This service is responsible for providing General Medicine consultations for patients referred by the Emergency Physicians, including the screening of all potential admissions to the GIM Wards. Every effort is made to ensure that referrals in the Emergency Department are seen as quickly as possible, with the goal that all referrals are seen within 4 hours. This rotation will develop the Medicine Residents’ triaging and consultative skills. When screening potential admissions to the GIM Wards, the Medical Resident will:
Ensure that admissions to General Internal Medicine are appropriate, according to the UAH Admission Process.
Identify the major medical problems, and ensure that the patient is clinically stable.
If the patient is not clinically stable, please ensure that measures are taken to resuscitate and stabilize the patient. Please ensure that there is proper communication especially for unstable patients with the patient’s family, the Emergency Physician. There should be consultation with Critical Care if appropriate.
In most cases, the Medicine Resident will be able to confirm that a patient is an appropriate admission within a very short period of time. Given the shortage of emergency beds and long wait times, the designated time to make this decision is 2 hours.
If the patient is appropriate for admission to a GIM Ward, complete a focused, problem oriented consultation. Identify the major medical problems, list specific recommendations for the initial investigation and treatment.
Admission orders will be completed including assigning an Attending Physician.
If the Medicine Resident determines that the patient does not require admission to hospital and can be managed with outpatient follow‐up, or should be referred to another service, he or she will complete a more comprehensive written consultation and review the consultation with the attending physician. All cases will be reviewed with the Attending Physician before patients are discharged from the Emergency Department or referred to alternative services.
All patients referred and triaged in the emergency department will be tracked and recorded with appropriate handover over a 24 hour period.
The Medicine Resident on-call will also be expected to provide supervision and direction to students and junior residents as required for all admissions at night and on weekends.
Medicine Residents are encouraged to contact the Staff Consultant on call without delay, whenever they are concerned about the investigation, treatment, or disposition of any referred patient.