Trauma pts

[Pineapplesinhawaii]

Newbie in EMED here.

Wondering how I can get my foot into helping out in the trauma bay? It seems everytime a trauma pt comes in, the residents get to do everything...

[ohiovolffemtp]

In a facility that has residents, it's going to be tough.  They'll probably get prioritized for all procedures and then for supervised opportunities to run trauma assessments and trauma codes.  Take ATLS - it's often the initial hoop to jump through to get approved.  Take an ultrasound course, learn how to do the eFAST exam.  Try to become as official as possible, or even unofficial, part of the residents' training program.

[dmdpac]

If you don't want to compete with residents you'll have to find a gig with no residents.  Taking ATLS and becoming proficient in ultrasound are good steps.  I also recommend doing both.  However, in a teaching facility with residents present you can pretty much count on the fact that they will always take precedence.  That's why they're there.  To learn how to do these things.

[Randito]

Show initiative. Do both of the things recommended above. Let attendings know that your goal is to get more comfortable with trauma. Just standing in that background for a while to learn the flow and who does what is really helpful at first. Be specific about your goals. 6 months in, most of the EM interns have done plenty of EFAST and won't mind letting a really motivated PA take this over. Maybe there are shifts with no junior resident and the senior would be willing to let you intubate or start a CVL? Is there a particular shift when all the EM residents are in conference? Ask to work that particular shift every week. There are opportunities, but you have to create them. 

[EMEDPA]

I second the notion above to get a second job without residents present. 

[dphy83]

Getting a second job without residents may work, but you also should be aware that most likely won't be at a level 1 center because most trauma centers (at least level 1s) are academic centers with residents. So going elsewhere may not improve your chances of seeing or managing these patients by a significant margin. Obviously there are level 2s, level 3s, and community hospitals that see trauma patients for definitive care or at least stabilization, but the bulk of the interesting trauma goes to level 1s (as it should).

I'd agree with everything Randito said. And in my experience that is the case - residents often appreciate the help (at least at my residency they did).

Working nights may get you more access. Oh, and go ahead and work the night of the 4th of July

[ohiovolffemtp]

Looking at a map of trauma centers will be helpful.  It's possible that level 2 or level 3 trauma centers may see lots of challenging trauma patients based on geography.  Level 1 trauma centers may not be close.  Weather may not permit EMS to fly or drive the patient to the level 1 trauma center.  Level 3 trauma centers often don't have residents.