Cardiology Rotation RJH Jan 4th to Jan 29th
Week 4
This last week has flown by, I rounded with the CCU team in the mornings and then spent the afternoons in the anticoagulation clinic. I also taught the warfarin class this week and continued to do discharge counselling. On Thursday I did some bridging for two patients, counselled them, helped them practice saline injections and organized special authority for their LMWH. I also gained experience interpreting a Vancomycin and Gentamicin level for a patient with polymicrobial endocarditis. This cardiology rotation has been very unique compared to other rotations, I have had many opportunities to watch cardiac procedures, tests and practice physical exam skills (blood pressure, feeling for irreg pulses, listening for S3/S4 sounds). I have really enjoyed the chance to learn about cardiology from a medical and medication perspective.
Week 3
During my third week I have continued to round with the CCU team, teach warfarin class and counsel patients at discharge. I have also gone to the anticoagulation clinic where I learned how to do the LMWH injection and tried a test injection with saline so I can help teach patients. I also shadowed a cardiologist while he performed a pulmonary ablation procedure to cure a patient of atrial fibrillation. This procedure was very interesting to watch; the patient is under general anesthesia while the physician makes a map of the left atria and then makes burn marks around the pulmonary veins to stop the unwanted conduction. I am currently continuing to work on a second drug information question about the efficacy of rectal aspirin post CABG.
Drug Information Question: ASA Supp Post CABG
Week 2
Having just finished week 2, I am really enjoying my cardiology rotation. This week I rounded with the CCU team (medical students and residents). This experience has helped me to advance my knowledge of cardiac procedures and diagnostic tools. I helped the team by doing medication reconciliation for newly admitted patients and helped identify drug interactions. I also did discharge teaching for patients leaving the cardiac ward on new medications such as a statin, ASA, Plavix, an ACEI and a beta blocker. I also assessed compliance and tried to improve medication compliance for a few patients by suggesting medication calendars or by organizing blisterpaks with their community pharmacy. I also helped the team by talking about cardiac medications (inotropes, vasopressors) and particular drug interactions that came up in rounds (PPI + Plavix, NSAID + ASA). Finally, I taught my first two anticoagulation classes this week which were very successful with 4 patients in each class.
Week 1
During my first week I have become oriented to the CCU and 4 Royal. I also attended one of the anticoagulation classes that I will start teaching next week and shadowed in the anticoagulation clinic. This week I started to work up CCU patients and joined nursing rounds. At the end the first week I shadowed a physician in the Cath Lab where I watched 4 procedures. I saw both radial and femoral catheterizations for diagnostic and stenting purposes. This shadowing opportunity was really interesting and a great way to learn cardiac physiology.
