The EM Clerkship Podcast

Never ignore a pregnant woman’s blood pressure. Introduction Pre-Eclampsia Pathophysiology unknown Pregnancy induced multi-organ dysfunction Definition Pregnancy PLUS BP 135/85 PLUS Proteinuria Eclampsia Preeclampsia PLUS Seizures HELLP Syndrome Preeclampsia PLUS Hemolysis PLUS Elevated liver enzymes PLUS Low platelets Step 1: Evaluate For Four Big Symptoms Swelling/edema Headache Visual changes A...

With this complaint, it’s ALL about doing a good history and exam. Step 1: Write Out Your Differential Diagnosis The KING Subarachnoid hemorrhage The QUEEN Meningitis 3 Killers in the BRAIN Stroke Hematomas Elevated ICP/Tumors 3 Killers in the VESSELS Arterial dissection Brain DVT (Dural Venous Sinus Thrombosis) Giant cell/temporal arteritis 3 MISCELLANEOUS killers Preeclampsia […]

Don’t forget to do a thorough GU exam! Step 1: Write Out Your Differential Diagnosis Remember 2-4-2-4 (2) In the upper abdomen Pyloric stenosis Pneumonia (4) In the lower abdomen Hirschsprung’s disease Intussusception Appendicitis Hernia (2) Genitourinary UTI Testicular/Ovarian torsion (4) Generalized Volvulus Necrotizing enterocolitis Henoch Schonlein Purpura Diabetic ketoacidosis Step 2: Do Pedi...

Tank. Clogged Pipes. Broken Pipes. Pump. Introduction “Tank” Hypovolemic shock Hemorrhagic shock “Clogged Pipes” Cardiac tamponade Tension pneumothorax Pulmonary embolism “Broken Pipes” Septic Shock Neurogenic Shock Anaphylactic Shock “Pump” Cardiogenic Shock Step 1: Fill the Tank Establish an IV IO line alternative in emergent situations Step 2: Consider Clogs Cardiac tamponade Diagnosis: Ultraso...

Hypoxemia fixed by only TWO things: FiO2 and PEEP Step 1: Add FiO2 If the patient is breathing… Nasal cannula Non-rebreather mask If the patient is NOT breathing… Bag-valve mask Step 2: Add PEEP *Cannot be completed in 60 seconds, but equipment can be requested If patient is breathing… BiPAP If the patient is NOT […]

“Airway” does not necessarily mean “Intubation” Introduction In emergency medicine we are taught “A-B-Cs” These are actions that can be accomplished in first 60 seconds of patient encounter Intubation takes several minutes to accomplish Intubating a crashing patient might even KILL them! Resuscitate THEN intubate Step 1: Suction Immediately suction if patient is… Altered and […]

Don’t forget to wear protective gear. Gown up! Initial Encounter History Anticoagulants Easy bleeding/bruising Lightheadedness Exam Pallor Tachycardia/Hypotension Step 1: Put on Personal Protective Equipment Gown Gloves Mask Eye Protection Step 2: Clear Nose and Visualize Bleeding Have patient blow out/remove any clot and look for source of bleed Kiesselbachs plexus “Anterior” epistaxis Sphenopala...

There are six cardiopulmonary causes of chest pain that you need to know. The SIX Causes Cardiac Acute coronary syndrome (ACS) Pericarditis with tamponade Pulmonary Pneumonia Pneumothorax Vascular Pulmonary embolism Aortic dissection Step 1: Core Measures Aspirin EKG Step 2: Look for the “King” (Acute Coronary Syndrome) Four high yield symptoms Radiation to the RIGHT […]

Patient presentations are the single most important skill to develop for your Emergency Medicine rotation. General Principles Stay focused, thorough, and organized Write out the basic 8-step presentation for reference The 8-Step Patient Presentation Summary statement Demographics Risk factors/Past medical history Chief complaint History OPQRST Try to give at least 4 descriptors This is for […]

To Do Well On WRITTEN Exam Study the “Core 4” body systems Neurology Headache Strokes Meningitis Cardiology Chest pain ACS EKG interpretation Pulmonary Shortness of breath PE GI Abdominal pain Nausea/vomiting Appendicitis To Do Well In the DEPARTMENT Study the “other stuff” Epistaxis Foley catheter issues Rectal bleeding Laceration repair Rashes Geriatric falls Suicidal ideation […]