Back Pain

EM Clerkship

Zack Olson, MD and Michael Estephan, MD

Education, Courses, Health & Fitness, Medicine

5 • 795 Ratings

🗓️ 5 February 2017

⏱️ 8 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Step 1: Identify Classic Red Flags for Can’t Miss Diagnoses Aortic Dissection and Abdominal Aortic Aneurysm (AAA) Age >50 Hypertension “Ripping” or “Tearing” pain Absent pulses in lower extremities Spinal Infections Fever Immunocompromized HIV Diabetes mellitus Transplant patients Spinal cord compression (especially cauda equina) Urinary retention Consider obtaining post-void residual Saddle anesthesia Fecal incontinence/decreased rectal […]

Transcript

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0:00.0	Hello, med students.
0:02.7	My name is Zach Olson, and thank you for downloading this episode of the EM Clerkship
0:08.6	Podcast.
0:11.6	Today we are covering a core topic.
0:14.8	You will see one of these patients on your rotation.
0:17.2	You'll probably see one of them almost every shift.
0:19.0	And if you listen closely, these can be really easy cases and a good boost for your slow.
0:26.0	So here's this week's case.
0:33.4	Okay, everybody, we have a 44-year-old male.
0:35.4	He's coming from work.
0:36.9	We picked him up in a lumber yard. He was lifting a box of chains they used, and he states he felt a sharp pain in his back and was M.A. able to walk after that.
0:46.3	Vital, we're all stable. He does smoke, doesn't have any history, nomads, no allergies.
0:51.3	We did give him 50 mics of fentanyl for pain relief, states it went from a 10 to a 6.
0:59.0	Yeah, so apparently they use these chains to kind of like lock down loads on trucks.
1:04.0	He was picking it up. He set it right down after the pain came on. No trauma. Didn't fall or anything like that. But then he kind of sat down and said he was unable to move afterwards.
1:15.7	Okay. Any questions?
1:18.0	All right. Good luck, Jim.
1:25.2	Today we are talking about the approach to back pain.
1:28.3	And here's why I love this complaint.
1:32.3	Sure, there are some really annoying chronic pain patients out there, but I like that you don't
1:38.3	really have to know testing or the workup very much.
1:41.3	The only testing you need to know for back pain is the imaging.
	...

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