ACADEMIC YEAR REVISED: 9/15/11

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E

LECTIVE

A

DDENDUM

A

PPROVED

A

FTER

J

ANUARY

1, 2011

FOR

THE

2011-2012 A

CADEMIC

Y

EAR

R

EVISED

:

9/15/11

This summary listing electives approved or renewed after January 1, 2011. They are not included in

the printed version of the 2011-2012 Handbook of Courses.

NEW ELECTIVES:

Elective profiles are listed following on the following pages of this section.

COURSE # COURSE NAME

_L

_OCATION

D

ATE

A

DDED

P

AGE

EM220.01 Emergent Bedsides Procedures UCLA/HAROR

7/20/11

1 MD455.01 Surgery and Anesthesiology Critical Care

Medicine

UCLA 9/12/11 2

ME210.09 Cardiology: Heart Failure and Transplantation

CS

9/15/11

3

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EM220.01

EMERGENT BEDSIDE PROCEDURES

Advanced Clinical Clerkship Location: UCLA/HARBOR 2011-2012

Revised: 7/12/11

STUDENT EXPERIENCES

CLOSE CONTACT WITH: X FULL-TIME FACULTY X CLINICAL FACULTY X FELLOWS

X RESIDENTS X INTERNS

X OTHER: Critical care nurses N/A

COMMON PROBLEMS/DISEASES 1. Head and neck emergencies 2. Establishing a surgical airway 3. Needle, tube and resuscitative

thora-cotomy

4. Advanced wound repair techniques 5. Diagnostic peritoneal lavage 6. Reduction of fractures and dislocations 7. Regional anesthesia in the ED 8. Central venous access

APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 10 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: N/A

TYPICAL WEEKLY SCHEDULE

Hour Monday Tuesday Wednesday Thursday Friday

AM

PM

ON-CALL SCHEDULE & WEEKEND ACTIVITIES: None

ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: Housing is available for externs at Harbor-UCLA. Scrubs may be worn for the entire rotation.

DESCRIPTION:Give students the opportunity to learn and practice the rapid recognition and management of life and limb threatening injuries at the bedside. Students will receive an in-depth review of the relevant anatomy and pathophysiology, interpretation of formal and bedside diagnostic imaging, and hands-on cadaver-based experience with managing each injury. Students will also perform procedures in the Harbor-UCLA Emer-gency Department under supervision, and will attend Harbor UCLA’s EM Grand Rounds and procedure conferences. It is our hope to provide a meaningful learning experience that will give students a skill set they may call upon in managing critically ill and injured patients in their residency training and beyond.

2011-2012 ROTATIONS BEGIN WEEKS: 33

DURATION:

STUDENTS / PERIOD: max 20 min 6 AVAILABLE FOR EXTERNS: Yes College Affiliation: Acute Care College

REPORT TO: . Dr. Sam Clarke, location TBD (either LRC room of CHS 13-060) at 9:00 AM

STUDENT COORDINATOR:

Lucy Hadley (310) 222-3501

E-MAIL: [email protected] SUPPORTING FACULTY:

Ravi Morchi, MD, Jamie Wikenheiser, PhD, Wendy Coates, MD

COURSE CHAIR: PHONE #:

Sam Clarke, MD (310) 222-3501

COURSE OBJECTIVES (in order of importance)

PHONE #:

1. Establish an understanding of the pathophysiology underlying traumatic injuries

2. Demonstrate knowledge of the relevant anatomy associated with multiple traumatic injuries

3. Understand the indications for performing common emer-gency procedures

4. Demonstrate proficiency in performing the following proce-dures on a model: 1. Lateral canthotomy; 2. Posterior nasal packing; 3. Nasal septal and auricular hematoma drainage and placement of a pressure device; 4. Cricothyrotomy; 5. Needle and tube thoracostomy; 6. Resuscitative thoracotomy; 7. Diagnostic peritoneal lavage; 8. Central venous catheter placement, with and without the use of ultrasound guidance; 9. Closed reduction of anterior shoulder dislocation, hip disloca-tion; 10. Closed reduction of wrist and ankle fractures; 11. List indications for regional anesthesia of face, upper and lower, extremity in the acute care setting; 12. Perform regional anes-thesia techniques listed above on a model.

5. Demonstrate use of ultrasound in venous access procedures and as an adjunct to regional anesthesia (brachial plexus block, femoral nerve block) in the acute setting.

6. Demonstrate proficiency in interpretation of radiologic studies relevant to each injury.

7. Understand the indications for various advanced wound clo-sure techniques including mattress, corner stitch, V-Y, ad-vancement flaps, subcuticular closures, and demonstrate proficiency for each on a model.

