Procedures
All medical residents are required to demonstrate proficiency in performing certain
required procedures and an understanding of the indications and interpretations.
Residents are instructed on proper techniques during their orientation, one-on-one
instruction by an attending physician or senior resident, and in special conferences
designed for that purpose.
The performance of all procedures is supervised by an attending physician or by a
senior resident who has demonstrated proficiency and has been certified in that
procedure. Documentation of all procedures is via the internet.
A procedure note is the responsibility of the resident performing the procedure.
Each note should include indications, description of the procedure, complications,
and any specimens obtained or tests ordered as a result of the procedure.
Signed informed consent must be obtained and placed in the patient's chart prior to
each procedure. Any additional information to document the circumstances or
parties involved in obtaining informed consent is added as a progress note or
included in the procedure note that is placed in the medical record.
Required procedures:
Advanced cardiopulmonary resuscitation
Access techniques to obtain venous and arterial blood
Arthrocentesis of the knee
Bladder catheterization
Central venous line placement
Nasogastric intubation
Lumbar puncture
Abdominal paracentesis
Thoracentesis.
Elective procedures:
Arterial line placement
Bone marrow aspiration
Elective cardioversion
Endotracheal intubation
Flexible sigmoidoscopy
Change of gastrostomy tube
Assistance in placement of percutaneous endoscopic gastrostomy (PEG)
Pulmonary artery balloon flotation catheter placement
Skin biopsy (punch)
Temporary pacemaker placement
Ambulatory electrocardiographic interpretation
Treadmill exercise testing, supervision and interpretation



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