EM Clerkship - Emergency Medicine for Students

By Zack Olson, MD

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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.

Episode Date
EM Clerkship Changes
Aug 18, 2019
ACS, Acidosis, AAA
Aug 11, 2019
Testicular Torsion and Prostatitis
Aug 04, 2019
PID and Ovarian Torsion
Jul 28, 2019
Urinary Tract Infection
Great blog post on topic… https://first10em.com/uti/
Jul 21, 2019
Ectopic Pregnancy
All women of childbearing age with abdominal pain need a pregnancy test
Jul 14, 2019
Adena Regional Medical Center (Pallaci)
Advising and Application Tips (35:45) UPDATE: The PICU rotation for this program has been moved to Nationwide Children’s Hospital in Columbus, OH.
Jul 07, 2019
Bowel Perforation and Bowel Volvulus
Jun 30, 2019
Bowel Ischemia and Bowel Obstruction
Jun 23, 2019
Maine Medical Center Interview (Perron)
Advising and Application Tips (32:50)
Jun 16, 2019
Biliary Stuff and Pancreatitis
Jun 09, 2019
Appendicitis and Diverticulitis
Jun 02, 2019
Abdominal Pain PBL (Part 2)
Presentation Based Learning Age, Gender, Pertinent Medical/Surgical History, Complaint At Least 4 Descriptors Red Flags/Pertinent Positives and Negatives Vital Signs Focused Physical Exam Suspected Diagnosis Can’t Miss Diagnoses Testing Plan Treatment Plan (If Asked) Anticipated Disposition
May 26, 2019
Abdominal Pain PBL (Part 1)
Presentation Based Learning Age, Gender, Pertinent Medical/Surgical History, Complaint At Least 4 Descriptors Red Flags/Pertinent Positives and Negatives Vital Signs Focused Physical Exam Suspected Diagnosis Can’t Miss Diagnoses Testing Plan Treatment Plan (If Asked) Anticipated Disposition
May 19, 2019
Mother’s Day and Social “Wellness”
Long distance family relationships and Emergency Medicine
May 12, 2019
Big Tests During EM Residency (and Beyond)
Oral Boards this week!
May 05, 2019
UT Nashville Interview (Reiter)
General Program Info (1:45) Day in the Life (8:08) Unique Stuff about Program (16:20) Advising and Application Tips (35:03)
Apr 28, 2019
Easter and Why I Am a Christian
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 […]
Apr 21, 2019
How to Crush Your SLOE (Tips 26-30)
The follow through and the CLOSE
Apr 14, 2019
How to Crush Your SLOE (Tips 21-25)
Your patient presentation and helping the resident/attending
Apr 07, 2019
How to Crush Your SLOE (Tips 16-20)
Tips and tricks for your physical exam
Mar 31, 2019
How to Crush Your SLOE (Tips 11-15)
Taking a patient history
Mar 24, 2019
Residency Resources
Congratulations on Matching into EM! This is how you should study during residency…
Mar 17, 2019
How to Crush Your SLOE (Tips 6-10)
Specific tips on how to take “ownership” of your patients.
Mar 10, 2019
How to Crush Your SLOE (Tips 1-5)
No BS, No cliche, specific tips on how to do well on your EM rotation. The ideal attitude of an EM student.
Mar 03, 2019
Life as EM Doctor
What is the knowledge set, lifestyle, and personality of an EM doctor?
Feb 24, 2019
State of the Podcast
Feb 17, 2019
Please Listen re EMS
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 https://www.nbc4i.com/news/local-news/memorial-held-for-crew-members-killed-in-survival-flight-crash/1759423171 […]
Feb 06, 2019
Airway (Part 4)
Plan B. What to do when you CAN’T intubate a patient.
Feb 03, 2019
Airway (Part 3)
How to intubate a patient…
Jan 27, 2019
Airway (Part 2)
This week we continue our discussion (started several years ago) on the most important procedural skill set in Emergency Medicine…. Airway!
Jan 20, 2019
Fungal Infections
Super random. Except for mucormycosis. Remember mucormycosis!
Jan 13, 2019
Getting S**t Done
My personal strategy on how I keep life organized and get stuff done.