Course Introduction Head and Neck

Anat-omy Intro to Emergent ENT

Procedures

Procedures Shift at Har-bor-UCLA Emergency Department

Thoracic and Abdominal Anatomy Intro to Emergent

Tho-racic and Abdominal Procedures

Harbor-UCLA EM Resident Conference

Advanced Wound Care Work Shop

Cadaver Lab Head and Neck

Procedures Shift at Har-bor-UCLA Emergency Department

Cadaver Lab Thoracic and Abdominal

Procedures

Use of Ultrasound as an Adjunct to Emer-gent Bedside

Proce-dures Cadaver Lab Regional Anesthesia and Reduction of Fractures/Dislocations PRIMARY CARE: DURATION: 2 weeks E-MAIL: [email protected] INPATIENT: OUTPATIENT: CONSULTATION: N/A 20% N/A

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MD455.01 SURGERY

AND ANESTHESIOLOGY CRITICAL CARE MEDICINE

Subinternship\Inpatient Location: UCLA 2011-2012

Revised: 9/12/11

CLOSE CONTACT WITH: X FACULTY

CLINICAL FACULTY FELLOWS

X RESIDENTS INTERNS

X OTHER: Nurses, Nurse Practioners, Respiratory Therapists

100% COMMON PROBLEMS/DISEASES

1. Respiratory failure & mechanical ventilation 2. Cardiogenic shock

3. Vasodilatory shock and use of pressors, inotropic agents and pacing

4. Hemorrhage, hypovolemia, resuscitation and transfusion

5. Acute renal failure and oliguria

6. Delirium and acute mental status changes 7. Cardiac rhythm disturbances

8. Atrial fibrillation and cardioversion

APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 3-5 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 50

AM

PM

ON-CALL SCHEDULE & WEEKEND ACTIVITIES: Two weeknights/week (Mon-Fri). On-call students will remain in-house until ~ 11pm ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: Sign out rounds are with the outgoing/overnight ICU attending.

Each day the student will meet with primary and consulting services and establish multidisciplinary care plans for patients.

DESCRIPTION: This sub-internship in surgical anesthesiology critical care medicine is designed to not only teach complex physiology and pharmacology but also to expose medical students to the specialties of surgery, anesthesiology and critical care medicine. Students are on a team of physicians, advanced prac-tice nurses and other healthcare professionals, caring for critically ill patients in the Cardo-Thoracic ICU. Our 24-bed CTICU is staffed 24 hours a day with in-house attending coverage. A rigorous didactic and bedside education program is in place for student education. The CTICU focuses on caring for patients before and after complex cardiothoracic operations including single or multiple cardiac valve replacement/repair, coronary artery bypass surgery, heart and lung transplantation as well as mechanical cardiac support. In addition to cardiac, aortic and general thoracic cases, students will manage a wide variety of patients following complex trauma and major surgical operations. Students also will be exposed to the care of patients transferred from outside hospitals.

2011-2012 ROTATIONS BEGIN WEEKS:

2, 5, 8, 11, 14, 17, 20, 27, 30, 33, 36, 39, 42, 45, 48 DURATION: weeks

STUDENTS / PERIOD: max 3 min 1 AVAILABLE FOR EXTERNS: Yes

COLLEGE AFFILIATION: Acute Care College

REPORT TO: Dr. Meltzer in the Cardio

-

Thoracic Intensive Care Unit (7

-

ICU) @ 7:30 am

STUDENT COORDINATOR:

Iris Mau 310-206-2567

E-MAIL: [email protected]

SUPPORTING FACULTY:

Anesthesiology: J. Meltzer, A. Dhillon, V. Gudzenko, S. Singh, R. Steadman, M. Steigler & D. Boldt; Surgery—M. Fink & J. Hiatt

Drs. Mitchell Fink & Joseph Meltzer 310-267-7745

PHONE #:

1. Demonstrate knowledge of mechanical ventilator techniques, including basic venti-lator techniques (synchronized intermittent mandatory ventilation, assist/control ventilation, pressure-support ventilation, continuous positive airway ventilation [CPAP]), advanced ventilator techniques (high-frequency/oscillation, prone, airway pressure-released, Bi-Level), non-invasive ventilator support and assessment pa-tients for initiation and discontinuation of mechanical ventilation.

2. Assist in the management of cardiopulmonary resuscitation; assist in the manage-ment hypovolemic, vasoodilatory, cardiogenic, neurogenic/spinal and anaphylactic shock; assist in the diagnosis and management of the systemic inflammatory re-sponsesyndrome (SIRS) and the multiple organ dysfunction syndrome (MODS), including fluid and transfusion therapy.

3. Treat infections, including patients with systemic infections (wound infections, pneu-monia, peritonitis, sepsis, and septic shock)

4. Assist in the management patients with hemodynamic instability and cardiac dys-function, including mechanical cardiac support tools, such as intra-aortic balloon pump (IABP), venovenous and venoaterial extracorporeal membrane oxygenation, and ventricular assist devices (VADs); assist in the management oof pacemakers (Implanted, transthoracic, transvenous, percutaneous), defibrillators (external, AICD), and inhaled nitric oxide and prostacyclin.

