The purpose of this podcast is to help medical students crush their emergency medicine clerkship and get top 1/3 on their SLOE. The content is organized in an approach to format and covers different chief complaints, critical diagnoses, and skills important for your clerkship.
ABEM-style cases presented on EM Clerkship are not my actual ABEM exam cases, and they are not based on my actual cases. I will never be discussing my actual exam details with anybody, including on this podcast. The cases were created independently, by me, for the purpose of medical education and improving patient care. Topics are chosen from the publicly available ABEM model of clinical practice and are built from scratch using a my own custom template. If you would like a copy of this template, please email me and I can send you a copy.
Salmoirago-blotcher E, Fitchett G, Leung K, et al. An exploration of the role of religion/spirituality in the promotion of physicians’ wellbeing in Emergency Medicine. Prev Med Rep. 2016;3:189-95.
Curlin FA, Lantos JD, Roach CJ, Sellergren SA, Chin MH. Religious characteristics of U.S. physicians: a national survey. J Gen Intern Med. 2005;20(7):629-34.
The Resurrection of the Son of God (Christian Origins and the Question of God, Vol. 3) -N.T. Wright (Amazon)
Thank you to our EMS.
There will be no episode this weekend. I plan on postponing the 2019 kickoff episode until next week out of respect for recent events. The pre-recorded 2019 kickoff episode will post at that time and we will be back on a normal schedule and with normal content. Thanks, Zack
Pilot: Jennifer Topper
Flight Paramedic: Bradley Haynes
Flight Nurse: Rachel Cunningham
When should you stop CPR and pronounce death?
Jordan MR, O’keefe MF, Weiss D, Cubberley CW, Maclean CD, Wolfson DL. Implementation of the universal BLS termination of resuscitation rule in a rural EMS system. Resuscitation. 2017;118:75-81.
Jabre P, Bougouin W, Dumas F, et al. Early Identification of Patients With Out-of-Hospital Cardiac Arrest With No Chance of Survival and Consideration for Organ Donation. Ann Intern Med. 2016;165(11):770-778.
Goto Y, Funada A, Goto Y. Duration of Prehospital Cardiopulmonary Resuscitation and Favorable Neurological Outcomes for Pediatric Out-of-Hospital Cardiac Arrests: A Nationwide, Population-Based Cohort Study. Circulation. 2016;134(25):2046-2059.
Kidney stones are a diagnosis of exclusion. When you see flank pain or testicular pain or lower abdominal pain on the triage note, you have to consider testicular torsion. Testicular torsion is a high risk, high morbidity diagnosis that is very time sensitive.
In this 5 part series I will be reflecting on a list of non-clinical stuff I learned while in residency. This week: showing up on time, voicing concerns, written evaluations, and watching what you say.
In this 5 part series I will be reflecting on a list of non-clinical stuff I learned while in residency. This week: managing time, what to study during your 1st year of residency, sleep, and annoying colleagues.
We are considering rabies prophylaxis on all animal bites or scratches that come to the Emergency Department. We don’t have to give it every time, but there is a specific protocol we’re supposed to follow
This is a concept episode for a series of lectures on Emergency Dermatology (one of my favorite topics). Over the course of several episodes, we will develop an organized, systematic, visual approach to the diagnosis of all life threatening rashes as well as the majority of the other rashes you will see in the ED.
Subarachnoid hemorrhage is the king of life-threatening headaches and is on my differential every time. This episode will cover how to take the history, exam, testing and treatment of this devastating diagnosis.
Most nutrition disorders are common sense, and we don’t really treat them in the ED very often. Vitamin D deficiency with it’s osteoporosis, Vitamin C with scurvy, and iron deficiency anemia. But there are several nutritional disorders that we do see frequently in the ED. They hide in the shadows of your most malnourished patients, and you can save them if you catch the disease in time.
When patient’s come in with MI or shortly after having an MI, you need to think beyond “Is this another heart attack?”. There is a whole list of complications from heart attacks that you need to remember, and that is what we’re covering this week.
tPA bleeding isn’t the most high yield scenario for your clerkship, but it is a perfect case to review the physiology of hemostasis and also might save a life when you’re a resident or attending someday.
tPA is currently the core treatment for ischemic stroke, and this week we will discuss some of the physiology on how this drug works as well as how to remember a VERY important list of tPA contraindications.
Neonatal jaundice is a common complaint in pediatric emergency medicine and a very high yield topic for your test. Identify one of 3 causes of neonatal jaundice while keeping the bilirubin number low enough to avoid brain damage.
Nausea and vomiting has a HUGE differential diagnosis but usually ends up being simple gastritis in the end. This week we will discuss a basic approach, treatment protocol, as well as to help out your attending.
Don’t be scared of the inborn errors of metabolism and endocrinology. They are really quite simple to screen for. Focus less on knowing the details of each one, and more on the general concept of what byproducts are building up and what substance is missing.
Cyanosis, difficulty feeding, failure to thrive, and shock can all be the presenting symptom of a cardiac abnormality. We will briefly overview cyanotic heart lesions, ductal dependent lesions, and CHF today.
Physicians get concerned about 4 serious bacterial infections (SBIs) when a baby or young child comes in with fever or possible sepsis. UTI, bacteremia, meningitis, and pneumonia. Start those antibiotics early, especially if the child appears sick.
I just stumbled on a study by The Doctors Company, a big malpractice insurer, looking at 332 closed claims against ED physicians. MOST of these cases were from missed or delayed diagnosis, and statistically, it was TWELVE diagnoses that made up the majority of these.
So, in the musical spirit of Christmas, my gift to you is the most high yield, medicolegal, differential diagnosis that exists In the world…
The Doctors Company. Emergency Medicine Closed Claims Study. April 2015. Accessed December 22, 2017
*Music Licensed by AudioJungle
Performing an emergency delivery is very intimidating. The good news is that in most scenarios, as long as you don’t drop the baby, it should go very naturally. However, there are exceptions to this which we will cover today.
EM physicians are the masters of EKG interpretation. We will cover an organized EKG interpretation system today with an emphasis on identifying life threats, and this will act as the foundation for your EKG interpretation skills for the rest of your career.
Really sick kids and babies are some of the scariest and most difficult cases we get in Emergency Medicine. This week we’re going to start with the general approach to the less-sick pediatric patient. We will use this as the groundwork for future episodes.
One of the topics that we typically DONT study much in Emergency Medicine is tropical medicine, and specifically fever in returning travelers. The reason this is important, is because MALARIA is a huge life threat in this patient population that can be easily missed. It is very important to ask about recent travel and then go through a simple approach when they say “yes”.