Jan 06, 2019
Palliative Care
Simple. Pragmatic. Palliative Care.  Lunney JR, Lynn J, Foley DJ, Lipson S, Guralnik JM. Patterns of Functional Decline at the End of Life. JAMA. 2003;289(18):2387–2392. doi:10.1001/jama.289.18.2387
Dec 30, 2018
Merry Christmas?
Flying Reindeer, Ham Heart, and the Nativity
Dec 25, 2018
Medical Clearance and Risk Assessment
Dec 23, 2018
Real Talk
Dec 16, 2018
NBME Shelf Review Part 11
Dec 09, 2018
NBME Shelf Review Part 10
Dec 02, 2018
NBME Shelf Review Part 9
Cardiology. Pulmonology.
Nov 25, 2018
NBME Shelf Review Part 8
More on Abdominal Pain
Nov 18, 2018
NBME Shelf Review Part 7
Nov 11, 2018
NBME Shelf Review Part 6
Nov 04, 2018
NBME Shelf Review Part 5
Ophthalmology, Tox, and other Ingestions
Oct 28, 2018
NBME Shelf Review Part 4
Topics specific to EM
Oct 21, 2018
NBME Shelf Review Part 3
Oct 14, 2018
NBME Shelf Review Part 2
Oct 07, 2018
NBME Shelf Review Part 1
Introduction and Electrolytes
Sep 30, 2018
Social Media and the Limits of FOAMed
Cancelling my episode this week. Be careful with what you post online and find a mentor!
Sep 23, 2018
Interview Season
Congratulations on getting those applications submitted! This week I will give some tips for interview season.
Sep 16, 2018
Stopping CPR
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 […]
Sep 09, 2018
Abdominal Aortic Aneurysm (Critical Diagnosis)
Kidney stones are a diagnosis of exclusion. When you see flank pain or testicular pain or lower abdominal pain on that triage note, you have to consider leaking abdominal aortic aneurysm as well.
Sep 02, 2018
Testicular Torsion (Critical Diagnosis)
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.
Aug 26, 2018
Flank Pain (Kidney Stones)
Kidney stones are a diagnosis of exclusion…
Aug 19, 2018
Stuff I Learned in Residency (Part 5)
In this 5 part series I will be reflecting on a list of non-clinical stuff I learned while in residency. This week: Humility, Listening, and Patients Per Hour.
Aug 12, 2018
Stuff I Learned in Residency (Part 4)
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.
Aug 05, 2018
Stuff I Learned in Residency (Part 3)
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.
Jul 29, 2018
Stuff I Learned in Residency (Part 2)
In this 5 part series I will be reflecting on a list of non-clinical stuff I learned while in residency. This week: podcasts, heroes, the pillars of EM, and disagreeing with your attending.
Jul 22, 2018
Stuff I Learned In Residency (Part 1)
In this 5 part series I will be reflecting on a list of non-clinical stuff I learned while in residency. This week: disability insurance, stuff that gets you fired, and “purpose”.
Jul 15, 2018
Vents are easy!!!! Today we will discuss the basic approach to using a ventilator machine.
Jul 08, 2018
Waffle House
Cold. Dark. Quiet. Get exercise. Avoid alcohol.
Jul 01, 2018
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
Jun 24, 2018
Occupational Exposures
You have to be very knowledgable about occupational exposures because this is the only chief complaint that I guarantee, you will eventually manage in a colleague. LEARN THIS.
Jun 17, 2018
Breast Complaints
Breast complaints are usually pretty straight forward. Just remember that all breast complaints are cancer until proven otherwise.
Jun 10, 2018
Neonatal Conjunctivitis
Neonatal conjunctivitis is a quick topic, but has some big LIFE THREATS which you’ll need to know for both real life and your test.
Jun 03, 2018
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.
May 27, 2018
Subarachnoid Hemorrhage (Critical Diagnosis)
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.
May 20, 2018
Bloody Diapers
Babies frequently have red stuff in their diapers, and when they do, mom will rush them to the department concerned that they are having a fatal GI bleed. Usually it’s not…
May 13, 2018
Nutrition Disorders
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, […]
May 06, 2018
Complications of MI
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.
Apr 29, 2018
The tPA Bleed
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.
Apr 22, 2018
Intro to tPA
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.
Apr 15, 2018
In this episode we will discuss 5 major allopathic Emergency Medicine organizations in the US and the differences between them.
Apr 08, 2018
There have been numerous changes recently in sepsis definitions. This is an update to our sepsis episode from last year.
