Round 25 (Seizure)
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 1 September 2021
⏱️ 33 minutes
🧾️ Download transcript
Summary
CAUTION: THESE NOTES CONTAIN SPOILERS!!
Case Introduction
You are working a shift at EM Clerkship General when you are called to the waiting room by the charge nurse for a seizing patient.
Initial Vitals
* Temp 99.0F* HR 97* RR 16* BP 120/80* O2 90%
Critical Actions
* Perform airway maneuvers to clear obstruction* Administer IV Benzodiazepines * Administer Hypertonic Saline* Diagnose Anterior Shoulder Dislocation* Perform & Describe Shoulder Reduction Procedure
Further Reading
EMDOCs – Anterior Shoulder
ALiEM – Park Method for Anterior Shoulder Dislocation
EMCrit – Hyponatremia
Transcript
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| 0:00.0 | Hello, everybody. 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. |
| 0:10.1 | This episode is sponsored by Pearson Rabbit's Insurance and today is round number 25 of the game. |
| 0:17.3 | Mike will need to perform today's case in real ABM oral boards format. He has 15 minutes to complete the case and has no idea what the case is ahead of time. These cases were created by me. They're not derived from actual ABM cases that I had and they are not real patients. I was trying to freak you out there a little bit, Mike, but I don't know how you felt. I was like, is this going to be the 30 minute one? Because you know it's coming, but this is not it. |
| 0:55.2 | Is the 30 minute a triple? Is that what that is? Yeah, it'll be a triple. Okay. Anyways, one day, when you least expect it when you're very fatigued and tired, not when you're fresh. Of course not. Mike, take out a piece of paper and a pencil. place the paper sideways in front of you. Outline a human body on the left side of it and let me know when you are ready. |
| 0:59.0 | Let's do it. |
| 1:00.0 | All right, let me get my timer started here. |
| 1:03.0 | Dr. Estefan, this will be a single patient encounter. |
| 1:06.4 | You will have 15 minutes to complete the case. |
| 1:09.5 | Before we begin, do you have any questions? |
| 1:11.6 | No, my friend. Let's go. All right. Let's begin. Your time starts now. |
| 1:17.2 | Dr. Estefan, you are working at Clerkship General when the nurse yells out, Doc, I need some |
| 1:22.0 | Ativan. Need you out in triage. Okay. I walk out in triage. What do I see? You see a middle-aged male and he appears to be seizing. |
| 1:37.6 | Okay. Like on the floor? He is laying on the floor of triage, yep. Okay. |
| 1:46.1 | And it's kind of like right out in the lobby. |
| 1:51.1 | He was, it looks like he was kind of maybe walking and he just fell down and started seizing. |
| 1:52.1 | Okay. |
| 1:54.5 | Let's see. |
| 1:55.2 | What do we know about him? |
| 1:56.7 | Can we like pull up medical records? |
| 1:59.7 | What was his chief complaint? Just checking his triage stuff triage, stuff? Yeah, family members, like, you know, Doc, he's just been vomiting. He's been vomiting, vomiting, vomiting, vomiting for like a day. And that's what brought him in. Mm-hmm. Okay. And what do I see? Like, is he convulsing all four extremities? |
| 2:19.8 | Yeah, you see him. |
| 2:21.8 | He is convulsing all four extremities. |
... |
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