Work on the inpatient orthopedic service as the senior lead PA of outpatient/inpatient orthopedic PAs - 15 PAs. Clinical responsibilities include initial assessment of emergency & hospital consults from various services/skills i.e. joint reductions, joint aspirations, splint & cast applications on both adult and pediatric patients. Communicating & initiating a plan with on-call orthopedic attending, fellow, and/or resident. Duties also included medical management of both pre-/post-operative as well as operative & non-operative hospital patients. Remainder of responsibilities include being surgical assistant in various orthopedic surgical procedures which include open reduction & internal fixation of fractures, hip/knee arthroplasties, fasciotomies, etc. Responsible for orders, medications, & summaries. Daily rounding with attendees on patients a& interdisciplinary daily rounds on the hospital floor. Lead responsibilities include evaluating outcomes of implemented interventions, attend staff meetings to discuss patient & unit requirements. Give input for design of research protocols and procedures. Responsible for EM sponsored clinical trials including regulatory issues, recruitment, and good clinical practice. Oversee daily operations for clinical research protocols in collaboration with other staff. Responsible for obtaining informed consent from study participants. Remain proficient in the utilization of commonly used clinical protocols and guidelines. Remain abreast of new treatment modalities and technologies within the field of orthopedics. Maintain competencies with the use of Med/Surg instruments and equipment. Participate in the interviewing process of clinical staff. Makes hiring recommendations. and discipline. Working knowledge of policies, procedures and practices necessary to facilitate safe and effective management of acute and chronic illness in patients presenting in ED with acute orthopedic issues.

Remote/Austere MedicineCurrently a medical provider in emergent/urgent/primary/occupational care and preventative services to on-site individuals in remote locations. Remote locations include Kabul, Afghanistan & Air Force Base in the Aleutian Islands. Patients include both civilian contractors & military personnel. Duties include performing initial history & physical assessment, determining whether persons require higher level of medical care. Responsibilities include making sure essential equipment is functioning, ordering & restocking supply and medication inventory, and maintaining an operational ambulance. Ability to perform simple to complex beside procedures phlebotomy, administering medications IV & IM, sutures, staples, I&Ds, joint dislocations, taking x-rays & interpreting, etc. Expected to stabilize and prepare sick and/or injured personnel for transport to a higher level of care. Experience with mass casualty event including triaging, treating, & determining evacuation of personnel.

Emergency DepartmentDuties include treating and evaluating ALL patient populations with non-life threatening and life-threatening medical conditions. Skills include gathering a detailed history from patients and then performing the appropriate physical exam to determine best course of action. This includes ordering and interpreting laboratory studies, diagnostic imaging (CT scans, ultrasounds, x-rays, etc.), and consulting with specialists (neurology, OB/GYN, urology, orthopedics, general surgery, cardiology, etc.). Responsibilities entail curating a plan that includes medications, prescriptions, referrals, and/or performing an intervention. Interventions range from bedside I&Ds, joint reductions, joint aspirations, complex & simple suturing & stapling, foreign object removal, gynecological exams, chest tubes, intubating, splinting/casting fractures/sprains, etc. Expert skills in verbal and written communication with patients, nurses, attendings, etc. Current work place has a significant volume of physical & emotional trauma (gunshot wounds, domestic abuse, child abuse, mental health, heroin/opiate overdose, etc.), as well as common emergent medical conditions such as CVA, MI, DKA/HHS, aortic dissection/rupture, sepsis, cardiac arrhythmias, etc.

General & Orthopedic SurgeryWork on an inpatient orthopedic, neuro-, and general (urology, vascular, plastics) surgery services. Responsibilities include initial assessment of emergency & hospital consults for specific services as well as communicating & initiating a plan with on-call attending. Duties also included medical management of both pre-/post-operative as well as surgical but non-operative patients. Remainder of responsibilities include being first surgical assistant in various surgical procedures which include but are not limited to open reduction & internal fixation of fractures, hip/knee arthroplasties, open & laparoscopic procedures such as appendectomies, cholecystectomies, resections, exploratory laparotomies, etc. Excellent written skills for admission & discharge notes as well as daily progress notes. Responsible for rounding with attendees on surgical patients. Consulted for skills requiring joint reductions, joint aspirations, difficult foley catheter insertions, surgical wound closures, etc.

Occupational MedicineProvided medical care for occupational and urgent care in a non-life-threatening setting for employees of clients & walk-ins. Clients included LAPD, LAFD, state & county agencies, local businesses & factories, etc. Responsibilities included acquiring a detailed history of the injury and/or illness and determining if it was work-related in nature, performing pre-employment physicals, and determining course of treatment. Able to perform simple & complex suturing/stapling, incision & drainage, and splinting/casting fractures/sprains. Tools used to determine injury/illness included ordering and interpreting x-rays & use of point of care testing that was compliant contractually with the client. Responsibilities also included ordering medications & different therapy modalities (PT, OT, chiropractor, & acupuncture) and/or referrals to specialists (orthopedics, PM&R, podiatry, etc), and determining work status/restrictions to ensure the rehabilitation of employees. Excellent verbal & written skills necessary for discussing patient care to patient, employer, and/or case manager/adjuster for work-person compensation cases.

Internal MedicineWorked in internal medicine outpatient & inpatient setting. Duties included comprehensive long-term health care for patient populations over age 18. Responsibilities include the diagnosis of health conditions, management of acute/chronic health conditions, performing & ordering preventative health screenings & immunizations, annual physicals, & referrals to specialists as needed. Practiced in several settings; long-term acute care hospitals, nursing homes, clinic, & psychiatric facility managing non-psychiatric health issues. Furthermore, worked in the hospitalist capacity dealing with acutely ill patients. Duties included daily rounding, writing admission/progress/discharge notes, ordering medications, therapies, & ordering consults as needed.