Apr 01, 2018
Neonatal Jaundice
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.
Mar 25, 2018
Abdominal Pain (Part 2)
It’s time to stop thinking in quadrants…
Mar 18, 2018
Match Week
Good luck!!!
Mar 14, 2018
When we get labs, we are usually getting a CBC as part of our testing. This week we will discuss what to do when the patient has a thrombocytopenia that you weren’t expecting.
Mar 11, 2018
Nausea and Vomiting
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.
Mar 04, 2018
Patients with Cirrhosis
We commonly see patients with advanced liver disease in the Emergency Department and we screen all of them for 5 common complications every time.
Feb 25, 2018
Peds T- Tummy and Non-Accidental Trauma
For our series finale we will review the 5 mega abdominal emergencies in kids as well as briefly discuss non-accidental trauma.
Feb 18, 2018
Peds I- Inborn Errors of Metabolism and Endocrinology
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.
Feb 11, 2018
Peds H- Heart Failure and Congenital Heart Disorders
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.
Feb 04, 2018
Peds S- Sepsis and Serious Bacterial Infections
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.
Jan 28, 2018
Peds H- Hyperglycemia and Hypoglycemia
H stands for hyperglycemia and hypoglycemia. Always check that blood sugar when you have a sick pediatric patient!
Jan 21, 2018
Peds O- Oxygen, Airway, and Respiratory Disorders
OH SHIT (grab the Broselow) is the mnemonic I use to help me think through my approach to the sick child. This week we are covering oxygenation, airway and respiratory disorders.
Jan 14, 2018
OH SHIT (Grab the Broselow)
This is the introduction episode for our upcoming series on the approach to a sick child.
Jan 07, 2018
Bleeding Disorders
As another special holiday treat we will be talking about the Big 3 hemostatic disorders that make people bleed too easily and how to fix them.
Dec 31, 2017
The 12 Most Common Lawsuit Diagnoses
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 […]
Dec 24, 2017
Have a great week. No episode. We’re working on updating the show notes.
Dec 17, 2017
Delivering Babies
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.
Dec 10, 2017
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.
Dec 03, 2017
Pediatric Exam
Sick. Not sick. This week we will discuss the fundamental pediatric exam that you need to remember regardless of how the patient looks.
Nov 26, 2017
Pediatrics 101
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.
Nov 19, 2017
Travel Emergencies
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 […]
Nov 12, 2017
Diarrhea is almost always a benign complaint, especially in well appearing patients, with stable vitals, and a lack of red flags. This week we will cover those red flags as well as some basic treatments when a  patient is complaining of bad diarrhea.
Nov 05, 2017
CT Scans
I’ve been getting lots of emails regarding which CT scan is the right scan to order in different situations. Contrast? No contrast? ORAL contrast? There are so many options! I recommend you know the core, high yield CT scans, and over time you’ll pick up the rest.
Oct 29, 2017
Appendicitis (Critical Diagnosis)
Everybody knows what appendicitis is (fever, migrating right lower quadrant pain, elevated WBC, pain with bumps in the road). Unfortunately, the issue is that appendicitis only sometimes presents in this classic fashion. Using history, exam, and imaging, it is always important to keep a high index of suspicion for appendicitis so that you don’t miss […]
Oct 22, 2017
Eye Complaints
Before you can learn the different eye diagnoses and how to treat them, you need to have a basic understanding of the ophthalmologic exam. Only after having this foundation can you finalize your approach to the red eye, acute vision loss, or eye trauma (which will be covered in future episodes). https://www.youtube.com/watch?v=w9wMJ6job_0&t=62s
Oct 15, 2017
The approach to bradycardia is very simple and straightforward. The most important thing is to remember you differential diagnosis. After that, it’s a simple algorithm that you’ll never forget.
Oct 08, 2017
Anaphylaxis (Critical Diagnosis)
Anaphylaxis is total body chaos resulting from massive, inappropriate degranulation of mast cells when exposed to an antigen. When this happens, you have to remember airway and epi. It will save a life.
Oct 01, 2017
Fluids (Guest)
IV fluids are something we deal with everyday in the emergency department. This podcast will teach you what you need to know about giving fluids.
Sep 27, 2017
Show Notes Update and Apps
There are 6 core apps that I’m currently using while running around the emergency department during my shifts, and we’ll cover the list in this episode. Also, we will soon be launching The EM Clerkship Pocket Guide which will replace the current, outdated, episode summaries. No specific date yet, but I already have the user […]
Sep 24, 2017
Surviving Overnights
One of the most difficult aspects of Emergency Medicine is shift work. Specifically, surviving overnights and the constant circadian chaos our body goes through by constantly rotating through morning, evening, and and overnight shifts. It happens to all of us, and in this episode I’m going to give you some personal strategies I’ve developed while […]
Sep 17, 2017
EM doctors specifically look for two things every time they see an EKG. Ischemic changes (STEMI, ST depressions, inverted T waves), and dysrhythmias (bradycardia and tachycardias). In this episode, we cover the 5 categories of tachycardias and a basic approach to each one.
Sep 10, 2017
Status Epilepticus (Critical Diagnosis)
On occasion, seizures won’t stop, or a seizure lasts longer then 5 minutes. Unlike a simple, single, resolved seizure, status epilepticus is an emergency. In these scenarios, we add to the descriptive and diagnostic workup discussed last week, and move on to a focused treatment algorithm to stop the seizure as soon as possible.
Sep 03, 2017
One of the most common neurologic complaints we encounter in the Emergency Department is seizure. Typically, a patient with epilepsy will have a breakthrough seizure, or somebody will try some drugs and get a seizure, or the seizure will be the first symptom of a dangerous medical condition. Regardless, 911 will almost always get called […]
Aug 27, 2017
Cardiac Arrest (ACLS)
You will probably witness a few cardiac arrest cases during your clerkship. Sometimes these happen in the hospital, but usually these patient’s will be brought into the ED, CPR in progress, by EMS. Just like in trauma, we follow a very basic, logical algorithm when we resuscitate these patients, and this algorithm is called ACLS.
Aug 20, 2017
RUQ Pain
It is really important to use the correct terminology when presenting a patient with right upper quadrant abdominal pain to your attending. If you want a good score on your SLOE, your differential diagnosis has to contain more than just “cholecystitis”. We will cover a basic approach today with a focus on the terminology to […]
Aug 13, 2017
Low Risk Chest Pain
Not all patients with chest pain are having a STEMI, or massive PE, or aortic dissection. In fact, most patients with chest pain will have a set of normal labs, feel better, and we then have to decide what to do next. Admit or Discharge? What if we send this low risk patient, complaining of […]
Aug 06, 2017
Gunshot Wounds
When most people think about trauma, they think about gunshot wounds. However, not all gunshots come in as a multi system trauma alert. Not all patients have been shot in the chest or belly and need to be rushed to the OR. Much more commonly, we are dealing with gunshot wounds to the extremities. In […]
Jul 30, 2017
Asthma and COPD (Critical Diagnosis)
COPD and asthma exacerbations are two of the most common pulmonary diseases we encounter in Emergency Medicine, and the severity of these attacks can vary from mild and basic to severe. It’s a clinical diagnosis, but there are lots of treatments to consider. Don’t be overwhelmed, we will cover a basic approach today.
Jul 23, 2017
GI Bleed
One of the most dangerous complaints in all of Emergency Medicine is the GI Bleed. Especially upper GI bleeds when patients are complaining of coffee ground emesis or black sticky poop. This week we will discuss the overall approach to anybody who comes in with a GI bleed.
Jul 16, 2017
Type and Screen? Type and Rh? Type and Cross? Emergency Release? I never received a talk in medical school about how to give blood to patients. So when I started residency, I was surprised and confused by how many options I could select when placing orders for blood! This episode covers the basic terminology you […]
Jul 09, 2017
Pulmonary Embolism (Critical Diagnosis)
This week we are having the talk… The PE talk. It will be one of the most high yield episodes we will ever have on the show. Before listening, please look up the Well’s Score and the PERC rule for reference, and email me with any questions. ~~~~~ Kline, J. A., & Kabrhel, C. (2017). […]
Jul 02, 2017
This week we are going to talk about the 3 types of hemoptysis, the differential diagnosis, and a basic approach.
Jun 18, 2017
Aspirin Overdose (Critical Diagnosis)
Aspirin overdoses are the great mimicker, and the queen of both intentional and unintentional overdoses. This week we will discuss a basic approach to this critical diagnosis.
