EM Clerkship

Deep Dive – Decompensated Hypothyroidism

Learn about Maddie’s experience in New Zealand as well as unique aspects of New Zealand medical practice. Disclaimer: This is based on personal experience. If you’d like to learn more, some resources are listed below. https://www.mcnz.org.nz/about-us/glossary https://pharmac.govt.nz/about/what-we-do/how-pharmac-works https://www.acc.co.nz https://www.luc.edu/media/lucedu/law/centers/healthlaw/pdfs...

You are working at Clerkship General when the triage nurse walks back and gets you. “Hey doc, we just put a hypoxic infant in bed 7”. Initial Vitals: HR: 168 RR: 44 BP: 81/40 O2: 81% (Room Air) Critical Actions: * Administer oxygen * Obtain chest xray * Correctly perform tube thoracostomy * Initiate non-accidental trauma workup * Complete mandated reporting

You are working at Clerkship General on New Year’s Day when you see a nurse running from triage. He is carrying an unresponsive child to the resuscitation bay. Initial Vitals: HR: 43 BP: 47/20 Temp: 66F RR: 4 O2: 95% (BVM) Critical Actions: * Obtain Core Temperature * Use the Broslow Tape * Follow PALS * Begin Invasive Warming * Transfer for ECMO

You are working at Clerkship General when you hear an EMS call on the base command radio. “Clerkship General. We are bringing you a minimally responsive 79 year-old female found lying on the floor inside her apartment. ETA 5 minutes” Initial Vitals: HR: 143 BP: 160/105 Temp: 106.3F RR: 22 O2: 99% Room Air Critical Actions: * Blood glucose * Obtain core temperature * Rapidly cool the patient * Diag...

Introduction: You are working at Clerkship General when the next chart is handed to you. It’s a 35-year-old female with a chief complaint of dizziness and fatigue. She is here accompanied by her husband. Initial Vitals: HR: 118 BP: 150/91 Temp: 100.4F RR: 20 O2: 99% Room Air Critical Actions: * Check pregnancy test * Check hemolysis labs * Diagnose TTP * Consult hematology * Initiate treatment for...

Transcript/Summary coming soon!

You are working at Clerkship General when you hear a woman screaming from triage… It’s baby time! Initial Vitals: HR: 120 RR: Shallow O2: 58% Critical Actions: * Place neonate in warmer * Administer positive pressure ventilation * Obtain pre-ductal pulse ox * Check blood glucose * Place umbilical vein catheter * Administer dextrose

Transcript coming soon!

You are working at Clerkship General when the nurse comes up to you and says, “Hey doc, EMS dropped off this guy named Randy from the memory care unit at the nursing home down the street. He’s in the hall bed outside of room 7. EMS says he’s here for confusion, we will get him in a room once we can get one clean. Initial Vitals: HR: 118 BP: 109/55 Temp: 102.5 F RR: 22 O2: 99% Room Air Critical Act...

Episode summary coming soon!

You are working at Clerkship General when you hear an EMS call on the radio. “Clerkship General, we are bringing you a 3 year old female with complaints of altered mental status. We are pulling in now.” Initial Vitals: HR: 129 BP: 98/66 Temp: 99.7F RR: 35 O2: 99% Room Air Critical Actions: * Check blood glucose * Check ingestion labs * Start bicarbonate drip * Call nephrology * Check venous blood...