EM Clerkship

By Zack Olson, MD and Michael Estephan, MD

Education Medicine

What's EM Clerkship about?

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.

5.0

509 ratings

Download our free app to listen on your phone

LAST EPISODE

Deep Dive – Round 26

10.15.2021

Cardiac Tamponade Cardiac Tamponade – A physiological state caused by a pericardial effusion in which the pressure in the pericardial sac is higher than the pressure inside the right sided chambers of the heart, leading to impaired filling, decreased cardiac ...

EM Clerkship episodes:

10.15.2021 Deep Dive – Round 26 Cardiac Tamponade Cardiac Tamponade – A physiological state caused by a pericardial effusion in which the pressure in the pericardial sac is higher than the pressure inside the right sided chambers of the heart, leading to impaired filling, decreased cardiac ...
10.01.2021 Round 26 (Stridor, Vomiting, Shock) Case Introduction You are working a shift at your local free-standing emergency room when a family of three checks in to be seen (a father and his two sons). Initial Vitals#1 (Chris, 18mo with stridor) * Temp 100.4F* HR 120* ...
09.15.2021 Deep Dive – Round 25 Hyponatremia in the ED Four questions to ask yourself: * Is the patient symptomatic from their hyponatremia (confusion, nausea/vomiting, ams, seizures, etc)?* If not, outpatient followup (unless super low)* Is the patient having severe neurologic symptoms from their hyponatremia? (seizures, ...
09.01.2021 Round 25 (Seizure) CAUTION: THESE NOTES CONTAIN SPOILERS!! Case Introduction You are working a shift at EM Clerkship General when you are called to the waiting room by the charge nurse for a seizing patient. Initial Vitals * Temp 99.0F* HR 97* RR ...
08.16.2021 Deep Dive – Round 24 Acetaminophen Overdose & Toxicology Pearls * History: Figure out how much was taken, what time the ingestion occurred, and if any other toxins were ingested* Physical Exam: Perform a regular physical exam, and in addition, perform the toxicologic physical exam!* ...
08.01.2021 Round 24 (Altered Mental Status) CAUTION: THESE NOTES CONTAIN SPOILERS!! Case Introduction You are working a shift at EM Clerkship General when you receive a radio call from EMS who are bringing in a young female who was found unresponsive. Initial Vitals * Temp 98.0F* ...
07.15.2021 Deep Dive – Round 23 Asymptomatic Hypertension * Make SURE the patient isn’t having symptoms of end organ dysfunction, which could make this hypertensive emergency (confusion, severe headache, blurry vision, weakness, chest pain, shortness of breath, seizures during pregnancy, etc). * ACEP clinical policy states, ...
07.01.2021 Round 23 (High Blood Pressure) CAUTION: THESE NOTES CONTAIN SPOILERS!! Case Introduction You are working a shift at EM Clerkship General when you are handed the next chart, a 60 year old male presenting with high blood pressure. Initial Vitals * Temp 98.0F* HR 90* ...
06.15.2021 Deep Dive – Round 22 Neonatal Resuscitation THIS IS A BASIC FRAMEWORK AND IS NOT COMPREHENSIVE * EVALUATE* Is the newborn crying/breathing spontaneously? Does the newborn have good tone? Is the newborn a term infant?* If YES, hand baby to mom for direct skin-to-skin.* If ...
06.01.2021 Round 22 (Cardiac Arrest) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkship General when the triage nurse runs and grabs both you and your attending for a patient in triage who has active CPR in progress. Initial ...
05.15.2021 Deep Dive – Round 21 Torsades de Pointes (TdP) A type of polymorphic ventricular tachycardia that is inherently unstable and often quickly degrades into ventricular fibrillation. It usually occurs in the setting of a prolonged QT interval, which can either be genetic or acquired. Treatment ...
05.01.2021 Round 21 (Drowning) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkship General when EMS calls you on the radio… “Hey doc we’re bringing a young female who drowned in a pool ETA 1 minute”. Initial Vitals ...
04.15.2021 Deep Dive – Round 20 Kawasaki Disease A small vessel vasculitis that affects children, usually <5 years old. Symptoms – remember the CRASH AND BURN mnemonic! Conjunctivitis Rash – nonspecific morbilliform or maculopapular rash, usually on torso Adenopathy – usually unilateral cervical lymphadenopathy Strawberry Tongue ...
04.01.2021 Round 20 (Dehydration) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkshift General when the next chart is handed to you – a four year old male named Tommy with chief complaint of dehydration. Initial Vitals * ...
03.15.2021 Deep Dive – Round 19 “The Brady Bunch” – Beta-Blockers, Calcium Channel Blockers, Digoxin, Clonidine Treatment of Beta Blocker OD * Activated Charcoal – Only if ingestion time was <1 hour ago, and only if patient is protecting their airway (or intubated). 2. Glucagon – ...
03.01.2021 Round 19 (Bradycardia) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkshift General when you are called to the resuscitation bay to see an elderly patient with unstable vitals brought in by EMS. Initial Vitals * Temp ...
02.16.2021 Deep Dive - Round 18 Four definitions you must know: * SIRS – Must have at least 2 of 4 SIRS criteria (listed below):* Fever (>38C) or Hypothermia (<36C)* WBC >12k or <4k ; OR Bandemia >10%* Tachycardia > 90* Tachypnea > 20* SEPSIS – ...
02.01.2021 Round 18 (Fatigue) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkshift General when a 20yo female accompanied by her mother checks into the ER with chief complaint of fatigue. Initial Vitals * Temp 101.2F* HR 122* ...
01.01.2021 Round 17 (Postpartum Fever) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at EM Clerkshift General when a sepsis alert is paged overhead for a young female who appears diaphoretic and confused. Initial Vitals * Temp 102.7F* HR 145* RR ...
12.01.2020 Round 16 (Allergic Reaction) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are sitting at your computer on an otherwise beautiful Friday afternoon when a mother brings her 16 year old son to the ED with chief complaint of allergic reaction. Initial Vitals * ...
11.01.2020 Round 15 (Syncope) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are working a shift at Clerkship General when a 51 year old female is brought in after a syncopal episode. Initial Vitals * Temp 100.2* HR 132* RR 28* BP 105/69* O2 ...
10.01.2020 Round 14 (Shortness of Breath) CAUTION: THESE NOTES CONTAIN SPOILERS!!! 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 * Temp 98.6* HR 99* RR 34* ...