5. Identify and manage malnutrition and assist in the institution of enteral and parental nutrition

6. Manage disorders in fluid, electrolyte and acid-base balance 7. Manage patients with liver and kidney dysfunction

8. Assist in the management patients both pre-and post lung and heart transplantation 9. Promote patient safety in the ICU including prophylaxis against gastrointestinal

hemorrhage,

10.Exhibit good judgment in stressful situations

6:00-6:45 Sign out rounds 6:45—8:30 Pt. care 9:00—11:30 Formal teach-ing rounds in CTICU 11:30— 2:00 Pt. care

6:00-6:45 Sign out rounds 6:45—8:30 Pt. care 9:00—11:30 Formal teaching rounds in CTICU

11:30— 2:00 Pt. care

6:00-6:45 Sign out rounds

7:00—9:00 Attend Anesthesia or Surgical Grand Rds 9:00—11:30 Formal teaching rounds in CTICU 11:30— 2:00 Pt. care 6:00-6:45 Sign out rounds 6:45—8:30 Pt. care 9:00—11:30 Formal teaching rounds in CTICU 11:30— 2:00 Pt. care 6:00-6:45 Sign out rounds 6:45—8:30 Pt. care 9:00—11:30 Formal teaching rounds in CTICU 11:30— 2:00 Pt. care 2:00– 3:00 “ICU 10”

Didactic Lecture Series 3:00 - 4:00 Pt. care 4:00—4:45 Sign out rounds

2:00– 3:00 “ICU 10” Didactic Lecture Series 3:00 - 4:00 Pt. care 4:00—4:45 Sign out rounds

2:00– 3:00 “ICU 10” Didactic Lecture Series 3:00 - 4:00 Pt. care 4:00—4:45 Sign out rounds PRIMARY CARE: 3 E-MAIL: [email protected] INPATIENT: OUTPATIENT: CONSULTATION: 15% 85%

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ME210.09

CARDIOLOGY: HEART FAILURE AND TRANSPLANTATION

Advanced Clinical Clerkship Location: CS 2011-2012

Revised: 9/15/11

CLOSE CONTACT WITH: X FULL-TIME FACULTY X CLINICAL FACULTY X FELLOWS

X RESIDENTS X INTERNS

X OTHER: Nurse practitioners and pharmacists 100% 0% 10% 90% COMMON PROBLEMS/DISEASES

1. Acute decompensated heart failure 2. Cardiac arrhythmias

3. Myocardial infarction 4. Heart transplant rejection

5. Opportunistic infections after transplan-tation

APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 10-15 TOTAL # OF PATIENTS EVALUATED EACH MONTH BY ENTIRE SERVICE: 50-70

AM

PM

ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS:

DESCRIPTION: Students will gain an understanding of the physical examination, diagnosis, and management of patients with advanced heart failure, inkling the role of evidence-based therapies, pulmonary artery catheterization, and heart transplantation. They will also learn to manage the long-term complications of patients post heart transplantation.

2, 5, 8, 11, 14, 17, 20, 27, 30, 33, 36, 39, 42, 45, 48 DURATION:

COLLEGE AFFILIATION: Academic Medicine College STUDENT COORDINATOR:

Judy Jacobs (310) 423-4658

Drs. Jon Kobashigawa, Jaime Moriguchi, Michele Hamilton, Antoine Hage, Jignesh Patel, Babak Azarbal, Lawrence Czer, and Ernst Schwarz , David Chang

Michelle M. Kittleson, M.D., Ph.D. (310) 248-8300

PHONE #:

1. Gain knowledge in the pathophysiology, natural history, appro-priate diagnostic evaluation, and therapeutic approach to heart failure.

2. Demonstrate proficiency in the physical exam findings of decompensated heart failure.

3. Apply evidence-based medicine to the treatment of decom-pensated heart failure.

4. Use hemodynamic data from pulmonary artery catheterization to guide therapy of patients with decompensated heart failure or heart transplant rejection.

5. Develop a basic understanding of the interpretation of echo-cardiograms, pulmonary artery catheterization, and coronary angiograms.

