EM Clerkship
Episodes
Peds T- Tummy and Non-Accidental Trauma
18 Feb 2018
Contributed by Lukas
Non-Accidental Trauma Estimated 10% of pediatric patients are victims of abuse Sexual abuse Physical abuse Neglect Common red flags Changing story Sto...
Peds I- Inborn Errors of Metabolism and Endocrinology
11 Feb 2018
Contributed by Lukas
Don’t be overwhelmed knowing/memorizing each inborn error of metabolism. The basic approach is actually quite easy!!! Inborn Errors of Metabolism (I...
Peds H- Heart Failure and Congenital Heart Disorders
04 Feb 2018
Contributed by Lukas
Common Chief Complaints Cyanosis Difficulty feeding Failure to thrive Cyanotic Heart Lesions Truncus arteriosus Aorta and pulmonary artery are fused S...
Peds S- Sepsis and Serious Bacterial Infections
28 Jan 2018
Contributed by Lukas
Pediatric “Sepsis” Consider in any toxic appearing child/neonate Especially with fever (or hypothermia) Treatment Early antibiotics Fluid bolus “...
Peds H- Hyperglycemia and Hypoglycemia
21 Jan 2018
Contributed by Lukas
Introduction In pediatric patients, have a low threshold to check blood sugar Undiagnosed diabetics commonly identified in ED during first episode of ...
Peds O- Oxygen, Airway, and Respiratory Disorders
14 Jan 2018
Contributed by Lukas
Applying oxygen is one of the first steps in treating any crashing child!!! Airway Emergencies Foreign body (FB) Patient presentation Stridor Choking ...
How to Save a Dying Baby
07 Jan 2018
Contributed by Lukas
When you have a critically ill child in front of you, always remember, OH SHIT, Grab the Broslow!!! Oxygen- Apply Oxygen and Consider Airway/Respirato...
Bleeding Disorders
31 Dec 2017
Contributed by Lukas
These are most important in trauma patients!!! Platelet Disorders Symptoms of SUPERFICIAL bleeding Mucosal bleeding GI bleeding Recurrent epistaxis Th...
How to Read an EKG
03 Dec 2017
Contributed by Lukas
Always remember…1, 2, 3, get an old EKG!!! Step 1: Identify the Rate and Rhythm Is it sinus rhythm? P wave before every QRS Is it one of the tachyca...
Pediatrics Exam
26 Nov 2017
Contributed by Lukas
Mnemonic: ABCDEF Appearance The ‘A’ in the pediatric assessment triangle Interactive vs distant Good tone vs floppy Calm and happy vs inconsolable...
Pediatrics History
19 Nov 2017
Contributed by Lukas
Always ask about pediatric patient’s ‘P-I-S-S’ status!!! Core Function Questions (P-I-S-S Status) Peeing Evaluates for dehydration Number of wet...
Fever in a Returning Traveler
12 Nov 2017
Contributed by Lukas
If a returning traveler has a fever, think malaria malaria malaria!!! Step 1: Ask your patient if they have traveled within the last year If yes… Yo...
Diarrhea
05 Nov 2017
Contributed by Lukas
If the patient is completely non-toxic and doesn’t have any red flags, they can usually go home without further testing!!! 3 Big (Non-Viral) Causes ...
Appendicitis
22 Oct 2017
Contributed by Lukas
Patients rarely have the “classic” presentation of appendicitis. Frequently it is misdiagnosed as GASTROENTERITIS!!! Three Stages of Appendicitis ...
Eye Complaints
15 Oct 2017
Contributed by Lukas
Common Complaints Red Eye Decreased Vision Trauma to the Eye Approach to a Vision Complaint Step 1: Assess visual acuity Visual acuity is the “vital...
Bradycardia
08 Oct 2017
Contributed by Lukas
Differential Diagnosis Mnemonic: HE DIES Hypothyroidism Elevated intracranial pressure (ICP) Cushings reflex Bradycardia Increased blood pressure Irre...
