EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
Case 17 (SR) – Infant with Tachycardia
Epizodes
Do you know what to do? Tune in for this month’s pediatric case.
What was the key to cracking this month’s case with mixed neurologic and respiratory symptoms? Let’s find out. For more resources and further reading, please see below: https://emcrit.org/ibcc/myasthenia/#drugs_to_avoid_in_MG https://www.emrap.org/corependium/chapter/recrDWsB2k1uYPL9U/Myasthenia-Gravis#h.chd38945ee0i https://www.uptodate.com/contents/overview-of-the-treatment-of-myasthenia-gravis https://pmc.ncbi.nlm.nih.gov/articles/PMC12450191/ https://pubmed.ncbi.nlm.nih.gov/41638015/
See if you can figure out what’s going on with this all-over-the-place case!
What happens when the stroke patient awaiting transfer has a sudden clinical change? How do you manage it? For more reading on today’s topic, check out: https://www.ebmedicine.net/topics/stroke/postthrombolysis-intracranial-hemorrhage https://www.ahajournals.org/doi/10.1161/STR.0000000000000513 https://thennt.com/nnt/thrombolytics-acute-ischemic-stroke/ https://www.ahajournals.org/do/10.1161/blog.20171227.203035
We all know patients boarding for admission or transfer are the new norm in emergency rooms nationwide. What happens when a patient pending transfer decompensates?
To learn more on today’s topic: https://www.emrap.org/corependium/chapter/recgSYYhIe7uv1r8x/Pediatric-DKA#h.mhab9ovl1fy9 https://www.chop.edu/clinical-pathway/diabetes-type1-with-dka-clinical-pathway https://emergencymedicinecases.com/wp-content/uploads/filebase/pdf/Episode%20063%20Apr2015%20Pediatric%20DKA.pdf https://www.ebmedicine.net/topics/endocrine/pediatric-emergency-medicine-diabetes#Cerebral-Edema Uptodate articles – “Hypokalemia in Children,” “Diabetic ketoacidosis in children: Cerebral injury (cerebral edema),”Diabetic ketoacidosis in children: Treatment and complications”
Gotta be gastroenteritis right? Tune in to find out!
Let’s talk teeth! For more learning, check out these resources: https://www.ncbi.nlm.nih.gov/books/NBK570590/ https://emergencymedicinecases.com/traumatic-dental-emergencies/ https://coreem.net/core/dental-trauma/ https://www.nuemblog.com/blog/oral-nerve-blocks
Crotalinae, elapidae, hymenoptera and more! Check out these additional resources for all things bites and stings! EB Medicine North American Snake Envenomations ALiEM Envenomations EMRAP Corependium Snake Bites and Insect/Arthropod Stings Links available on emclerkship.com
Snakes and scorpions and spiders, oh my! What bit our patient and how did Dr. Rumney handle it?
Hypertensive emergency? Urgency? Crisis? What's the difference? For further reading, check out: https://www.ebmedicine.net/topics/cardiovascular/emergency-medicine-hypertensive-emergencies
The altered hypertensive elderly patient - what's the diagnosis? Stroke? Trauma? Sepsis? Dr. Tweedt gets put to the test in this latest case, following a new format designed to mirror new 2026 ABEM Certifying Exam.
Do you struggle with rashes? Learn about this life threatening rash on our deep dive. If you haven't listened to the case yet, first check out The Game Season 3 Round 9 with Maddie Watts and Sean Rumney. Sources: UptoDate - SJS/TEN Diagnosis and Management https://www.dermacompass.net/en/diseases/stevens-johnson-syndrome-and-toxic-epidermal-necrolysis3 https://dermnetnz.org/topics/stevens-johnson-syndrome-toxic-epidermal-necrolysis https://www.ncbi.nlm.nih.gov/books/NBK574530/ https://onlinelibrary.wiley.com/doi/full/10.1155/dth/6527730 https://pmc.ncbi.nlm.nih.gov/articles/PMC8814784/
Everyone's favorite chief complaint... rash. What could it be? Join Dr. Rumney in cracking this latest case
Hear about the importance of own occupation disability insurance for physicians with none other than the expert herself - Stephanie Pearson from Pearson Ravitz!
Welcome to Isobel's new series called "Upstairs", where she gives us various pearls and teaching points from her experiences on off service rotations.
Deep Dive - Decompensated Hypothyroidism
Learn about Maddie’s experience in New Zealand as well as unique aspects of New Zealand medical practice. Disclaimer: This is based on personal experience. If you’d like to learn more, some resources are listed below. https://www.mcnz.org.nz/about-us/glossary https://pharmac.govt.nz/about/what-we-do/how-pharmac-works https://www.acc.co.nz https://www.luc.edu/media/lucedu/law/centers/healthlaw/pdfs/advancedirective/pdfs/8/robin.pdf https://nzformulary.org
You are working at Clerkship General when the triage nurse walks back and gets you. “Hey doc, we just put a hypoxic infant in bed 7”. Initial Vitals: HR: 168 RR: 44 BP: 81/40 O2: 81% (Room Air) Critical Actions: * Administer oxygen * Obtain chest xray * Correctly perform tube thoracostomy * Initiate non-accidental trauma workup * Complete mandated reporting
You are working at Clerkship General on New Year’s Day when you see a nurse running from triage. He is carrying an unresponsive child to the resuscitation bay. Initial Vitals: HR: 43 BP: 47/20 Temp: 66F RR: 4 O2: 95% (BVM) Critical Actions: * Obtain Core Temperature * Use the Broslow Tape * Follow PALS * Begin Invasive Warming * Transfer for ECMO
You are working at Clerkship General when you hear an EMS call on the base command radio. “Clerkship General. We are bringing you a minimally responsive 79 year-old female found lying on the floor inside her apartment. ETA 5 minutes” Initial Vitals: HR: 143 BP: 160/105 Temp: 106.3F RR: 22 O2: 99% Room Air Critical Actions: * Blood glucose * Obtain core temperature * Rapidly cool the patient * Diagnose rhabdomyolysis
