For my first site evaluation, I presented two patients. The first patient that I presented was an experience that I will carry with me for a long time. A pregnant patient presented with vaginal bleeding. She was three months pregnant and had recently migrated to the US. Upon beginning the pelvic exam, it became clear that she was having a miscarriage. I presented this patient and discussed with Professor Mohamed the various learning moments I had throughout this case. This was the first time that I did a pelvic exam on a patient and I was able to visualize the products of conception in the vaginal vault. We discussed the important of providing emotional support to patients and recognizing the pivotal role that we play in these moments. I also prepared a patient that I had seen who had presented to the ER with classic symptoms of appendicitis. I was excited to discuss this patient because his story seemed so in line with the description of appendicitis that we had been taught. However, it became an even greater learning experience for me because the patient’s CT came back normal. This was important for me because it reminded me that although patients may present in ways that suggest specific diagnoses, it is important to keep an open mind when treating them. I also prepared five drug cards for this site evaluation based on drugs that I had seen used in the ER.
For my second site evaluation, I prepared another set of five drug cards. We discussed these drugs and Professor Mohamed shared clinical pearls with us about each drug based on his experience in the ER. It was very helpful to hear more about the drugs from a provider that uses these drugs to treat patients and to hear more about how they can be used clinically. I also presented a patient that I had seen in the ER. This patient came to the ER with complaints of left eye pain and swelling. The PA and I were concerned for preseptal vs orbital cellulitis and I had the opportunity to perform fluorescein staining as well as measure the intraocular pressure. This was a great experience for me as well because I had not previously done an eye workup and was able to use instruments I had not used before. I also included a journal article about the use of corticosteroids in the treatment of preseptal and orbital cellulitis. Although corticosteroids are not considered standard of care when treating these diagnoses, it was interesting to learn about their benefits and why a provider may choose to use them.