Jun 11, 2017
Tylenol Overdose (Critical Diagnosis)
The king of all overdoses is acetaminophen. In this episode we will discuss an approach to this overdose with an emphasis on the life-saving antidote, N-Acetylcysteine (NAC).
Jun 04, 2017
Getting Into Medical School
This special episode is dedicated to Tyler who wants to know more about the process for getting into medical school. It’s been several years since I’ve done this myself, and alot has changed over the years. But some advice is timeless, and so this week we will cover the basics that you will need to […]
May 28, 2017
The First 5 Minutes
This week we will discuss some Emergency Medicine 101. This is my personal approach to the initial management of crashing patients. Not only does this algorithm work well in real life, it also works well in sim, and during verbal cases with my attendings. Listen to the old ABC episodes if you want to go […]
May 21, 2017
Non-Pregnant Vaginal Bleeding
This is the follow up to our previous episode on vaginal bleeding. This week, we will discuss an approach to vaginal bleeding when the patient is NOT pregnant.
May 14, 2017
Fingertip Injuries
Today we are learning what to do when somebody cuts their fingertip off. Trust me, it’s not as straight-forward as you would think.
May 07, 2017
1st Trimester Vaginal Bleeding
This is one of the most common chief complaints in all of Emergency Medicine. You will have one of these cases during your rotation. The most important thing to remember are your 5 tests and also how to present these cases to your attending.
Apr 30, 2017
This week we are going to cover a basic approach to the constipated patient with a focus on the possible treatments for constipation.
Apr 23, 2017
One of the best events you can volunteer for as a medical student is your local marathon. You learn about musculoskeletal injuries, heat injuries, electrolyte emergencies, as well as prepare yourself for the occasional seizure, cardiac arrest, and case of anaphylaxis. You learn procedures like starting IVs, obtaining vitals, and basic wound care. It really […]
Apr 16, 2017
You’ve heard about this story by now. Today we are going to talk about what happened at the Summa EM residency program and why it closed. Even more importantly, we are going to discuss what we can learn from this and how to be smarter when choosing residency programs in the future.
Apr 09, 2017
DKA (Critical Diagnosis)
DKA is one of my favorite diagnoses to treat because it follows a nice, simple, algorithmic approach. These patients are incredibly sick, but your attending will be very impressed if you have an understanding of the basic protocol. The hardest thing to remember is that the blood sugar is the LEAST important part of DKA management. Dehydration, […]
Apr 02, 2017
As doctors, we treat pain. It’s good medicine, gets good patient satisfaction, and is usually why the patient came to the ED in the first place. But we are also in the middle of a prescription narcotic epidemic. So the question is, how do we appropriately and safely prescribe narcotics? Today we will cover the […]
Mar 26, 2017
Laceration (Repair)
In this episode we will be discussing a laceration repair procedure. Don’t overcomplicate things. Keep it nice and simple. And you will be successful.
Mar 12, 2017
Laceration (Evaluation)
Laceration Repair is one of your core 3 procedures and is critical to master if you want to get a good SLOE. You have to very carefully consider if the wound should even be repaired at all! Otherwise it might get infected and the patient will have a bad outcome. However, if your presentation is […]
Mar 05, 2017
Sore Throat
During my clerkship, every time a patient came in with a sore throat, my attending would ask me, “Zack, what are the 4 life threatening causes of sore throat!?”  I could never remember the answer, but after the episode today you will. Also, extra special thanks to Dr. O’Connell and Elsevier for allowing us to use the book USMLE […]
Feb 26, 2017
The Future of Trauma (Interview)
In this EM Bolus we will be discussing the future of trauma resuscitation with Dr. Sam Tisherman, a professor of trauma surgery at the University of Maryland. He is currently conducting a very interesting study that has the potential to drastically change our approach to trauma forever. What if we cool trauma patients after they have died? What if […]
Feb 22, 2017
Procedural Sedation
One of the most common procedures we do in the emergency department is procedural sedation. One doctor does the primary procedure, one doctor pushes meds and watches airway. There are 5 common medications that I have seen used in the ED. We will cover these as well as the general approach today.
Feb 19, 2017
Lets talk about oxygen. Hypoxia is bad, and we need to know how to help these patients. However, giving TOO much oxygen is also bad. In this episode we will review the basics of oxygen administration as well as review the current literature so you can impress your attendings when they try to pimp you.
