141 episodes

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.

EM Clerkship - Emergency Medicine for Students Zack Olson, MD

    • Medicine
    • 5.0, 2 Ratings

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 10 (Allergic Reaction)

    Round 10 (Allergic Reaction)

    ~~CAUTION: THESE NOTES CONTAIN SPOILERS!!!







    Case Introduction







    A 45 year old female is exposed to peanut butter and shrimp pizza and begins to have an apparent allergic reaction…















    Initial Vitals







    * Temp 98.8* HR 130* RR 35* BP 70/40* O2 92%







    Critical Actions







    * Verbalize Airway Evaluation* Complete a FOCUSED History and Exam* Normal Saline Bolus* Epinephrine both IM and (subsequently) IV* Glucagon 1mg IV







    Final Diagnosis







    Refractory Anaphylaxis Due to Beta Blockers







    Tips and Tricks







    You still need to obtain a quick history and exam even if you know the diagnosis in the first few seconds of the case







    Additional Reading







    * Basic approach to anaphylaxis (EM Clerkship)* Tranexamic acid as first-line emergency treatment for episodes of bradykinin-mediated angioedema induced by ACE inhibitors. (PubMed)* Glucagon infusion in refractory anaphylactic shock in patients on beta-blockers. (PubMed)

    • 30 min
    Round 9 (Seizure)

    Round 9 (Seizure)

    CAUTION: THESE NOTES CONTAIN SPOILERS!!!







    Case Introduction







    The nurse brings back a young adult male from the lobby who is having a seizure…







    Initial Vitals







    * Temp 98.8* HR 90* RR 10* BP 120/80* O2 92%







    Critical Actions







    * Verbalize ABCs on a Critical Patient* Obtain Immediate Blood Glucose Level* Give Benzodiazepine* Initiate Workup of New-Onset Seizures* Give Pyridoxine (Vitamin B6)







    Final Diagnosis







    Isoniazid Toxicity







    Tips and Tricks







    When the patient is unable to provide history, attempt to obtain the information from external sources







    Additional Reading







    * Isoniazid toxicity overview (Life in the Fast Lane)* Basic approach to seizures (EM Clerkship)* Basic approach to status epilepticus (EM Clerkship)* Ketamine for refractory status epilepticus (PubMed)







    Corrections







    Ketamine not Keppra as potential induction agent for status epilepticus (32:40)

    • 38 min
    Round 8 (Fall)

    Round 8 (Fall)

    CAUTION: THESE NOTES CONTAIN SPOILERS!!!







    A man can have as many diseases as he damn well pleases! Hickam’s dictum







    Case Introduction







    EMS brings in an elderly man who has fallen…







    Initial Vitals







    * Temp 98.6* HR 58* RR 16* BP 105/60* 99%







    Critical Actions







    * Treat the patient’s pain* Consult orthopedics for a hip fracture* Obtain an EKG* Treat Severe Hyperkalemia* Consult nephrology for dialysis







    Final Diagnosis







    Ground level fall resulting in hip fracture, missed dialysis, and severe hyperkalemia







    Tips and Tricks







    Patient’s will frequently have more than one final diagnosis. Do not prematurely close an the initial, obvious, diagnosis.







    Additional Reading







    * Basic approach to hyperkalemia (EM Clerkship)* EKG manifestations of hyperkalaemia (LITFL)

    • 29 min
    Round 7 (Headache)

    Round 7 (Headache)

    CAUTION: THESE NOTES CONTAIN SPOILERS!!!







    Case Introduction







    Just a routine day at your hospital, your next patient has a chief complaint of headache…







    Initial Vitals







    * Temp 98.8* HR 88* RR 16* BP 130/80* O2 99%







    Critical Actions







    * Identify Acute Angle Closure Glaucoma* Initiate Appropriate Treatment for Acute Angle Closure Glaucoma* Emergent Consult to Ophthalmology* Recheck Intra-Ocular Pressure After Initiating Treatment







    Dangerous Actions







    * Giving NSAIDS (The Patient Had This on Allergy List)* Performing a Lateral Canthotomy







    Final Diagnosis







    Acute Angle Closure Glaucoma







    Tips and Tricks







    Do not be surprised or scared when an examiner has a monotone voice and flat affect







    Additional Reading







    * Management of acute angle closure glaucoma (PubMed)* Basic approach to eye complaints (EM Clerkship)

    • 30 min
    Round 6 (Back Pain)

    Round 6 (Back Pain)

    CAUTION: THESE NOTES CONTAIN SPOILERS!!!







    Case Introduction







    A notorious, disheveled frequent flyer presents to your emergency department for her back pain and is asking for more Dilaudid…







    Initial Vitals







    * Temp 99.0* HR 99* RR 18* BP 118/78* O2 99%







    Critical Actions







    * Ask about Red Flags for Spinal Infection* Perform a Thorough Spinal Exam* Obtain MRI Spine with Contrast* Initiate Broad Spectrum Antibiotics* Treat Pain when Pathology Identified







    Final Diagnosis







    Spinal Epidural Abscess







    Tips and Tricks







    Don’t let consultants or other members of your team talk you out of appropriate management of a patient







    Additional Reading







    * Basic approach to Back Pain (EM Clerkship)* Epidural Abscess Overview (AAFP Website)

    • 52 min
    Round 5 (Geriatric Fall)

    Round 5 (Geriatric Fall)

    CAUTION: THESE NOTES CONTAIN SPOILERS!!!







    Case Introduction







    The nurse is asking you to evaluate a 70 year old male who has been placed in a hall bed after hitting the back of his head. She wants to know if you would like to call a trauma alert…







    Initial Vitals







    * Temp 103.7 (Hidden by Examiner)* HR 115* RR 18* BP 110/75* O2 99%







    Critical Actions







    * Diagnose Fournier’s Gangrene on Secondary Survey* Obtain Full Vital Signs Including Temperature* Perform Sepsis “Core Measures”* Initiate Appropriate Treatment for Fournier Gangrene* Immediate Surgical Consultation







    Final Diagnosis







    Septic Shock due to Fournier Gangrene







    Tips and Tricks







    Always ask for the patient’s temperature if it is not given with initial vital signs







    Additional Reading







    * Fournier Gangrene Overview (PubMed)* Basic Approach to Sepsis (EM Clerkship)* Basic Approach to Trauma (EM Clerkship)

    • 43 min

Customer Reviews

5.0 out of 5
2 Ratings

2 Ratings

Top Podcasts In Medicine

Listeners Also Subscribed To