09.01.2020 Round 13 (Dizziness) CAUTION: THESE NOTES CONTAIN SPOILERS!!! 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 * Temp 98.6* HR 109* RR 20* BP ...
08.01.2020 Announcement The website it updated! Please check it out and email me with any technical issues or other comments/concerns. Enjoy your shift!
07.01.2020 Round 12 (Difficulty Breathing) CAUTION: THESE NOTES CONTAIN SPOILERS!!! 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 * Temp 98.8* HR 145* RR 45* BP 60/30* O2 ...
06.01.2020 Round 11 (Headache) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction 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… Initial Vitals * Temp 98.9* HR 99* ...
05.01.2020 Round 10 (Allergic Reaction) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction A 45 year old female is exposed to peanut butter and shrimp pizza and begins to have an apparent allergic reaction… Initial Vitals * Temp 98.8* HR 130* RR 35* BP 70/40* O2 ...
04.01.2020 5 Things I Am Learning from COVID-19 I → Episode Summary
03.01.2020 Round 9 (Seizure) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction The nurse brings back a young adult male from the lobby who is having a seizure… Initial Vitals * Temp 98.8* HR 90* RR 10* BP 120/80* O2 92% Critical Actions * Verbalize ...
02.01.2020 Round 8 (Fall) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction EMS brings in an elderly man who has fallen… Initial Vitals * Temp 98.6* HR 58* RR 16* BP 105/60* 99% Critical Actions * Treat the patient’s pain* Consult orthopedics for a hip ...
01.13.2020 BONUS – Demanding Patients Special Thanks to Mohamed Soliman for contributing this episode!
01.01.2020 Round 7 (Headache) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction Just a routine day at your hospital, your next patient has a chief complaint of headache… Initial Vitals * Temp 98.8* HR 88* RR 16* BP 130/80* O2 99% Critical Actions * Identify ...
12.01.2019 Round 6 (Back Pain) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction A notorious, disheveled frequent flyer presents to your emergency department for her back pain and is asking for more Dilaudid… Initial Vitals * Temp 99.0* HR 99* RR 18* BP 118/78* O2 99% ...
11.10.2019 BONUS- Upper Extremity Fractures Special thanks to Fraser Kegal from McGill University for creating this excellent content.
11.01.2019 Round 5 (Geriatric Fall) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction The nurse is asking you to evaluate a 70 year old male who has been placed in a hall bed after hitting the back of his head. She wants to know if you ...
10.01.2019 Round 4 (Flank Pain) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction The nurse tells you that you have a new patient and is requesting a verbal order for nausea medicine. She advises you that the patient is the CEO of your hospital… Initial Vitals ...
09.22.2019 Round 3 (Chest Pain) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction An ill appearing patient has been rushed back from the lobby, clutching his chest, you are needed immediately at the bedside… Initial Vitals * Temp 99.1* HR 95* RR 20* BP 120/80* O2 ...
09.16.2019 Round 2 (Seizure) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction EMS brings in a postictal 34 year old female after she has a seizure. She is complaining of a headache… Initial Vitals * Temp 98.9* HR 110* RR 10* BP 175/115* O2 95% ...
09.08.2019 Round 1 (Altered Mental Status) CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction You are called to the resuscitation bay for a poorly responsive patient that has been brought in by EMS. Initial Vitals * Temp 98.8* HR 78* RR 4* BP 124/78* O2 98% Critical ...
08.25.2019 MUST LISTEN (re ABEM) ABEM-style cases presented on EM Clerkship are not my actual ABEM exam cases, and they are not derived from my actual exam cases. I will never be discussing my specific exam details with anybody, including on this podcast. The cases ...
08.18.2019 EM Clerkship Changes F→ Episode Summary
08.11.2019 ACS, Acidosis, AAA and Other Miscellaneous Causes of Abdominal Pain There are HUNDREDS of other non-GI/GU causes of abdominal pain… Acute coronary syndrome (ACS) * Test with EKG and troponin * Treat with aspirin and heparin Acidosis * Diabetic Ketoacidosis (DKA)* Respiratory Acidosis (COPD)* Salicylate Toxicity (Remember MUDPILES) Abdominal Aortic ...
08.04.2019 Testicular Torsion and Prostatitis Testicular Torsion History * Pain in the testicles * Referred pain in the flank or lower abdomen* Usually sudden and severe* Usually WITHOUT urinary symptoms Exam * Asymmetric testicular lie* High riding testicle* Tenderness and swelling of the testicle itself* ...
07.28.2019 PID and Ovarian Torsion Women have two additional diseases that must be added to the differential diagnosis of their abdominal pain. PID and ovarian torsion. Pelvic Inflammatory Disease (and Tube-Ovarian Abscess) Deep pelvic infections high in the reproductive tract frequently caused by sexually transmitted ...
07.21.2019 Urinary Tract Infections How to Read a Urinalysis * Signs of Inflammation* Leukocyte Esterace* WBCs Multiple conditions cause inflammation on a urinalysis. Anything that causes nearby inflammation (appendicitis, pelvic infections, diverticulitis) or slows urine output (dehydration, renal disease) can commonly elevate these markers. ...
07.14.2019 Ectopic Pregnancy All women of childbearing age who present with abdominal pain need a pregnancy testa core teaching of EMergency medicine Ectopic pregnancy is the leading cause of maternal death in the first trimester History * Abdominal pain present in 90% of ...
06.30.2019 Bowel Perforation and Volvulus Bowel Perforations History Perforation takes time, frequently symptoms were either ignored or not noticed as can occurring in… * Elderly, diabetic, or immunosuppressed patients (frequently have minimal symptoms)* Pediatric patients (unable to or scared to mention symptoms) Exam Commonly have ...
06.23.2019 Mesenteric Ischemia and Small Bowel Obstruction Mesenteric Ischemia * Celiac truck supplies blood to the stomach and duodenum* SMA supplies blood to the rest of the small bowel and proximal colon* IMA supplies blood to the distal colon and rectum Arterial flow can be blocked because ...
06.16.2019 Maine Medical Center Interview (Perron) F→ Episode Summary
06.09.2019 Biliary Diseases and Pancreatitis Biliary Diseases * Biliary Colic- A gallstone DOES NOT GET STUCK, but it slowly rolls out of the gallbladder, through the cystic duct, then the common bile duct and pancreatic duct. This results in several hours of crampy “colicky” pain ...

