Introduction to Harborview Trauma Call
Ortho Call at HMC can be very busy with the shear volume of patients that the residents see as the consult resident. Also most of those consults we see need a reduction of a fracture or a relocation of a joint, and then some sort of splint or pin to stabilize the limb. Therefore each consult can be labor intensive. In the first half of the year, 4th year medical students come from all over the country to do sub-internships at HMC and help out the person on call to see if this is the kind of program for them. The second half of the year we don't usually have anyone to help us out. That's where UW medical student come in. Those of you whoare interested in Ortho, ER, Sports Medicine, or Primary Care can come follow the resident around and learn about the care of fractures and dislocations. As a medical student it was about the only rotation where I felt like I was actually useful to the team.
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1) Log in at:
username:htc
password:htc@00SMIG(those are zeros)
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To add a date:
1) Click on the "Add+" link at the top of the calendar.
2) Enter your name and class and the date you're signing up for.
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2) This will open a new window. Click on the "more" link.
3) Click the "Edit" tab.
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All the information you would ever want to know!(From the Residents)
Preparing the day before
Get plenty of sleep the night before. The residents would reallyappreciate it if the medical students planned to take 12 (weekday) or 24hr(weekend) shifts. This allows us to maximize the time that you guys canhelp out, we can spend teaching (instead of orienting), and should providethe best experience for everyone. Another key piece of advice to make itthrough a long evening is to stay hydrated. It's easy to forget to drink
when there's a lot going on, but it's a lot easier to stay awake andfunctional when you're hydrated.
Where do I go when I arrive?
When you arrive at Harborview, the best place to enter is the Emergency Department. You can head to the front desk, and ask them to use the phone to page the ortho resident on call, or page the resident from your cell phone (instructions in the next section). Ultimately, the resident will tell you where to go (The “On-Call” room or “Fish Bowl” after you have gotten in contact with them.
When to arrive and what you do upon arrival
On weekdays, I would plan on showing up between 6 and 7pm, on weekends,
please arrive around 6:45 am (NO later than 6:55am), as we have sign-out at
7am. This can be an excellent learning experience, as we will go over cases
in the morning that will be handed off to the oncoming team, and often these
discussions revolve around ER workup, management, and indications for
surgery, etc.
To page the ortho resident, dial4-3000 (or 744-3000 from an outside line) and ask the operator to page the orthopedic consult resident to whatever number you are at. Tell them you are a UW medical student who is signed up to follow them around. Whoever is on call can direct you and give you a quick orientation. If it is busy, they may have the intern do those things.
If you want to make your lives easier -
pick up scrubs beforehand either from the UW or Harborview. You can drop
your stuff on in the sixth floor call room (I'll have to get back to you on
the exact room number), and we can give you the call room passcode when you
call. Plan to meet us down in the fishbowl (if we're not there, we're
either in the cafeteria, the call room, or one of the resuses.
What read about beforehand
The most common consults are probably ankle
fractures and boxer's/distal radius fractures, following that you can see
just about anything, from femur and tibia fractures to pelvic and acetabular
injuries, to spine injuries. I would read about the former ahead of time so
you have a general idea what we focus on, and the remainder you can pick up
on the fly. Feel free to ask for any suggested reading articles - and
please share the wealth. If there's something that we don't know as well as
we would like, sometimes the most helpful thing is to help us look stuff up.
Expectations
We really need your help. Sometimes that means having you
scribe while we perform a history and physical exam, and sometimes that will
mean helping us hold a leg or helping get splint material or local
anesthetic material ready. Anything that you can do to expedite our ability
to see patients makes you invaluable. Just be aware that different R2's
will have different comfort levels with having you do things. The more you
work with us, however, and the more you seem to know, then the more
comfortable we'll feel giving you some level of responsibility/autonomy.
The splint buckets
These are generally pre-made for short leg splints. The
materials that should be in each short leg are posted on the card in the
splint room. In general, this consists of:
Two stacks of 5 layers of six inch plaster
One stack of 10 layers of six inch plaster
6 four inchwebrils
1 six inch bias (yellow cotton roll)
Three stacks of fluffed webril padding
Four or six inch primapore tape to finish off the
splint.
For a long leg splint, we'll need all of the above plus
Two more stacks of 5 layers of six inch plaster
At least four six inch webril rolls
For a long arm splint, we'll need
Four stacks of 8 layers of four inch plaster
About six three inch webril rolls
One four inch bias roll
Tape (four inch primapore)
These are the most common forms of splints placed in the ER. We'll be happy
to help show you guys how we like to put these on and what we're looking for
when we reduce fractures and place molds. Please let us know what questions
you have.
Feel free to email us at
Or visit our webpage at
- The OSSMIG Team