To describe the general nature and level of work performed by physician assistants in the Emergency Department. This should not be construed as an exhaustive list of all the responsibilities and duties of the physician assistant or senior physician assistant. Physician assistants are credentialed to perform direct clinical functions in all areas of the Emergency Department, including the Adult ED, Fast Track, Pediatric Emergency Department, and ED Observation Unit.

Under the general supervision of the Attending Physician, the Physician Assistant in delivering primary care in the Emergency Department will perform the following duties:

1. Perform focused or comprehensive histories and physical examinations on ED patients and formulate a diagnostic and treatment plan.
2. The documentation of the patient encounter will be completed on the medical record and will include information pertinent to the history of present illness and past medical history (including allergies and current medications). 
3. Implementing treatment protocols and undertaking clinical decision making, under the supervision of an Emergency Medicine attending, for patients in the ED Observation Unit during its hours of operation. 
4.  Write orders for diagnostic tests, medications, consultations, immunizations and clinic referrals.
5. Review, interpret and document the results of the diagnostic tests ordered.
6. Confer with the supervising Attending Physician and nursing staff to ensure delivery of optimum quality of patient care and to keep them apprised of clinical developments, patient concerns, etc.
7. Write prescriptions in accordance with hospital guidelines.
8. Counsel patients when appropriate on health education issues and disease prevention.
9. The PA must present all cases to the supervising Attending Physician.
10. All referrals for consultation will be discussed with and approved by the supervising Attending Physician.
11. The PA must review all EKGs, laboratory and radiologic results with the supervising Attending Physician prior to discharging the patient from the ED.
12. Perform other duties pursuant to clinical responsibility, such as arranging follow-up for patients, obtaining informed consent from patients, recalling patients for further evaluation and treatment, and escorting patients when necessary to other areas of the hospital or interhospital transfers, inform patients of necessary post-discharge instructions as required.
13. Complete and document participation in continuing medical education required of physician assistants in order to meet requirements for certification, including assigned lectures and conferences.
14. Participate in the administrative and academic aspects of the ED in staff meetings, QA activities, conferences, morning reports and other duties as required professionally or at the request of the supervising Attending Physician, the Director of Service, and/or Chief Physician Assistant.
15. The PA may perform the following procedures under general supervision:
    • Venipuncture and initiating IV fluids
    • Ordering of routine x-rays and laboratory studies
    • Ordering of medications in accordance with hospital guidelines
    • Catheterization of the urinary bladder
    • Nasogastric tube insertion
    • Reduction of dislocations
    • Splinting of orthopedic injuries
    • Arterial puncture for the purpose of blood gas determination
    • Minor surgical procedures (e.g., suturing, incision and drainage, wound checks, etc.)
    • Initiate emergency procedures including Basic and Advanced Cardiac Life Support
16. The PA may perform the following procedures under direct supervision:
    • Endotracheal intubation
    • Participate in the resuscitation of cardiopulmonary and other complex medical emergencies.
    • Participate in the management of complex surgical emergencies.
    • Order controlled drugs and psychotropic medications in accordance with established hospital guidelines.
    • Placement of central venous catheters, venous cutdown, joint aspiration, lumbar puncture and other emergency procedures at the discretion of the supervising Attending Physician.

-Completion of NYS- approved program for the training of physician assistants or specialist assistants, usually via Bachelor of Science program or degree in closely related field.

-NCCPA Certification

-NYS PA License

-BCLS/ACLS/PALS certification

-Registration required with NYS as Physician Assistant.

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