The purpose of this podcast is to help medical students crush their emergency medicine clerkship and get top 1/3 on their SLOE. The content is organized in an approach to format and covers different chief complaints, critical diagnoses, and skills important for your clerkship.
Round 5 (MW) – Leg Pain
You are working at Clerkship General Hospital when EMS calls in a female with opioid overdose, but she won’t stop complaining of leg pain…
O2 Sat: 100%
* Treat patient’s pain without NSAIDs (history of solitary kidney)
* Assess patient’s leg pain beyond the point of just fracture vs. no fracture
* Recognize the signs and symptoms of compartment syndrome
* Get orthopedic surgery to bedside emergently for fasciotomy
* Recognize and treat rhabdomyolysis
DKA (Deep Dive R4 MW)
Diabetic Ketoacidosis – hyperglycemia, ketosis, and anion gap metabolic acidosis
* Don’t forget about euglycemic DKA (especially in setting of SGLT2 inhibitor) or mimics such as alcoholic ketoacidosis
* Treatment of the ketoacidosis * Insulin (usually a drip or bolus + drip) – only once K>3.5* Volume Resuscitation (NS initially, change to LR)* Bicarb drip (poor evidence, only as last resort for critical patients)* Treatment of electrolyte abnormalities* Correct sodium for hyperglycemia* Replete potassium if K5.0, PO and IV simultaneously* consider central line if patient hypokalemic and in extremis/critical DKA* Management of respiratory status* Avoid intubation at all costs unless altered or impending respiratory failure* APNEA KILLS* Mechanical ventilation limits your minute ventilation, leading to worsening acidosis. Breath stacking occurs if you set the RR too high.* Support work of breathing with NIPPV (high IPAP, low EPAP)* If intubation necessary, consider awake intubation or consider using bicarb pushes if performing RSI
EMCRIT – DKA
Round 4 (MW) – Shortness of Breath
You are working a shift at Clerkship General when the charge nurse comes and grabs you to see a 24yo male who appears to be in respiratory distress.
* Diagnose DKA* Replete potassium* Start insulin AFTER potassium repletion* EITHER place central line for faster K repletion OR initiate bipap to allow time for potassium repletion via existing peripheral line* Admit to ICU
EMCrit – DKA
Interviews Part 2 – Acing your interview
Before interview day, do your research on programs and interviews and reflect on the way in which you want to portray yourself.
On interview day, have a cheat sheet with notes about your conversations, questions, and pro-cons. Remember to stay calm, take a pause if you need to, and above all be authentic to who you are.
After interview day, be sure to capture you gut impression and write down any follow-up questions or concerns remaining.
Here are some resources to use for interview day:
EMRA Residency Interview Guide
AliEM – Dos and Don’ts of residency interviewing
EMRA – Common Interview Questions
EMRA – Making the most out of interview day
ALiEM – EM Match Advice Podcast Episode
Black Box Warnings (Deep Dive R3 MW)
show notes coming soon
Round 3 (MW) – MVC
Show comments to be posted shortly
EM Clerkship has been my go to throughout my clinical year of PA school. I started listening during my ER rotation and it was so helpful and I just couldn’t stop listening even after going to a new rotation. The information is solid and presented in a way that’s entertaining and engaging. 11/10 recommend!!
I am about to venture off to clinical year of PA school in 2 short months and I wish I had found this podcast sooner. I cannot say enough good things about it; it’s extremely informative in a more simple and entertaining manner than conventional materials. I love listening to the residents go through their interview/thought process of a work up so I can engrave it more into my mental memory. I love the little 10-15 minute deep dives for when that’s all my brain can handle. It’s absolutely amazing and I hope you guys keep making content. Future providers appreciate it so much.
This is an awesome adjunct to my clinical training during PA school. I love the patient case episodes and the follow up episodes that go in depth about the topic. I’d recommend to anyone going through school or residency right now as an MD/DO, PA, or NP.