Older episodes

EM Clerkship

What's EM Clerkship about?

Download our free app to listen on your phone

EM Clerkship episodes:

Deep Dive – Round 26

Round 26 (Stridor, Vomiting, Shock)

Deep Dive – Round 25

Round 25 (Seizure)

Deep Dive – Round 24

Round 24 (Altered Mental Status)

Deep Dive – Round 23

Round 23 (High Blood Pressure)

Deep Dive – Round 22

Round 22 (Cardiac Arrest)

Deep Dive – Round 21

Round 21 (Drowning)

Deep Dive – Round 20

Round 20 (Dehydration)

Deep Dive – Round 19

Round 19 (Bradycardia)

Deep Dive - Round 18

Round 18 (Fatigue)

Round 17 (Postpartum Fever)

Round 16 (Allergic Reaction)

Round 15 (Syncope)

Round 14 (Shortness of Breath)

Round 13 (Dizziness)

Announcement

Round 12 (Difficulty Breathing)

Round 11 (Headache)

Round 10 (Allergic Reaction)

5 Things I Am Learning from COVID-19

Round 9 (Seizure)

Round 8 (Fall)

BONUS – Demanding Patients

Round 7 (Headache)

Round 6 (Back Pain)

BONUS- Upper Extremity Fractures

Round 5 (Geriatric Fall)

Round 4 (Flank Pain)

Round 3 (Chest Pain)

Round 2 (Seizure)

Round 1 (Altered Mental Status)

MUST LISTEN (re ABEM)

EM Clerkship Changes

ACS, Acidosis, AAA and Other Miscellaneous Causes of Abdominal Pain

Testicular Torsion and Prostatitis

PID and Ovarian Torsion

Urinary Tract Infections

Ectopic Pregnancy

Bowel Perforation and Volvulus

Mesenteric Ischemia and Small Bowel Obstruction

Maine Medical Center Interview (Perron)

Biliary Diseases and Pancreatitis

Other shows like EM Clerkship: