Site Visit Summary

    I chose the to present HPIs that focused on my weaknesses. Since my goal for this rotation was to become comfortable with Neuro exam and DDx, both patients I chose to present at the first visit had a headache as a chief complaint but with two very different outcomes. I was able to do a through Neuro assessment on them and discuss the DDx with my preceptor in depth which was very helpful.

   For my second visit I chose the STEMI patient that I got to follow all the way to the Cath lab since that case was very memorable for me. I did not assess the bruit on my Physical exam which later, when I presented an article on risks of Cardiac Catheterization, turned out being extremely important. One of the potential adverse effects is an AV fistula which would present as a continuous bruit on physical exam. Therefore, discovering and documenting a preexisting bruit is crucial for an initial assessment of patient that is about to undergo catheterization.

   Overall, I am missing less and less details in the patient assessment but there’s still things to work on. I need to make sure my history and physical are as thorough as possible since not only they provide a window into a potential diagnosis but they are also a way to protect myself legislatively providing a proof the patient had a preexisting condition rather than the cause of certain things turning out being iatrogenic.