Month: May 2016

Priapism

When I was on my clerkship, a few of my classmates had patients present to the emergency department with priapism. It’s not common. But even if you don’t get a case during your clerkship, you will certainly see one during residency. There are two types of priapism: ischemic and non-ischemic. Ischemic is the type we will focus on this week. It is the most common type and, unfortunately, the most dangerous type. But don’t be scared, it’s not that hard. Just remember your anatomy, and follow the 5 basic steps.

Preeclampsia (Critical Diagnosis)

It’s time to start diving deep into the critical diagnoses of Emergency Medicine. Partially because I think we need to mix up the format every once in awhile to keep things interesting, but also because your attending will expect you to know the basics about these common emergencies. Today, we’re starting with preeclampsia. Never ignore a blood pressure greater than 135/85 in a pregnant woman! This is a HUGE pitfall that young doctors make, because a mildly elevated blood pressure may be the only objective warning you get before the patient develops massive end-organ damage, pregnancy failure, eclampsia, and HELLP syndrome. ALL pregnant patients >20 weeks and ALL recently postpartum patients with a blood pressure greater than 135/85 need certain tests, treatments, and OBGYN consultation. They might have the critical diagnosis – Preeclampsia

Headache

Headache is one of the most common chief complaints that you will see on your clerkship. Luckily, it is also one of my favorite cases to evaluate. Why do I love it so much? Because I don’t need to be completely dependent on ancillary testing! IT’S ALL ABOUT THE HISTORY AND EXAM. In this episode, we will cover the critical differential diagnosis for headache, the key red flags, exam, and a simple plan. This is a CORE neurologic topic. So listen extra closely today, and be sure to check out the website if you need a written summary  of the content.

Patient Encounters

During your clerkship, you will rapidly develop a flow for your shift. What do you do when you first pick up a chart? How much do you let your patients ramble? After you evaluate your patient, do you sprint at full speed straight to your attending? What do you do AFTER your initial evaluation? It takes years to master this skill.

The first step is to develop a basic approach. Today, I’m going to give you MY approach to a patient encounter. From the moment that chart touches my hand to the moment that patient leaves the department. Feel free to adapt it however you want, but this is definitely a decent starting point.

Tummy Ache (Pediatrics)

Today we are moving on to a completely new topic, we are going to be discussing a simple approach to pediatric GI complaints. I hope you enjoy it. The majority of this episode will be covering the life-threatening, differential diagnosis for pediatric abdominal pain. It is 12 items long, and can be thought of in regions: Upper Abdomen, Lower Abdomen, Genitourinary, and Generalized.

Also, in this episode, we will discuss how to obtain a quick pediatric GI history, the 5 most common tests that get ordered on children, and a basic GI treatment plan.

Even if your department doesn’t accept children, I still highly encourage you to listen, as this is not only a topic on your shelf, but also a huge topic on Step 2.

Let me know if you have any feedback on the content, and please check out the new website emclerkship.com

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