EM Clerkship

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**EM Clerkship**

The purpose of this podcast is to help medical students crush their emergency medicine clerkship and get top 1/3 on their SLOE. The content is organized in an approach to format and covers different chief complaints, critical diagnoses, and skills important for your clerkship.

Latest Episodes:

Deep Dive R25 MW Oct 17, 2024

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Transcript/Summary coming soon!

Round 25 (MW) Laboring Mom in Triage Oct 01, 2024

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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

Deep Dive MW R24 Sep 16, 2024

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Transcript coming soon!

Round 24 (MW) Nursing Home Transfer Sep 02, 2024

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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 Actions:
* Check a blood glucose
* Obtain a full set of vitals
* Diagnose necrotizing soft tissue infection
* Consult surgery before a CT scan
* Correct antibiotic coverage

Deep Dive MW R23 Aug 17, 2024

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Episode summary coming soon!

Round 23 (MW) Pediatric Altered Mental Status Aug 01, 2024

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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 gas

Deep Dive MW R22 Jul 16, 2024

Show notes

Guillain-Barre Syndrome (GBS) – Autoimmune polyneuropathy that results in widespread demylination of peripheral nerves
Typically occur 1 week after a triggering infection
Paresthesias/Neuropathic Pain -> Ascending symmetric paralysis -> Respiratory Failure
Major Diagnostic Criteria
* Progressive limb weakness in multiple limbs that is relatively symmetric
* Diminished/Absent deep tendon reflexes in affected limbs
* No alternative diagnosis
* CSF studies have false-negatives – May see albuminocytologic dissociation (Elevated protein with normal cell counts)
Treatment – IVIG and monitor respiratory status

Round 22 (MW) Fall with Weakness Jul 03, 2024

Show notes

Critical Actions:
* Treat the Patient’s Pain
* Perform a detailed neurologic exam (including reflexes)
* Perform LP
* Administer IVIG
* Check NIF or FVC and intubate prior to transfer

Deep Dive MW R21 Jun 16, 2024

Show notes

Orbital Compartment Syndrome – needs to be diagnosed CLINICALLY
On exam, LOOK for: Proptosis, Ophthalmoplegia, Afferent Pupillary Defect, Vision Loss
On exam, FEEL for: Rock hard globe, tense eyelids, resistance to retropulsion
IOP > 40 means immediate canthotomy is indicated!
Don’t perform if open globe is present
Lateral Canthotomy Procedure: Anesthetize, Devascularize, Canthotomy, Cantholysis (inferior crus first)
Paperclip Eyelid Retractors

Round 21 (MW) Geriatric Fall Jun 01, 2024

Show notes

You are working at Clerkship General when the next chart is put into your rack. It’s a 76 year-old male who has fallen.
Initial Vitals:
HR: 101
BP: 138/85
Temp: 98.0F
RR: 20
O2: 99% (Room Air)
Critical Actions:
* Diagnose Retrobulbar Hematoma
* Diagnose Subdural Hematoma
* Reverse Anticoagulation
* Perform a Lateral Canthotomy Procedure
* Administer Tetanus Shot
* Elevate the Head of Bed

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