For my first site evaluation, I presented a few patients that I had seen in the OR and in the clinic. One of the more complex cases that I saw involved a woman with a left upper lung nodule which appeared as a ground glass opacity on CT. The woman was scheduled for a left upper lobectomy to excise the nodule and test for malignancy. The woman underwent successful thoracotomy with lobectomy and was transferred to the SICU for close monitoring during her recovery. Although this patient was slightly more complex than many other patients I interacted with, I found her story to be fascinating and enjoyed discussing it with my site evaluator. We reviewed the many factors that needed to be addressed once she was admitted to the SICU such as extubation, monitoring chest tube output and foley output, restarting home medications and when to begin enteral feeding. Professor Rachwalski reviewed my SOAP notes very carefully and provided me with guidance to improve my SOAP notes. I also prepared five drug cards for my site evaluation. One of the more interesting drugs that I included was dantrolene – a medication used to treat malignant hyperthermia. As malignant hyperthermia is induced by a reaction to anesthesia, I thought it was interesting to learn more about it and be familiar with the presentation of the reaction. 

For my second site evaluation, I prepared another four patients to discuss with Professor Rachwalski. One of these patients presented with bilateral deQuervain’s tenosynovitis. I chose to address this case in my research article that I presented. The article addressed whether methylprednisolone acetate injections with thumb spica cast are more effective than thumb spica cast alone. The study concluded that injection in combination with casting is the most effective approach. This is the treatment modality that we chose for our patient. I also prepared five drug cards for this site evaluation. Professor Rachwalski reviewed my SOAP notes with me, and I was pleased to see that my SOAP notes had improved from my first site eval. I was careful to include the suggestions and guidance that Professor Rachwaslki had given me during my first site eval and I saw that it really made a difference and improved my SOAP notes. I was glad to see that I had made improvement and I look forward to continuing to improve in this area.