The EM Clerkship Podcast

Four definitions you must know: * SIRS – Must have at least 2 of 4 SIRS criteria (listed below):* Fever (>38C) or Hypothermia (12k or 10%* Tachycardia > 90* Tachypnea > 20* SEPSIS – Must have SIRS + have a suspected infectious source (eg pulmonary, urinary, intra-abdominal, etc)* SEVERE SEPSIS – Must have Sepsis + ONE of the following criteria indicative of end organ dysfunction:* Hypotension (MAP...

Four definitions you must know: SIRS – Must have at least 2 of 4 SIRS criteria (listed below): Fever (>38C) or Hypothermia (<36C) WBC >12k or <4k ; OR Bandemia >10% Tachycardia > 90 Tachypnea > 20 SEPSIS – Must have SIRS + have a suspected infectious source (eg pulmonary, urinary, intra-abdominal, etc) SEVERE SEPSIS […]

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkshift General when a 20yo female accompanied by her mother checks into the ER with chief complaint of fatigue. Initial Vitals * Temp 101.2F* HR 122* RR 22* BP 110/90* O2 98% Critical Actions * Obtain travel history in patient presenting with fever of unknown source* Perform sepsis workup and treatment in...

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkshift General when a 20yo female accompanied by her mother checks into the ER with chief complaint of fatigue. Initial Vitals Temp 101.2F HR 122 RR 22 BP 110/90 O2 98% Critical Actions Obtain travel history in patient presenting with fever […]

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkshift General when a sepsis alert is paged overhead for a young female  who appears diaphoretic and confused. Initial Vitals * Temp 102.7F* HR 145* RR 32* BP 141/85* O2 93% Critical Actions * Workup and treat for sepsis upfront (Cultures, Lactate, IVF, Abx)* Order TSH with Free T4* Administer non-selectiv...

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkshift General when a sepsis alert is paged overhead for a young female  who appears diaphoretic and confused. Initial Vitals Temp 102.7F HR 145 RR 32 BP 141/85 O2 93% Critical Actions Workup and treat for sepsis upfront (Cultures, Lactate, IVF, […]

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are sitting at your computer on an otherwise beautiful Friday afternoon when a mother brings her 16 year old son to the ED with chief complaint of allergic reaction.   Initial Vitals * Temp 98.7* HR 155* RR 28* BP 125/85* O2 99% Critical Actions * Interpret ECG * Interview patient alone (and identify trigger)* Perform vagal maneuver* A...

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are sitting at your computer on an otherwise beautiful Friday afternoon when a mother brings her 16 year old son to the ED with chief complaint of allergic reaction.   Initial Vitals Temp 98.7 HR 155 RR 28 BP 125/85 O2 99% Critical Actions Interpret ECG Interview […]

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at Clerkship General when a 51 year old female is brought in after a syncopal episode. Initial Vitals * Temp 100.2* HR 132* RR 28* BP 105/69* O2 85% Critical Actions * Give supplemental Oxygen* Diagnose Pulmonary Embolism* Administer Heparin* Assess contraindications for tPA* Administer tPA Final Diagnosis Massive P...

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at Clerkship General when a 51 year old female is brought in after a syncopal episode. Initial Vitals Temp 100.2 HR 132 RR 28 BP 105/69 O2 85% Critical Actions Give supplemental Oxygen Diagnose Pulmonary Embolism Administer Heparin Assess contraindications for tPA Administer […]

Case Introduction You are sitting at your computer on an otherwise quiet night when a young male is brought into your ED in obvious respiratory distress. Initial Vitals * Temp 98.6* HR 99* RR 34* BP 105/69* O2 95% Critical Actions * Give Albuterol + Ipratropium + Steroids* Obtain Chest Xray* Give Magnesium* Place patient on BiPAP* Give IV Beta Agonist (Epinephrine) Final Diagnosis Status Asthmatic...

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are sitting at your computer on an otherwise quiet night when a young male is brought into your ED in obvious respiratory distress. Initial Vitals Temp 98.6 HR 99 RR 34 BP 105/69 O2 95% Critical Actions Give Albuterol + Ipratropium + Steroids Obtain Chest Xray Give […]

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working at your local hospital when the next chart gets put in your rack. You groan. The chief complaint is dizziness.. Initial Vitals * Temp 98.6* HR 109* RR 20* BP 105/69* O2 100% Critical Actions * Diagnose Upper GI Bleed* Initiate IV Proton Pump Inhibitor* Obtain Type and Screen* Admit Patient to the Hospital* Identify Medicati...

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working at your local hospital when the next chart gets put in your rack. You groan. The chief complaint is dizziness.. Initial Vitals Temp 98.6 HR 109 RR 20 BP 105/69 O2 100% Critical Actions Diagnose Upper GI Bleed Initiate IV Proton Pump Inhibitor Obtain Type […]

The website it updated! Please check it out and email me with any technical issues or other comments/concerns. Enjoy your shift!

The website it updated! Please check it out and email me with any technical issues or other comments/concerns. Enjoy your shift!

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction A young gentlemen runs out to triage yelling “I can’t breath!” and collapses to the floor in front of the nurse… Initial Vitals Temp 98.8 HR 145 RR 45 BP 60/30 O2 85% Critical Actions Give Supplemental Oxygen Identify Pneumothorax Prior to Imaging Correctly Perform Needle Thoracostomy Correctly […]

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are having a busy day in the department when you are paged overhead to the resuscitation bay for an ill appearing patient with a headache… Initial Vitals Temp 98.9 HR 99 RR 18 BP 180/110 O2 94% Critical Actions Verbalize a Full Neurologic Examination Obtain CT Scan […]

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 […]

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 […]

CAUTION: THESE NOTES CONTAIN SPOILERS!!! 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 […]

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 […]

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 […]

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 […]

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction The nurse tells you that you have a new patient and is requesting a verbal order for nausea medicine. She advises you that the patient is the CEO of your hospital… Initial Vitals Temp 98.9 HR 99 RR 18 BP 120/80 O2 98% Critical Actions Perform Genitourinary Exam […]