Feb 12, 2017
Back Pain
Similar to patients with a headache, patients with back pain typically require very little testing. Rather, these encounters are focused entirely around a search for red flags. I LOVE these types of cases. These cases are straightforward, and you have the potential to sound REALLY smart in front of your attending if you remember the life […]
Feb 05, 2017
Patient Satisfaction
Patient satisfaction is getting lots of bad publicity these days, and I think it’s gone too far. Certainly, patient satisfaction surveys have the potential cause multiple adverse outcomes, and we’ve all heard about the study linking patient satisfaction with mortality. However, there are some aspects of patient satisfaction that are undeniably good patient care, and that is […]
Jan 29, 2017
Sepsis (Critical Diagnosis)
Today we are talking about one of the most dangerous disorders a patient can have… Sepsis. There is a lot to cover with this including the history of sepsis management, definitions, and a modern day approach. We will cover each of these things and more in this week’s episode.
Jan 22, 2017
Rural Medicine (Interview)
Thank you for downloading our first EM Bolus episode! These episodes are intended to give a more in-depth look into the real world of Emergency Medicine and your future career. This week’s episode is dedicated to all of our PA listeners. Chip Lange, PA-C, creator of the TOTAL EM podcast will be joining us to discuss […]
Jan 18, 2017
Dental Pain
Get excited the next time you have a patient with dental pain! Because this is one of those chief complaints that will give you tons of points on your SLOE as long as you can articulate your way through it. This is also one of those rare opportunities where you get to demonstrate procedural skills […]
Jan 15, 2017
There are two big categories of vertigo: central and peripheral. And your entire exam should be focused around identifying which type the patient has. Central vertigo is typically the one we get most concerned about in the ED because it is caused by abnormalities in the brain. Peripheral causes tend to be much less critical […]
Jan 08, 2017
Hyperkalemia (Critical Diagnosis)
Hyperkalemia is the single most important electrolyte abnormality you need to know for your clerkship. It is very deadly, and you need to act quickly or the patient will might go into cardiac arrest. If your patient has hyperkalemia, get and EKG and give calcium. That is the most important thing you need to remember for […]
Jan 01, 2017
Chest Xrays
We order lots of imaging in emergency medicine, and during your clerkship, you may be expected to interpret any of these images for yourself. Obviously, you may not be able to perfectly interpret everything, and that’s OK. However, you absolutely HAVE to know how to interpret a chest X-ray. It is very high yield for […]
Dec 11, 2016
Pregnancy Injury
For our last trauma episode, we will be covering the basic approach to injuries in pregnant women. These can be very stressful cases, but the good news is that the approach is very straight forward. It’s just 5 extra interventions you have to perform in addition to your normal trauma resuscitation.
Dec 06, 2016
Leg Injury
Leg injury is one of the most common types of trauma we see in Emergency Medicine. The most important thing to remember about these types of injuries are the Ottawa rules. These are very VERY high yield. Learn them now and you will be well prepared for your rotation.
Nov 20, 2016
GU Injury
Genitourinary injuries are an often neglected aspect of trauma, but they are very important because they lead to long term morbidity if missed. In this episode we will cover a general approach to GU trauma as well as the 4 main injuries types you will encounter.
Nov 13, 2016
Abdominal Injury
Abdominal trauma is probably the most difficult and most subjective type of trauma that you can evaluate. There is no perfect decision criteria that you can use. There is no perfect test. It all comes down to some magical combination of clinical gestalt and objective findings. Sure, we can usually tell when the patient needs to go straight […]
Nov 06, 2016
Heart Injury
This week we are continuing our trauma series and talking about cardiac injury. There are 3 big diagnoses in this section that we will cover: cardiac tamponade, aortic dissection, and blunt cardiac injury. All 3 can kill your patient, and all 3 are easy to evaluate for if you know what to look for. We […]
Oct 30, 2016
Lung Injury
Injuries to the chest are one of the most common, most life-threatening, and most important injuries that occur during severe trauma. In this episode we will cover injuries to the lungs with a specific focus on the 3 life threatening diagnoses that must be considered during every case: tension pneumothorax, open pneumothorax, and hemothorax.
