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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.

Cardiac Arrest (ACLS)

You will probably witness a few cardiac arrest cases during your clerkship. Sometimes these happen in the hospital, but usually these patient’s will be brought into the ED, CPR in progress, by EMS. Just like in trauma, we follow a very basic, logical algorithm when we resuscitate these patients, and this algorithm is called ACLS.

RUQ Pain

It is really important to use the correct terminology when presenting a patient with right upper quadrant abdominal pain to your attending. If you want a good score on your SLOE, your differential diagnosis has to contain more than just “cholecystitis”. We will cover a basic approach today with a focus on the terminology to use in your differential diagnosis.

Low Risk Chest Pain

Not all patients with chest pain are having a STEMI, or massive PE, or aortic dissection. In fact, most patients with chest pain will have a set of normal labs, feel better, and we then have to decide what to do next. Admit or Discharge? What if we send this low risk patient, complaining of chest pain, home? What if they get home and die of a massive MI, and you had seen them the day before for chest pain? That’s why this is a huge topic that your attendings will want you to understand. In this episode we will talk low risk chest pain, and specifically, the HEART score.

Gunshot Wounds

When most people think about trauma, they think about gunshot wounds. However, not all gunshots come in as a multi system trauma alert. Not all patients have been shot in the chest or belly and need to be rushed to the OR. Much more commonly, we are dealing with gunshot wounds to the extremities. In this episode, we will cover the basic approach to the extremity gunshot wound.

Asthma and COPD (Critical Diagnosis)

COPD and asthma exacerbations are two of the most common pulmonary diseases we encounter in Emergency Medicine, and the severity of these attacks can vary from mild and basic to severe. It’s a clinical diagnosis, but there are lots of treatments to consider. Don’t be overwhelmed, we will cover a basic approach today.

GI Bleed

One of the most dangerous complaints in all of Emergency Medicine is the GI Bleed. Especially upper GI bleeds when patients are complaining of coffee ground emesis or black sticky poop. This week we will discuss the overall approach to anybody who comes in with a GI bleed.

Blood

Type and Screen? Type and Rh? Type and Cross? Emergency Release? I never received a talk in medical school about how to give blood to patients. So when I started residency, I was surprised and confused by how many options I could select when placing orders for blood! This episode covers the basic terminology you need to know so that you can sound smart on your clerkship.

Pulmonary Embolism (Critical Diagnosis)

This week we are having the talk… The PE talk. It will be one of the most high yield episodes we will ever have on the show. Before listening, please look up the Well’s Score and the PERC rule for reference, and email me with any questions.

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Kline, J. A., & Kabrhel, C. (2017). Emergency Evaluation for Pulmonary Embolism, Part 2: Diagnostic Approach. Journal of Emergency Medicine, 49(1), 104–117. https://doi.org/10.1016/j.jemermed.2014.12.041

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