For the emergency medicine rotation, I presented eight H&P’s reflecting several different patient presentations including urinary tract infection, acute coronary syndrome, Bell’s Palsy, cardiac arrhythmia, rectal bleed, and pulmonary embolism rule out. My first H&P included assessment and plan at point of initial evaluation of the patient. I wrote up initial labs and imaging to be obtained as well as a differential diagnosis based on the initial evaluation. I received feedback regarding documentation of pertinent results and further work-up planned. I tried to implement these changes into subsequent H&P’s by getting as much information on lab results and imaging as possible. Including these pertinent findings allowed me to add a disposition regarding admission or discharge plan. Finishing up an H&P with all that information made for a clearer presentation and allowed for the reader to get a better picture of the patient and their work-up.

I also presented 10 pharm cards with details about indications, contraindications, drug class, adverse effects, and dosing. I chose medications that I would see being ordered while following patients in the ED. Pharm cards were useful as I found myself remembering doses and seeing how the mechanism of action of a drug is helpful in treating the given indication. I received feedback on needing to memorize adverse effects more thoroughly, as I had struggled with that during presentations. Adverse effects are important to keep in mind in order to warn the patient about what to expect with a given medication and assess if the benefit outweighs the adverse effects for a particular patient.

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