Oct 16, 2016
Neck Injury
Today we will be covering neck injury. Specifically, we will cover soft tissue injury of the neck. It can be divided into blunt and penetrating trauma. And because this is where the blood vessels are located, the test of choice for these injuries will be a CT angiogram. We’ll discuss the indications for CTA, when […]
Oct 09, 2016
C-Spine Injury
This episode will overview cervical spine injuries in trauma. First you put the collar on, then you take it off. The tricky part is learning WHEN to take the collar off. You have two options. Option 1 is to use a decision rule called the NEXUS criteria. Option 2 is to get a CT of […]
Oct 02, 2016
Face Injury
We are continuing our trauma series this week and will be discussing facial trauma. Severe injuries to the face sound complicated, but I promise you they’re not. In this episode we will cover the basic management of all facial trauma as well as the 6 major injuries you might see during your rotation.
Sep 25, 2016
Application Day (Interview)
Congratulations on getting those applications submitted! Today, we’re trying a different format. This is an interview with Dr. Mark Reiter, program director at the University of Tennessee – Nashville, about application day and ERAS. When I was a medical student, I had absolutely no idea what went through a program director’s mind on application day. […]
Sep 18, 2016
Head Injury
Over the next several weeks we are going to be doing a series of episodes on trauma. Starting today with head trauma. There are lots of critical diagnoses that you cannot miss with head injuries, and you need to order a CT head without contrast if you suspect any of them. One way to help you […]
Sep 11, 2016
USMLE Step 3
We’re taking a mental break this week and talking about Step 3. I took the test last month and found out a few weeks ago that I passed! And so in this episode we’ll be breaking down the details of test day, study strategy, and my overall thoughts about how it went. Step 3 is definitely […]
Sep 04, 2016
Abdominal Pain
The most common chief complaint in Emergency Medicine is abdominal pain. Most students already have an understanding of the basic approach to this problem. We know to ask about fevers, palpate the abdomen, and give something for nausea. In this episode we will be discussing an additional 5 steps that tend to be overlooked with […]
Aug 28, 2016
Stroke (Critical Diagnosis)
Today we are talking about the critical diagnosis of stroke. Specifically, we need to discuss what to do during ischemic strokes. And the most important thing to remember is that TIME IS BRAIN. If you ever suspect that your patient is having a stroke, you need to get your attending immediately. After that, stroke protocols […]
Aug 21, 2016
Shortness of Breath
The most important thing to remember about shortness of breath is that you need to keep your thoughts and actions focused by using an organized approach. I recommend thinking anatomically. The differential diagnosis for this complaint is huge, and it’s really easy to make mistakes if you don’t develop a system. Also, you MUST calculate […]
Aug 14, 2016
The key to understanding syncope is understanding who is at high risk and who can go home. Over the years, numerous different studies have been done looking at this topic. The easy way to remember the approach to syncope is 6-6-6. There are 6 high risk EKG findings. 6 important risk factors, and 6 deadly […]
Aug 07, 2016
Pain Management
It’s definitely not the most exciting topic in emergency medicine, but it’s easily one of the most important. Every single shift you will be required to manage a patient’s pain. In this episode, we will be covering the 6 major pain medicines that you need to know for your clerkship- including doses. Those medicines are PO […]
Jul 24, 2016
STEMI (Critical Diagnosis)
We get hundreds of EKGs every day looking for ST elevation myocardial infarction. And when you finally see it, you have to know what to do. In 2013, the American Heart Association updated their STEMI management guidelines, and that is what we are learning about today. Make sure you understand the material in this episode, […]
Jul 17, 2016
Altered Mental Status
AEIOU TIPS. This is easily one of the most important mnemonics of emergency medicine because it represents the differential diagnosis for altered mental status. Obviously, this is not meant to be an exhaustive list, but it certainly provides a good framework to start with. Even as a resident, I still will write out this differential when I’m […]
Jul 10, 2016
Welcome to clerkship season! Over the next few months we will be going through the biggest, hugest, most important topics in emergency medicine. And today, we will be starting off with toxicology. After covering the general approach to a toxicology case, we will also be overviewing the “Big 5” toxidromes of emergency medicine: anticholinergic, cholinergic, opioid, sedative, and sympathomimetic.  And the one […]
Jul 03, 2016
