Round 21 (Drowning)

EM Clerkship

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

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

4.9 • 816 Ratings

🗓️ 1 May 2021

⏱️ 34 minutes

🔗️ Recording | iTunes | RSS

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Summary

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

* Temp 95.0F* HR 55* RR 5-6* BP 110/82* O2 90%

Critical Actions

* Evaluate for traumatic injury (and/or place C-Collar)* Intubate the patient* Identify Long QT Syndrome on ECG* Treat Pulseless Polymorphic VTach with defibrillation and IV magnesium* Treat Polymorphic VTach (pulse present) with overdrive pacing (transcutaneous pacing or isoproterenol)

Further Reading

Torsades de Pointes – EMCrit

Transcript

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0:00.0	Hello, residents. My name is Zach Olson. I'm joined today by Mike Estefan and thank you for downloading this month's episode of the EM Clerkship Podcast.
0:11.5	This episode is sponsored by Pearson Rabbit's Insurance. We will talk more about Pearson Rabbit's later in this episode. Today is round number, I think, tell me if I'm wrong, Mike, 21 of the game. I think
0:22.2	we're up to 21 now. We are. This is getting pretty, we're getting pretty far into this here.
0:28.4	Mike, you're going to need to perform today's case in real ABEM oral boards format. You'll have 15
0:33.8	minutes to complete the case. And for everyone that's listening, he has no idea what the case
0:38.5	is ahead of time. These cases are created by me. They're not derived from actual ABM cases
0:44.4	that I had. They're not real patience. Mike, take out a piece of paper and a pencil. Place the
0:50.3	paper sideways in front of you, outline a human body on the left side of it, and let me know when
0:53.6	you are ready. All ready for you, outline a human body on the left side of it, and let me know when you are ready.
0:56.6	All ready for you, Zach.
1:03.5	All right. Dr. Estefan, this will be a single patient encounter. You'll have 15 minutes to complete the case.
1:05.8	Before we begin, do you have any questions?
1:08.6	No, sir. Let's go.
1:11.3	All right, let's begin. Dr. Estefan, you're working at Clerkship General and EMS calls in over the radio, a young adult female drowning victim arriving in one minute.
1:20.2	Okay.
1:22.2	Oh, boy.
1:24.0	All right.
1:26.4	Let's clear a bed in the bay and get airway equipment at bedside and get a team in there.
1:35.0	All right.
1:36.2	Um, you got the team in the bay.
1:37.7	You got a bed ready.
1:38.8	Um, EMS arrives.
	...

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