Month: August 2016

Abdominal Pain

The most common chief complaint in Emergency Medicine is abdominal pain. Most students already have an understanding of the basic approach to this problem. We know to ask about fevers, palpate the abdomen, and give something for nausea. In this episode we will be discussing an additional 5 steps that tend to be overlooked with this chief complaint as well as some can’t miss items on your differential diagnosis. 

Stroke (Critical Diagnosis)

Today we are talking about the critical diagnosis of stroke. Specifically, we need to discuss what to do during ischemic strokes. And the most important thing to remember is that TIME IS BRAIN. If you ever suspect that your patient is having a stroke, you need to get your attending immediately. After that, stroke protocols follow a very regimented pattern that we will be overviewing today.

Shortness of Breath

The most important thing to remember about shortness of breath is that you need to keep your thoughts and actions focused by using an organized approach. I recommend thinking anatomically. The differential diagnosis for this complaint is huge, and it’s really easy to make mistakes if you don’t develop a system. Also, you MUST calculate a Well’s Score and PERC criteria for your patients with shortness of breath. This is how you determine what tests to pick when you evaluate for pulmonary embolism. Learn this now, because your attendings will quiz you on this frequently during your clerkships.

Syncope

The key to understanding syncope is understanding who is at high risk and who can go home. Over the years, numerous different studies have been done looking at this topic. The easy way to remember the approach to syncope is 6-6-6. There are 6 high risk EKG findings. 6 important risk factors, and 6 deadly syncope mimics (aka the “Rule of 15s”). Patients with these are at high risk for sudden death and typically need to be admitted, even if they sound like a “simple” case of “orthostatic” syncope.