Emergency/Orthopedic Trauma and Community Health

OS 508M.40B Subject & Catalog Number

Description

Prior approval required, please email Megan Eichhorn, Clinical Coordinator, at meichhorn@carlosotisclinic.org, forward approval to registrar@hms.harvard.edu.
This course takes place at The Carlos Otis Stratton Mountain Urgent Care Clinic in Stratton Mountain, VT. The clinic is staffed with 2-3 volunteer physicians that change out weekly. The doctors consist of Orthopedic surgeons and Emergency room physicians each week from late November through mid-April. The clinic also has Residents who are doing Fellowships in Sports medicine or EM. There is a Clinical nurse manager, an Executive Director as well as a business administrator. The clinic is staffed with ACLS/trauma trained experienced nurses, X-ray Technologists as well as Paramedics and EMT's from Ski Patrol. The clinic owns and operates its own ambulance service.
One student is accepted per month and are expected to be an integral member of the staff, helping to assess and treat patients as well as lending a hand with clinic operations.  On a busy weekend the clinic may see 40+ patients in a day, with severe trauma, plus medical emergencies such as cardiac arrests, liver lacerations, splenic injuries as well as chest trauma, major head trauma, etc. The clinic has adult and pediatric airway boxes as well as variety of medications for intubations, sedation, etc., and there are 2 Zoll machines on site. On the orthopedic side the student will become skilled with the history, physical exam and X-ray assessment of a wide variety of musculoskeletal injuries as well as using hands on help from the attending, resident and nursing staff. Many of the fractures and dislocations are definitively treated and immobilized at the clinic. The clinic has a state-of-the-art X-ray equipment as well as a mini-C-arm machine, a doppler as well as ultrasound. On the EM side the students will also become skilled with the history and physical exams as well. The student will see everything from lacerations, colds, flu, strep, covid, STEMI's, seizures, transient global amnesia, pneumo's, chest tube placement, TBI's, stroke etc.   The clinic cares for the local community members and resorts employees and guests. The clinic is set up and prepared for most major emergencies.
Serious injuries requiring hospital care or evaluation, (CT, MRI) are sent by ambulance to various hospitals in the VT, NH area. Life threatening injuries that can not be sent by ground are sent by Med-flight to (Dartmouth a level 1 trauma center), or to (Albany Medical Center a level 1 trauma center). On busy days 3-4 ambulance runs are the norm. 
The students and the physicians carry radios and their cell phones so that they may ski or snowboard if not needed in the clinic and are called in for patients.  There is no call schedule per se, but students are expected to be available daily from 8:30 am to 5:00 pm or until the last patient leaves.  Most graduates from this clerkship have found it to be a busy and stimulating time while also being able to enjoy the surrounding facilities at one of New England's premier winter sports destinations.