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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 an unresponsive 6-year-old female found foaming at the mouth by her babysitter. ETA 2 minutes.”
Initial Vitals:
BP: 125/80
HR: 62
RR: 34
O2: 81% (Non Rebreather)
Critical Actions:
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Shoulder dystocia is an OB emergency. Remember McRobert’s maneuver and suprapubic pressure. For more information, take a look at the resources below.
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Maddie’s 7 Cardinal Movements of a Successful Delivery:
1. Head comes out
2. Head turns
3. Cord Assessment
4. Anterior shoulder delivered
5. Posterior shoulder delivered
6. Body delivered.
7. Baby on mom’s chest
T’s of Postpartum Hemorrhage:
1. Tone
2. Trauma
3. Tissue
4. Thrombosis
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You are working at Clerkship Rural when the nurse hands you your next chart to see. It’s a 59 year old farmer with chest pain.
Initial Vitals:
BP: 156/97
HR: 110
RR: 22
O2: 98% (Room Air)
Temp: 98.8F
Critical Actions:
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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 an agitated and combative 30 year old male, we’ll see you in 5 minutes.”
Initial Vitals:
BP: 192/105
HR: 134
RR: 22
O2: 99% (Room Air)
Temp: 98.8 F
Critical Actions:
Dangerous Actions:
Check Out:
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You are working at Clerkship General when the charge nurse comes and grabs you… “Hey doc, we need you in room 2, this kid looks sick…”
Initial Vitals:
BP: 68/40
HR: 128
RR: 22
O2: 99% (Room Air)
Temp: 103.5F
Critical Actions:
Check Out:
Pearson Ravitz Webinar – “Disability Insurance 101 for Residents”
https://us06web.zoom.us/webinar/register/1416806357023/WN_ziYRNc0kT8yAyOOJZ-Xk2g
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You are working at Clerkship General on an overnight shift when the next chart is handed to you. It’s a 35 year old male with a chief complaint of groin pain.
Initial Vitals:
BP: 150/90
HR: 107
RR: 20
O2: 99% (Room Air)
Temp: 98.0F
Critical Actions:
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In this long-form episode we will discuss opioid use disorder, the leading cause of death in young adults in the United States. What you do matters!
References
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This episode will answer 3 big pre-Match Day questions:
1. How do I go about making my rank list?
2. What about post-interview communication both from and to programs?
3. How does this whole thing called the Match actually work?
Resources:
https://www.emra.org/books/msadvisingguide/preparing-and-submitting-your-rank-list/
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Case Introduction
You are sitting at your computer on an otherwise quiet night when a young male is brought into your ED in obvious respiratory distress.
Initial Vitals
Critical Actions
Final Diagnosis
Status Asthmaticus
Tips and Tricks
Frequently perform verbal reassessments on patients with the examiner (vitals, patient appearance, pain, etc)
Additional Reading
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Case Introduction
You are working at your local hospital when the next chart gets put in your rack. You groan. The chief complaint is dizziness..
Initial Vitals
Critical Actions
Final Diagnosis
Upper GI Bleed due to Peptic Ulcer
Tips and Tricks
If you get stuck in a case and don’t know what to do next. Identify all abnormal findings that you have been provided
Additional Reading
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The website it updated! Please check it out and email me with any technical issues or other comments/concerns. Enjoy your shift!
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Case Introduction
A young gentlemen runs out to triage yelling “I can’t breath!” and collapses to the floor in front of the nurse…
Initial Vitals
Critical Actions
Final Diagnosis
Pneumothorax Secondary to Penetrating Chest Trauma
Tips and Tricks
Be careful, lack of visual cues during oral cases can mislead you!
Additional Reading
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You are having a busy day in the department when you are paged overhead to the resuscitation bay for an ill appearing patient with a headache…
Acute Subarachnoid Hemorrhage on Anticoagulation
Always ask the patient if they have allergies prior to administering ANYTHING.
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A 45 year old female is exposed to peanut butter and shrimp pizza and begins to have an apparent allergic reaction…
Refractory Anaphylaxis Due to Beta Blockers
You still need to obtain a quick history and exam even if you know the diagnosis in the first few seconds of the case
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The nurse brings back a young adult male from the lobby who is having a seizure…
Isoniazid Toxicity
When the patient is unable to provide history, attempt to obtain the information from external sources
Ketamine not Keppra as potential induction agent for status epilepticus (32:40)
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EMS brings in an elderly man who has fallen…
Ground level fall resulting in hip fracture, missed dialysis, and severe hyperkalemia
Patient’s will frequently have more than one final diagnosis. Do not prematurely close an the initial, obvious, diagnosis.
A man can have as many diseases as he damn well pleases!
Hickam’s dictum
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Just a routine day at your hospital, your next patient has a chief complaint of headache…
Acute Angle Closure Glaucoma
Do not be surprised or scared when an examiner has a monotone voice and flat affect
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A notorious, disheveled frequent flyer presents to your emergency department for her back pain and is asking for more Dilaudid…
Spinal Epidural Abscess
Don’t let consultants or other members of your team talk you out of appropriate management of a patient
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