The EM Clerkship Podcast

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkship General when EMS calls you on the radio… “Hey doc we’re bringing a young female who drowned in a pool ETA 1 minute”. Initial Vitals Temp 95.0F HR 55 RR 5-6 BP 110/82 O2 90% Critical Actions Evaluate for traumatic […]

Kawasaki Disease A small vessel vasculitis that affects children, usually <5 years old. Symptoms – remember the CRASH AND BURN mnemonic! Conjunctivitis Rash – nonspecific morbilliform or maculopapular rash, usually on torso Adenopathy – usually unilateral cervical lymphadenopathy Strawberry Tongue – erythema, swelling, or cracking of lips/mucous membranes Hands – swelling, erythema, or desquama...

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkshift General when the next chart is handed to you – a four year old male named Tommy with chief complaint of dehydration. Initial Vitals Temp 100.4F HR 132 RR 22 BP 98/64 O2 98% Critical Actions Identify key historical findings […]

“The Brady Bunch” – Beta-Blockers, Calcium Channel Blockers, Digoxin, Clonidine Treatment of Beta Blocker OD Activated Charcoal – Only if ingestion time was <1 hour ago, and only if patient is protecting their airway (or intubated).   2. Glucagon – the best answer for the exam, unlikely to work in real life 3. Epinephrine Drip […]

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkshift General when you are called to the resuscitation bay to see an elderly patient with unstable vitals brought in by EMS. Initial Vitals * Temp 98.0F* HR 43* RR 18* BP 60/40* O2 98% Critical Actions * Diagnose the etiology for the bradycardia (BB overdose)* Administer Atropine* Administer Glucagon* Adm...

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkshift General when you are called to the resuscitation bay to see an elderly patient with unstable vitals brought in by EMS. Initial Vitals Temp 98.0F HR 43 RR 18 BP 60/40 O2 98% Critical Actions Diagnose the etiology for the […]

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 […]