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EM Clerkship

Deep Dive MW R7

EM Clerkship

Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD

Education, Science, Life Sciences, Courses, Health & Fitness, Medicine

5 β€’ 795 Ratings

πŸ—“οΈ 16 March 2023

⏱️ 11 minutes

🧾️ Download transcript

Summary

Obtain IV Access – get two large bore IVs (18g or larger) Resuscitate – un-crossmatched blood at first, don’t forget type and screen! Medicate – Give Pantoprazole always, Octreotide and Ceftriaxone if hx liver disease, reverse anticoagulation if indicated Imaging – Upright CXR to assess for perforation, CTA if concerned for lower GIB Consult – […]

Transcript

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0:00.0

Hello, students. My name is Mike Estefan and I thank you for joining me today on this month's deep dive episode on the EM Clerkship podcast.

0:11.0

Today's episode is going to be a deep dive on GI Bleeds. But before we begin, just a word from our sponsor at Pearson Rabbitits Insurance, which is my own personal disability insurance

0:22.5

agency. Pearson Ravits helped me secure own occupation disability insurance. What this means is,

0:29.5

if for any reason I am unable to perform my specific job as an ED physician, I will get paid

0:36.8

a large chunk of my post-tax salary, even if I am still able to work as an ED physician. I will get paid a large chunk of my post-tax salary, even if I am still

0:40.8

able to work as an educator or in a non-procedural setting. Keeping the details vague intentionally,

0:48.1

one of my close friends who is a physician was recently injured and is currently out of work.

0:53.9

This friend did not have disability insurance.

0:57.0

And his reasoning was, I was otherwise young and healthy, why would I need disability insurance?

1:03.0

Thankfully, he's doing okay and will return to work in a couple months, but this was a major scare for him.

1:09.0

And he is in the process of obtaining disability

1:12.2

insurance as we speak, although not at the low rates that can be guaranteed if you get this

1:17.4

as a resident. Don't be like my friend and get protected before you get hurt. Check out Pearson

1:24.1

Rabbits at www.personravitz.com and schedule a free consultation appointment today.

1:31.6

Now, back to our episode. Let's talk GI bleeds, specifically upper GI bleeds. Now, I personally

1:39.8

break these patients up into two different categories. You have your HPI patient and your ABC patient.

1:47.9

And this is exactly what it sounds like. Your typical HPI patient will be a GI bleed that is

1:53.4

hemodynamicly stable and you have the time to perform a full history and physical lawn.

1:59.0

Whereas your ABC patient is your GI bleed that needs

2:02.4

resuscitation now.

2:04.4

Let's start by talking about the history portion for our HPI patient.

2:08.9

I take the time to ask questions here, and I always ask what color the blood is, meaning

...

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