. They lose their control due to the sickness of their lovely kids.
1️⃣8️⃣ Do not ever think to get rid of your patient by dumping to second shift or early admission. You may reach no diagnosis or decision, but be clear why you admit and extend time in ED
1️⃣9️⃣ There are many people around you. Learn something valuable from all of them - consultants, residents, nurses, managers and other leaders. You may just need to observe more and more.
2️⃣0️⃣Enjoy your shift. Every shift should have a story to tell later - happiness, pain , fun , drama, tragedy, grief and death. You may also see all types of personalities in one shift.
Good luck 🌹and happy holidays
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