Before we start clerkship season, we need to address the most important issue impacting emergency medicine: HALF of our physicians are experiencing burnout this year (Medscape). This is a huge problem. It leads to decreased speed, patient satisfaction, safety, and staff wellness. We have to learn to invest in our wellness now, or we will be statistically unlikely to achieve our full potential […]
Jun 25, 2016
BRUE (Pediatrics)
Brief. Resolved. Unexplained. Events. A few months ago the American Academy of Pediatrics (AAP) released a set of guidelines on the management of a  common pediatric condition formally known as ALTE (now known as BRUE). These babies used to ALL be admitted to the hospital for extensive testing. However, this is no longer the case. […]
Jun 19, 2016
Trauma is easily the most interesting topic in all of emergency medicine. We might not see it quite as much as chest pain and abdominal pain, but trauma is certainly one of the top 10 things you will see most commonly on your clerkship. Today I am going to give you an overview of a course called ATLS- […]
Jun 06, 2016
When I was on my clerkship, a few of my classmates had patients present to the emergency department with priapism. It’s not common. But even if you don’t get a case during your clerkship, you will certainly see one during residency. There are two types of priapism: ischemic and non-ischemic. Ischemic is the type we will focus on this week. […]
May 30, 2016
Preeclampsia (Critical Diagnosis)
It’s time to start diving deep into the critical diagnoses of Emergency Medicine. Partially because I think we need to mix up the format every once in awhile to keep things interesting, but also because your attending will expect you to know the basics about these common emergencies. Today, we’re starting with preeclampsia. Never ignore […]
May 23, 2016
Headache is one of the most common chief complaints that you will see on your clerkship. Luckily, it is also one of my favorite cases to evaluate. Why do I love it so much? Because I don’t need to be completely dependent on ancillary testing! IT’S ALL ABOUT THE HISTORY AND EXAM. In this episode, we will cover the critical […]
May 16, 2016
Patient Encounters
During your clerkship, you will rapidly develop a flow for your shift. What do you do when you first pick up a chart? How much do you let your patients ramble? After you evaluate your patient, do you sprint at full speed straight to your attending? What do you do AFTER your initial evaluation? It takes years to […]
May 09, 2016
Tummy Ache
Today we are moving on to a completely new topic, we are going to be discussing a simple approach to pediatric GI complaints. I hope you enjoy it. The majority of this episode will be covering the life-threatening, differential diagnosis for pediatric abdominal pain. It is 12 items long, and can be thought of in […]
May 02, 2016
Circulation (Shock)
Today is episode C, the final episode in our 3 part podcast series on the approach to a crashing patient. In previous episodes we covered AIRWAY: how the first thing we need to do is suction and move the posterior portion of the patient’s tongue. We covered BREATHING: how we need to fix hypoxia by increasing […]
Apr 25, 2016
Today is episode B in a series about our approach to the crashing patient. As we discussed in the previous episode, at some point during your clerkship, you will have a patient that starts dying right in front of your eyes. And it will be very scary! In Emergency Medicine, we fall back onto the “A-B-Cs” whenever […]
Apr 18, 2016
During your clerkship, you will be encountering sick patients. This is obvious. However, I promise that at least one of these patients will catch you VERY off guard. It usually goes like this, you are walking into a room, ready to take a history from (what sounded like) a straight-forward patient. But as soon as you open that […]
Apr 10, 2016
If you listened to the introduction episode, you heard my story about the patient with a bleeding nose. I had NO IDEA what to do. It was embarrassing. And that specific situation is what inspired the creation of this episode. Nosebleeds can be scary! You will probably have a patient with this during your clerkship, and the […]
Apr 03, 2016
Chest Pain
Today I would like to teach you about the biggest, awesomest, most stereotypical chief complaint that there is in all of Emergency Medicine: chest pain. This is a huge topic on your shelf exam, and you really need to have an in-depth understanding of it to do well on your clerkship. HOWEVER, you have to start with […]
Mar 27, 2016
Patient Presentations
We are going to discuss a very important topic today. How do you give a good patient presentation to your attending?  This is the single most important skill you need to develop on your clerkship. Your presentations need to be FOCUSED, THOROUGH, and ORGANIZED. Don’t be nervous. There is a gold-standard presentation format that was published for […]
Mar 27, 2016
Today, I am very excited to announce that The Emergency Medicine Clerkship Podcast (and its affiliate website) are officially LAUNCHED!!! Over the next several weeks, I plan on streamlining and simplifying the technical side of my publishing process. I anticipate that I will finish this soon, and that the podcast itself will be posting episodes at full speed early […]
Mar 20, 2016