The EM Clerkship Podcast

In this long-form episode we will discuss opioid use disorder, the leading cause of death in young adults in the United States. What you do matters! References

This episode will answer 3 big pre-Match Day questions: 1. How do I go about making my rank list? 2. What about post-interview communication both from and to programs? 3. How does this whole thing called the Match actually work? Resources: https://www.emra.org/books/msadvisingguide/preparing-and-submitting-your-rank-list/

Aortic Dissection – when there is a tear in the intima layer of the aorta and the blood dissects the intima away from the media creating a false lumen in the aorta Further Reading: Core EM – Aortic Dissection LITFL – Aortic Dissection

You are working at Clerkship General when the base command phone rings – “Hey doc just wanted to give you a heads up on this stroke alert we’re bringing you – we have a 70yo M with sudden onset left arm numbness and weakness, last known well 2 hours ago, we’ll be there in about […]

Not your typical wellness episode – by Zack

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… Initial Vitals: Temp: 98 BP: 120/80 HR: 89 RR: 20 O2 Sat: 100% Critical Actions:

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 […]

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. Critical Actions: 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 […]

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 […]

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Understand the timeline – research programs to find out when they extend invites and when they host interviews Prepare for invitations – set up email and text notifications, get a calendar Accept invitations – respond promptly and keep your calendar updated Optimize invitations – any interview date you get is a good one, but planning […]

Summary of Key Points 1. You should consider ectopic pregnancy in every patient who is capable of bearing children 2. If a patient of child bearing age presents with severe abdominal pain or vaginal bleeding and is either hemodynamically unstable or very ill appearing, this is a ruptured  ectopic pregnancy until proven otherwise and I […]

You are working at Clerkship General when the next chart gets handed to you – a 31 year old female presenting with abdominal pain. Initial Vitals: BP: 109/65 HR: 96 RR: 21 O2: 99% Temp: 99.1F Critical Actions: Obtain pregnancy test Confirm IUP Administer Rhogam Treat UTI Counsel the patient and discharge them Further Reading: […]

Things to consider when selecting residency programs to apply to:  1.  What type of program (County, Community, Academic) 2.  What length of program (3 year vs. 4 year) 3.  Location 4.  Culture and Lifestyle 5.  Niches in EM Further Resources: EMRA Residency MapDoximity NavigatorSAEM Residency FairEMRA Residency Fair

3 Steps to assessing your competitiveness for matching in an EM residency:  1.  Get a good advisor. 2.  Look at the data. 3.  Maximize your potential. Further Reading: EMRA – Apply smarter not harderEMRA HangoutsEMRA Student-Resident Mentorship ProgramNRMP Charting the OutcomesNRMP Residency DataALiEM – Match AdviceUTSW Texas STAR

The future of emergency medicine seems bleak. Listen to Zack’s perspective on the future of our beloved specialty in part TWO of this two-part series.

You are working your FIRST SHIFT EVER at Clerkship General hospital when a 60 year old female presents with shortness of breath. Initial Vitals: HR: 92 RR: 28 BP: 120/80 O2%: 89% Temp: 101.2F Critical Actions: Obtain full set of vital signs Diagnose PNA and COPD exacerbation Administer appropriate antibiotics Treat symptoms with steroids and […]

The future of emergency medicine seems bleak. Listen to Zack’s perspective on the future of our beloved specialty in part one of this two-part series.

You are working at *rural* Clerkship General when you receive a radio call from EMS – 7yo male from a severe bus accident with a large scalp laceration, unable to control the hemorrhage. Initial Vitals HR: 136 RR: 22 BP: 80/35 O2%: 100% Temp: 98F Critical Actions: Perform ATLS Algorithm Control Hemorrhage Transfuse pRBCs Replete […]

Asymptomatic Bradycardia – usually don’t treat Symptomatic Stable Bradycardia – atropine, further workup Symptomatic Unstable Bradycardia – SIMULTANEOUS treatment with medications and electricity Meds: Trial of atropine, then either epinephrine, dopeamine, or isoproterenol Electricity: Transcutaneous Pace –> TVP DDX of Bradycardia – BRADIE Blocks (av blocks) Reduced vital signs (hypoxemia, hypo...

What is most important to programs from ERAS? SLOEs, clinical grades on EM rotations and residency interviews. How do you look good on interviews? Have a thorough ERAS application that gives interviewers lots to ask about! On ERAS, there are four sections in the curriculum vitae portion: Education – honorary societies, medical school awards, other […]

ERAS Pt 1: The 8 Parts of the ApplicationThere are 8 parts to the application: Personal and Biographic Information – mostly self-explanatory Curriculum Vitae (Resume) – keep an updated CV throughout medical school to makethis easy to fill out, be concise but specific Personal Statement – start early Letters of Recommendation – should ideally have […]

You are working at Clerkship General when you are called to see a 70 yo male who is presenting with shortness of breath. Initial Vitals Temp 98.0 HR 36 RR 28 BP 80/35 O2 82% Critical Actions Interpret ECG Correctly (3rd degree AV block) Order a troponin Perform and Describe transcutaneous pacing Perform and Describe […]

DOPES D-Displacement – endotracheal tube dislodges from trachea, or falls into right mainstem bronchus O-Obstruction – Mucous plugging, bronchospasm, patient biting tube P –Pneumothorax – Look out for pneumothorax, it can be subtle E – Equipment – Disconnected/unpowered equipment, ensure everything is powered on and connected appropriately S – Stacking – common in asthma/COPD due […]