Emergency Department Rotation at Chatham Kent Health Alliance

Chatham-Kent Health Alliance (CKHA) provides health care in the municipality of Chatham-Kent, in the heart of South Western Ontario, located between London and Windsor.  We provide excellence in quality care to a local population base of over 110,000 residents of Chatham-Kent, South Lambton and Walpole Island. Our organization has 300 beds over two sites - the primary site being Chatham the secondary site is Wallaceburg.  

CKHA has two separate 24/7 emergency departments, one on each site.  Our annual patient visits for Chatham are 48,000 and Wallaceburg  22,000.  The emergency department in the Chatham site was built in 2003 and is fully equipped, including an ultrasound machine. The Sydenham site was built in the mid 1990's and includes on-call DI and Lab after hours, and works closely with the Chatham site to facilitate patient care. 

Our Department of Emergency Medicine has three CCFP (EM) graduates.  Staffing includes three full-time physicians, six part-time and four casual at the Chatham site. Our Sydenham site has four local physicians providing the majority of care during the week; one CCFP (EM) physician who provides regular shifts from London; and a variety of other physicians who regularly take shifts.  Our Chatham ED has a Fast-Track area, staffed by local family physicians that, along with a nurse-practitioner clinic, assess and treat the majority of the CTAS 4 and 5 patients.  We have a four bed observation unit in the Chatham ED and a 2 bed unit in Wallaceburg; both are monitored by our emergency physicians.  

Our organization has consultant support from Internal Medicine, General Surgery, Orthopaedics, Urology, Ophthalmology, Otolaryngology, OB/GYN, Paediatrics, Radiology and Anaesthesia.  Our Chatham site has 24 hour in hospital Lab/DI, and Respiratory Therapists.  Our Diagnostic Imaging department offers advanced skills in Ultrasound, CT and MRI imaging. Our medical staff is a cohesive supportive team of health care professionals who are dedicated to excellence in patient care.

Our organization offers a model that supports and prioritizes undergraduate and residency learning.  We have
accommodations, facilities, and supports to make your experience a valuable and enjoyable part of your EM year.

A  CCFP (EM) resident working in an EM rotation at the Chatham-Kent Health Alliance will be exposed to a variety of
learning opportunities.  Teaching is case-based, with opportunities for more formal sessions if requested.

Residents will have the opportunity to see undifferentiated patients, referrals from community physicians, and all aspects of ED care for medical, surgical and paediatric patients.  Our EDs provide care to patients with a high volume of acute or critical illnesses.   

In the Wallaceburg site, we have an ED practice in a small town, and access to all speciality services in Chatham.

At our Chatham site, one ED physician sees the more acute and ill patients and up to 2 additional ED or Family Medicine physicians attend to patients of CTAS 3, 4 and 5. These physicians support the lead ED physician during peak times, arrests, multiple trauma and sedation, providing a well rounded experience in community hospital ED care.                              

An EM resident will have ample opportunity to participate and help lead care during resuscitation, multiple trauma, sedation, ultrasound, suturing, fracture reduction and casting, X-ray interpretation, mental health crisis, and surgical and medical emergencies (sepsis etc).

While the EM resident will have the opportunity to assess and manage patients with a large degree of independence, our EDs physical plant ensures regular close contact with the resident's supervisor to enhance both learning and patient safety. There will be a preceptor present on site at all times.  It will be expected that all patients CTAS level 1, 2, 3 will be reviewed with the preceptor prior to disposition.  CTAS level 4 and 5 will be given a level of independence in accordance with the learner and supervisor's comfort and skills.  Investigations may be ordered by the resident, with the exception of CT and MRI scans where the supervisor should be aware of the indication for the scan.  The resident will have the opportunity to deal directly with consultants.  The resident will also have the opportunity to accompany acutely ill patients on transport where appropriate. Ambulance ride outs can be arranged. Major procedures and procedural sedation may be done by the resident with the supervisor or delegate in attendance.

There is a great deal of flexibility with scheduling your rotations and electives.

A suggested EM rotation would include:

14 emergency shifts of 8 hours each, scheduled as:

          o A  minimum of 3 day, 3 evening, 3 night , 3 weekend shifts
          o Of these a minimum of 6 should be done with the designated primary supervisor and the remainder may be
             done with other members of the CKHA ED faculty.

- 1 Case study or educational topic presentation to the emergency physician group or to ED nursing staff, based on a
patient care event at CKHA.

- 3 skill development days will be spent in CKHA.  These are designed for the learner to get exposure to other areas
that the resident identifies as a personal need.

In addition, if requested by the EM Resident, further elective opportunities exit in: 

          o Anaesthesia - a  full day in the OR that would include intubations, LMAs, procedural sedation and difficult
             airway review
          o Radiology - a full or half day with a radiologist to review plain films imaging, CT, Ultrasound, and MRI. 
          o Ophthalmology -1/2 day; focus on slit lamp exam
          o ICU - 1/2-full day - to review ventilator settings, pressors, and ICU care
          o Casting and Fractures  1/2 day; with the casting technician in the Orthopaedic Clinics;  

Other specialities as requested.

At CKHA you will find your best opportunity for an EM elective to achieve your learning goals.

For more information please feel free to contact:

Dr. Dave Huffman:   This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Dr. Gary Tithecott:   This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Stephanie Bruinsma:      This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Or visit our web site at:  www.physicianswanted.com and check out two important sections:   "Educational
Opportunities"  and  "Emergency" under "Opportunities Available" -  which hosts our Emerg video.