Anaphylaxis
01 Oct 2017
Contributed by Lukas
Airway and Epi! Airway and Epi! Airway and Epi! Introduction Anaphylaxis is caused by massive uncontrolled release of chemicals after exposure to “a...
Tachycardia
10 Sep 2017
Contributed by Lukas
Basic Approach Step 1: Is this SINUS tachycardia? P before every QRS? Treat the underlying condition Step 2: Is this a NARROW and REGULAR rhythm? SVT ...
Status Epilepticus
03 Sep 2017
Contributed by Lukas
Introduction Simple seizure Seizure ends in 5 minutes OR Patient has a 2nd seizure before waking up from 1st Initiate status epilepticus pathway Appro...
Seizure
27 Aug 2017
Contributed by Lukas
Basic Approach Step 1: Describe the seizure Did patient have an aura? Was there loss of consciousness? What did the movements look like? Did they have...
Cardiac Arrest (ACLS)
20 Aug 2017
Contributed by Lukas
Hard, fast, unrelenting chest compressions are the core of ACLS!!! Step 1: Check the Patient’s Pulse If the patient does not have a pulse, start CPR...
RUQ Abdominal Pain
13 Aug 2017
Contributed by Lukas
There are 5 key diagnoses classically associated with right upper quadrant (RUQ) abdominal pain. Cholelithiasis and Biliary Colic Cholelithiasis = Gal...
Gunshot Wounds (Arms and Legs)
30 Jul 2017
Contributed by Lukas
Evaluate 5 important structures when evaluating gunshot wounds in an extremity. Blood Vessel Injuries 3 Categories Hard-Signers Mnemonic: HARD Bruit H...
Asthma and COPD
23 Jul 2017
Contributed by Lukas
5 core treatments and 5 MORE treatments 5 Core Treatments Albuterol Beta agonist Bronchodilator Core treatment for asthma Ipratropium Anti-muscarinic ...
GI Bleed
16 Jul 2017
Contributed by Lukas
Basic Categories Upper GI Bleed Symptoms Coffee ground emesis Melena Black tarry stool Digested blood Common causes Peptic ulcer disease Varices Lower...
Pulmonary Embolism
02 Jul 2017
Contributed by Lukas
Introduction Pulmonary embolism (PE) is caused when a deep venous thrombosis from somewhere else in the body “embolizes” and becomes lodged in the...
Hemoptysis
18 Jun 2017
Contributed by Lukas
There are 3 main “categories” of hemoptysis… Mild, “Streaky” Hemoptysis Most common diagnosis Bronchitis Testing plan Chest xray Rules out a...
Salicylate Overdose
11 Jun 2017
Contributed by Lukas
Salicylate toxicity is the great toxicologic mimicker!!! Step 1: When to Suspect Salicylate Overdose Signs of CNS stimulation Tachypnea Hyperthermia A...
Acetaminophen Overdose
04 Jun 2017
Contributed by Lukas
Acetaminophen is the most important overdose in toxicology Step 1: Check a Serum Acetaminophen Level Common situations where testing is ordered Suicid...
Non-Pregnant Vaginal Bleeding
14 May 2017
Contributed by Lukas
Common Causes Structural Cancer Post-menopausal bleeding is cancer until proven otherwise Fibroids Adenomyosis Polyps Coagulopathy Present in approxim...
1st Trimester Vaginal Bleeding
30 Apr 2017
Contributed by Lukas
The pregnancy test is the most important test in females of reproductive age! Five Important Tests in 1st Trimester Vaginal Bleeding CBC Hemoglobin/He...
Constipation
23 Apr 2017
Contributed by Lukas
Common Causes of Constipation Lifestyle Low fiber diet Minimal water intake Poor exercise Medications Especially opiates Endocrine/electrolytes Hypoth...
Diabetic Ketoacidosis (DKA)
02 Apr 2017
Contributed by Lukas
The blood sugar is NOT the emergency- Acidosis, Hypokalemia, and Dehydration are!!! Signs and Symptoms Vomiting Abdominal pain Polydipsia Polyuria Ste...