6. Indentify the indications and contraindications to heart trans-plantation.

7. Understand the pharmacology of immunosuppression therapy and treatment of heart transplant rejection.

8. Gain knowledge of the common short– and long– term compli-cations of heart transplantation.

7:30 Pre-rounds with resident/intern 9-10:30 Rounds with

attending and fellow 10:30-11:00 Didactic teaching with attending 11am-12pm Follow-up

7:30 Pre-rounds with resi-dent/intern 9-10:30 Rounds with

at-tending and fellow 10:30-12 pm Follow-up of

patients

7:30 Pre-rounds with resident/intern 9-10:30 Rounds with attending and fellow 10:30-11:00 Didactic teaching with attending

11am-12pm Follow-up

7:30 Pre-rounds with resident/intern 9-10:30 Rounds with attending and fellow 10:30-12 pm Follow-up

of patients

7:30 Pre-rounds with resident/intern 9-10:30 Rounds with

attending and fellow 10:30-11:00 Didactic teaching with attending 11am-12pm Follow-up 12-1 Noon conf.

1-4 Admissions, follow-up of patients, bedside

teaching with fellow, review of studies 4-5 Sign-out rounds with

resident/fellow

12-1 Noon conf. 1-4 Admissions, follow-up of patients, bedside teach-ing with fellow, review of

studies 4-5 Sign-out rounds with

resident/fellow

12-1 Noon conf. 1-4 Admissions, follow-up

of patients, bedside teaching with fellow, review of studies 4-5 Sign-out rounds with

resident/fellow

12-1 Noon conf. 1-4 Admissions, follow-up of patients, bedside teaching with fellow,

review of studies 4-5 Sign-out rounds with resident/fellow 12-1 Noon conf. 1-4 Admissions, follow-up of patients, bedside teaching with fellow,

review of studies 4-5 Sign-out rounds with resident/fellow INPATIENT: OUTPATIENT: CONSULTATION: PRIMARY CARE: 3 weeks E-MAIL: [email protected] REPORT TO:

Judy Jacobs, Becker Bldg., Becker 116, North Tower, 9:00 a.m.

E-MAIL: judith [email protected]

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ME210.10 INPATIENT

CARDIOLOGY

Advanced Clinical Clerkship Location: UCLA 2011-2012

Revised: 9/15/11

CLOSE CONTACT WITH: X FULL-TIME FACULTY CLINICAL FACULTY X FELLOWS

X RESIDENTS X INTERNS

X OTHER: Nurse practitioner 100%

COMMON PROBLEMS/DISEASES 1. Preoperative cardiac evaluation 2. Cardiac arrhythmias

3. Congestive heart failure 4. Ischemic heart disease 5. Post-operative cardiac surgery 6. Infective endocarditis

APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 4-8 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: >150

AM

PM

ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS:

*Didactics cover common cardiology topics ranging from arrhythmias, valvular heart disease, EKG readings

DESCRIPTION: The student will be a member of an inpatient consultation team consisting of the attending, cardiology fellow, internal medicine resident and nurse practioners. The student will have the opportunity to participate in 1-2 hours of didactic sessions daily. He/ she will be expected to present their patients during attending rounds, discuss their cases and follow their patients during their hospitali-zation.

2, 5, 8, 11, 14, 17, 20, 27 30, 33, 36, 39, 42, 45, 48 DURATION: weeks

COLLEGE AFFILIATION: Academic Medicine College REPORT TO: Attending on consults @ 9:00am in Ronald

Reagan, room 7215 in the Echo Lab STUDENT COORDINATOR:

Stella Tripp (310) 794-9736

E-MAIL: [email protected]

Drs. J. AboulHosn, A. Baas, M. S. Lee, W. M. Suh, and E. Yang

Henry Honda, MD (310) 794-9736

PHONE #:

1. Perform preoperative cardiac evaluations of patients and optimization of their perioperative medical management 2. Understand the role of preoperative cardiac testing in risk

stratification and management in the preoperative setting 3. Acute management of cardiac issues (e.g. arrhythmias, CHF,

ischemia) in the inpatient setting

4. Understand the indications for cardiac tests, including echo-cardiograms, stress tests, and imaging studies.

5. Mastering EKG interpretations.

7:45-8:15 Didactics* 9:30-11:30 Attendng

Rds Noon-12:30 Internal Medicine House Staff

Conference

7:45-8:15 Didactics* 9:30-11:30 Attendng Rds

Noon-12:30 Internal Medicine House Staff

Conference 7:45-8:15 Didactics* 9:30-11:30 Attendng Rds Noon-12:30 Cardiology Fellows Conference 7:45-8:15 Didactics 9:30-11:30 Attendng Rds Noon-12:30 Cardiology Fellows Conference 7:45-8:15 Didactics* 9:30-11:30 Attendng Rds Noon-12:30 Cardiol-ogy Fellows

Confer-ence 3:00-5:00 Attending Rounds 5-6 Cardiac Catheteriza-tion Conference 3:00-5:00 Attending Rounds 3:00-5:00 Attending Rounds 3:00-5:00 Attending Rounds 3:00-5:00 Attending Rounds PRIMARY CARE: 3 E-MAIL: [email protected] INPATIENT: OUTPATIENT: CONSULTATION: 100%