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Resident Supervision

The Residency Supervision Area is designed to assist hospitals and clinics with the protocols outlined for specific duties residents and fellows can perform. These guidelines are determined by the faculty of the University of Tennessee Health Science Center. Any questions about certain procedures not listed should be addressed to the faculty and not decided by the resident or fellow.

A credentialed and privileged attending physician ultimately provides supervision or oversight of each resident's patient care activities. Direct supervision by a qualified attending physician is required in the OR/Delivery Room or for non-routine invasive procedures like Cardiac Cath, Endoscopy, and Interventional Radiology. The standards for resident supervision in patient care settings are described in GME Policy #410.

Christopher Isennock

Isennock, Christopher - PGY - 3

Department of Emergency Medicine
Resident Supervision

All PGY 1, 2, and 3 Emergency Medicine Residents are supervised directly until competence is shown. After the date shown, interns are able to perform the procedures listed with indirect supervision with supervision available upon request.  Some residents will achieve competence before the listed date based on clinical rotation schedules, but all should be competent by the date shown in order to advance.

 

In an EMERGENCY, emergency medicine residents may perform procedures to preserve or restore life or limb or prevent the acute deterioration of patients without delaying for supervision. They are expected to call immediately for supervision or activate the hospital code system (whichever they deem appropriate) while implementing emergency medical services or procedures.

 

Residents can do the following procedures under direct supervision at any time:

PGY1 year

PGY2

PGY3

Procedure:

OK for

INDIRECT

Supervision

History & Physical Exam

July 1

X

X

Incision and Drainage of Abscess

Aug 1

X

X

Restraint Order (Medical or Violent)

Aug 1

X

X

Emergency Suturing/wound closure

Aug 1

X

X

Central Line placement

Aug 1

X

X

Peripheral Line Placement and IO Device use

July 1

X

X

Endotracheal Intubation (Direct Laryngoscopy and Video)

Aug 1 

X

X

Cricothyrotomy and surgical airway

Aug 1

X

X

Chest Thoracostomy Tube placement and management

Aug 1 

X

X

Pericardocentesis

Aug 1

X

X

Arthrocentesis

Aug 1

X

X

Paracentesis

Aug 1

X

X

Pleurocentesis

Aug 1

X

X

Removal of Superficial Foreign Body

Aug 1

X

X

Removal of Orifice Foreign Body

Aug 1

X

X

ED Ultrasound (FAST, FB, CVL)

Aug 1

X

X

Drainage of Peritonsillar Abscess

Aug 1

X

X

Rectal Exam with Guaiac Test

July 1

X

X

Gastrostomy or J tube replacement

Aug 1

X

X

Nasogastric Tube placement and/or lavage

Aug 1

X

X

Nasal packing for epistaxis control

Aug 1

X

X

Pelvic Exam OB/GYN

July 1

X

X

Vaginal Delivery

Aug 1

X

X

Perimortum C-section

Direct only

X

X

Management of adult cardiac arrest or resuscitation

July 1

X

X

Management of pediatric cardiac arrest or resuscitation

July 1

X

X

Management of adult Trauma, all levels

July 1

X

X

Management of pediatric Trauma, all levels

July 1

X

X

Ventilator Management

Aug 1

X

X

Procedural Sedation (This should always have direct supervision when available)

Direct only

Direct only

X

General & Regional Pain Management

Aug 1

X

X

Arterial Line Placement and ABG

Aug 1

X

X

Cardiac Pacing and Defibrillation

July 1

X

X

Lumbar Puncture

Aug 1

X

X

Slit lamp eye exam and tonometry

Aug 1

X

X

Reduction of Fracture or Dislocation

Aug 1

X

X

Extraordinary Procedures (any the physician deems emergent or save life/limb/etc.)

July 1

X

X

*ED Thoracotomy (Attending present for all PGY-1 and 2 cases unless not possible)*

Direct only

Direct only

X

Please contact the EM Program Director for any concerns or

May 26, 2022

Dec 1, 2023