Laceration Repair
12 Mar 2017
Contributed by Lukas
Step 1: Pain Control Local anesthesia Most common agent is lidocaine (frequently already in laceration repair kits) Inject through wound edges (not th...
Laceration Evaluation
05 Mar 2017
Contributed by Lukas
Lacerations are the single best opportunity to demonstrate your procedural skills during your clerkship!!! To Close or Not To Close? Closing a wound w...
Sore Throat
26 Feb 2017
Contributed by Lukas
You must know the FOUR emergent causes of sore throat! Step 1: Apply the Centor Criteria Determines if patients is at risk for Group A strep (“strep...
Procedural Sedation
19 Feb 2017
Contributed by Lukas
Procedural sedation is one of the core procedures in Emergency Medicine. You WILL see this during your clerkship Common Scenarios Cardioversion Orthop...
Back Pain
05 Feb 2017
Contributed by Lukas
Step 1: Identify Classic Red Flags for Can’t Miss Diagnoses Aortic Dissection and Abdominal Aortic Aneurysm (AAA) Age 50 Hypertension “Ripping” ...
Dental Pain
15 Jan 2017
Contributed by Lukas
Minor complaint. Huge SLOE points! Step 1: Identify Which Tooth is Causing Pain Bonus points if you number teeth correctly! Number 1-32 Tooth #1 is to...
Vertigo
08 Jan 2017
Contributed by Lukas
Does the patient have CENTRAL vertigo (bad) or PERIPHERAL vertigo? Step 1: How Does Patient Describe the Vertigo? Asking the patient to describe their...
Hyperkalemia
01 Jan 2017
Contributed by Lukas
Hyperkalemia = EKG… EKG changes = Calcium… Step 1: Recheck the Potassium Most common cause of hyperkalemia is PSEUDOhyperkalemia Caused by too agg...
How to Interpret a Chest X-Ray
11 Dec 2016
Contributed by Lukas
A-B-C-D-E-F-G Two Types of X-Rays Anterior-Posterior (“AP”) Classic “portable” xray The beam shoots from in front of the patient (anterior) TO...
Trauma in Pregnancy
06 Dec 2016
Contributed by Lukas
Mom is Scared. You are Scared. Don’t Be Scared. General Principles Evaluate for intimate partner violence in all poorly explained traumas during pre...
Genitourinary Trauma
13 Nov 2016
Contributed by Lukas
Four important injuries. Four different imaging studies to obtain. Step 1: Obtain Pelvic X-Ray Commonly performed at bedside as part of initial trauma...
Abdominal Trauma
06 Nov 2016
Contributed by Lukas
Step 1: Does This Patient Need Surgery NOW? Obvious penetrating injury to abdomen Peritonitis Hypotensive Step 2: FAST Scan Performed with bedside ult...
Cardiac Trauma
30 Oct 2016
Contributed by Lukas
Cardiac tamponade. Aortic Dissection. Blunt cardiac injury. Cardiac Tamponade Blood fills pericardial sac Increasing pressure on myocardium - Decrease...
Thoracic Trauma
16 Oct 2016
Contributed by Lukas
Step 1: Perform ATLS Primary Survey (B- Breathing) Signs of respiratory distress/injury Shortness of breath Hypoxemia Tracheal deviation Diminished br...
Neck Trauma
09 Oct 2016
Contributed by Lukas
The hardest question… Should you get a CTA? Blunt Trauma of Neck Obtain CTA if… Patient has neurologic deficit Numbness Weakness Visual changes Pa...
C-Spine Trauma
02 Oct 2016
Contributed by Lukas
Step 1: Protect the Spine Apply cervical collar Step 2: Apply NEXUS Criteria Use the “SPINE” mnemonic Spinal midline tenderness Painful distractin...
Facial Trauma
25 Sep 2016
Contributed by Lukas
There are 6 major areas/injuries to the face. Basic Approach to Facial Injury Step 1: Airway Indications for intubation after trauma Burns to the airw...
Head Trauma
11 Sep 2016
Contributed by Lukas
CT scan without contrast is your test of choice. Step 1: Consider Your Differential Diagnoses Five high-yield head trauma diagnoses Skull fracture Ext...
