I recently completed my seventh rotation in emergency medicine from August 26 to September 27, 2024. During this time, I learned to quickly evaluate patients using the ABCDE (Airway, Breathing, Circulation, Disability, Exposure) approach, which allowed me to prioritize those needing immediate intervention. This systematic assessment proved invaluable, especially when managing multiple patients simultaneously. I frequently encountered cases of chest pain, shortness of breath, and trauma, which required swift decisions regarding diagnostic testing and treatment plans. This experience helped me develop the ability to differentiate between life-threatening emergencies and less critical conditions, an essential skill in emergency medicine.

I gained practical experience in assessing abscesses, determining optimal incision points, deciding on wound packing, and providing post-procedure care instructions to patients. These experiences significantly improved my technical skills and boosted my confidence in handling common emergency procedures. I also became adept at recognizing subtle red flags that indicated severe underlying conditions, such as altered mental status, hypotension, or tachypnea—often early signs of sepsis or other critical illnesses. For example, I learned to recognize that a sudden, severe headache might indicate a subarachnoid hemorrhage or that chest pain with diaphoresis could signal an acute myocardial infarction. These experiences underscored the importance of conducting a thorough history and physical exam in detecting warning signs.

Working closely with attending physicians, residents, and radiologists, I was able to correlate imaging findings with clinical presentations, enhancing my diagnostic accuracy. I had numerous opportunities to interpret diagnostic images, including X-rays, CT scans, and ultrasound, which allowed me to develop confidence in identifying conditions such as pneumothorax on a chest X-ray and recognizing when a CT scan was necessary for abdominal pain.

However, I realized that I occasionally doubted my clinical judgment when faced with unfamiliar cases. Moving forward, I recognize the importance of trusting my training while seeking guidance when needed. To build confidence, I plan to actively participate in case discussions and seek constructive feedback from supervising PAs and physicians. Additionally, my documentation was sometimes slower than desired, and I intend to improve this by practicing concise and structured charting to enhance both accuracy and efficiency.

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