Appendicitis (Critical Diagnosis)

Everybody knows what appendicitis is (fever, migrating right lower quadrant pain, elevated WBC, pain with bumps in the road). Unfortunately, the issue is that appendicitis only sometimes presents in this classic fashion. Using history, exam, and imaging, it is always important to keep a high index of suspicion for appendicitis so that you don’t miss the diagnosis.

Eye Complaints

Before you can learn the different eye diagnoses and how to treat them, you need to have a basic understanding of the ophthalmologic exam. Only after having this foundation can you finalize your approach to the red eye, acute vision loss, or eye trauma (which will be covered in future episodes).

https://www.youtube.com/watch?v=w9wMJ6job_0&t=62s

Bradycardia

The approach to bradycardia is very simple and straightforward. The most important thing is to remember you differential diagnosis. After that, it’s a simple algorithm that you’ll never forget.

Anaphylaxis (Critical Diagnosis)

Anaphylaxis is total body chaos resulting from massive, inappropriate degranulation of mast cells when exposed to an antigen. When this happens, you have to remember airway and epi. It will save a life.

Fluids (Guest)

IV fluids are something we deal with everyday in the emergency department. This podcast will teach you what you need to know about giving fluids.

Show Notes Update and Apps

There are 6 core apps that I’m currently using while running around the emergency department during my shifts, and we’ll cover the list in this episode. Also, we will soon be launching The EM Clerkship Pocket Guide which will replace the current, outdated, episode summaries. No specific date yet, but I already have the user interface designed and the content is now being written. ┬áStay tuned.

Surviving Overnights

One of the most difficult aspects of Emergency Medicine is shift work. Specifically, surviving overnights and the constant circadian chaos our body goes through by constantly rotating through morning, evening, and and overnight shifts. It happens to all of us, and in this episode I’m going to give you some personal strategies I’ve developed while in training.

Tachycardia

EM doctors specifically look for two things every time they see an EKG. Ischemic changes (STEMI, ST depressions, inverted T waves), and dysrhythmias (bradycardia and tachycardias). In this episode, we cover the 5 categories of tachycardias and a basic approach to each one.

Status Epilepticus (Critical Diagnosis)

On occasion, seizures won’t stop, or a seizure lasts longer then 5 minutes. Unlike a simple, single, resolved seizure, status epilepticus is an emergency. In these scenarios, we add to the descriptive and diagnostic workup discussed last week, and move on to a focused treatment algorithm to stop the seizure as soon as possible.

Seizure

One of the most common neurologic complaints we encounter in the Emergency Department is seizure. Typically, a patient with epilepsy will have a breakthrough seizure, or somebody will try some drugs and get a seizure, or the seizure will be the first symptom of a dangerous medical condition. Regardless, 911 will almost always get called if the seizure is witnessed, and by the time the patient gets to you, the seizure is almost completely resolved or they are stable and post-ictal. It is our job to sort through these cases.

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