Stroke
21 Aug 2016
Contributed by Lukas
Get your attending! Step 1: Obtain Last Known Well Stroke treatments including tPA and thrombectomy both require last known well
Syncope
07 Aug 2016
Contributed by Lukas
6 EKG Findings. 6 Risk Factors. 6 Mimics. Step 1: Get an EKG This is the only “required” test for a patient with syncope Other common tests CBC Ev...
Common Pain Medications
24 Jul 2016
Contributed by Lukas
Acetaminophen. Ibuprofen. Hydrocodone. Ketorolac. Morphine. Hydromorphone. Oral Acetaminophen (Tylenol) Give every 4-6 hours Regular strength – 325m...
STEMI
17 Jul 2016
Contributed by Lukas
You have 90 minutes to restore blood flow. Step 1: Obtain EKG and Call STEMI Alert This activates ED resources as well as cath lab, interventional car...
Toxicology
04 Jul 2016
Contributed by Lukas
Poison Control Hotline: 1-800-222-1222 Step 1: Evaluate the Airway General principles “If they can’t speak, they can’t control their airway” “...
BRUE (Pediatrics)
20 Jun 2016
Contributed by Lukas
3 Categories: High Risk BRUE. Low Risk BRUE. Not a BRUE. Step 1: Is This a BRUE? Brief
Trauma
06 Jun 2016
Contributed by Lukas
Airway/C-spine. Breathing. Circulation. Disability. Exposure. Secondary Survey. Airway and C-Spine General airway principles “If they can’t speak,...
Priapism
30 May 2016
Contributed by Lukas
The nerve, artery, and vein are at 12 o’clock. The urethra is at 6 o’clock. Two Types of Priapism High flow (non-ischemic) Common causes Trauma AV...
Preeclampsia (Critical Diagnosis)
23 May 2016
Contributed by Lukas
Never ignore a pregnant woman’s blood pressure. Introduction Pre-Eclampsia Pathophysiology unknown Pregnancy induced multi-organ dysfunction Definit...
Headache
16 May 2016
Contributed by Lukas
With this complaint, it’s ALL about doing a good history and exam. Step 1: Write Out Your Differential Diagnosis The KING Subarachnoid hemorrhage Th...
Tummy Ache
03 May 2016
Contributed by Lukas
Don’t forget to do a thorough GU exam! Step 1: Write Out Your Differential Diagnosis Remember 2-4-2-4 (2) In the upper abdomen Pyloric stenosis Pneu...
Circulation (Shock)
26 Apr 2016
Contributed by Lukas
Tank. Clogged Pipes. Broken Pipes. Pump. Introduction “Tank” Hypovolemic shock Hemorrhagic shock “Clogged Pipes” Cardiac tamponade Tension pne...
Breathing
19 Apr 2016
Contributed by Lukas
Hypoxemia fixed by only TWO things: FiO2 and PEEP Step 1: Add FiO2 If the patient is breathing… Nasal cannula Non-rebreather mask If the patient is ...
Airway
11 Apr 2016
Contributed by Lukas
“Airway” does not necessarily mean “Intubation” Introduction In emergency medicine we are taught “A-B-Cs” These are actions that can be ac...
Epistaxis
03 Apr 2016
Contributed by Lukas
Don’t forget to wear protective gear. Gown up! Initial Encounter History Anticoagulants Easy bleeding/bruising Lightheadedness Exam Pallor Tachycard...
Chest Pain
27 Mar 2016
Contributed by Lukas
There are six cardiopulmonary causes of chest pain that you need to know. The SIX Causes Cardiac Acute coronary syndrome (ACS) Pericarditis with tampo...
Patient Presentations
27 Mar 2016
Contributed by Lukas
Patient presentations are the single most important skill to develop for your Emergency Medicine rotation. General Principles Stay focused, thorough, ...
Introduction
20 Mar 2016
Contributed by Lukas
To Do Well On WRITTEN Exam Study the “Core 4” body systems Neurology Headache Strokes Meningitis Cardiology Chest pain ACS EKG interpretation Pulm...