Round 32 (Pediatric Vomiting)

EM Clerkship

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

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

4.9 • 816 Ratings

🗓️ 1 April 2022

⏱️ 30 minutes

🔗️ Recording | iTunes | RSS

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Summary

You are working at Clerkship General when you see your next patient : a 3 year old male accompanied by his father with chief complaint of vomiting.

Initial Vitals

* Temp 98.6* HR 50* RR 20* BP 95/55* O2 100%

Critical Actions

* Identify the history of ingestion* Check a blood glucose* Call Poison Control* Treat with DigiBind* Treat subsequent anaphylaxis

Further Reading:

EMCrit – Digoxin Toxicity

The Tox and the Hound – Digoxin: to bind or not to bind

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. This episode is sponsored by Pearson Ravits Insurance, my personal independent life and disability insurance agent. We will talk more about Pearson Ravits later in this episode, but let's get
0:21.3	into it. Today is round number 32 of the game. Mike will need to perform today's case in
0:26.3	real ABEM oral boards format. He has 15 minutes to complete the full case. He does not know what the
0:31.6	case is ahead of time. If Mike hits all of the critical actions that I have listed out beforehand,
0:36.8	he wins. If he doesn't or performs a dangerous action, I will win.
0:40.3	These cases were created by me.
0:41.5	They're not actual ABM cases that I had.
0:43.6	They're not real patients.
0:44.6	Mike, take out a piece of paper and a pencil.
0:47.0	Place the paper sideways in front of you.
0:48.2	Outline a human body on the left side of it and let me know when you are ready.
0:51.4	I am ready.
0:52.8	Let's do this, Zach. Awesome. All right, let's do this. Dr. Estefan,
0:57.7	this will be a single patient encounter. You will have 15 minutes to complete the case. Before we begin,
1:03.3	do you have any questions. I do not have any questions. Let's do it. All right, let's begin.
1:10.7	Dr. Estefan, you are working at Clerkship General when a young father, Let's do it. All right. Let's begin.
1:18.3	Dr. Estefan, you are working at clerkship general when a young father brings in his three-year-old son with the chief complaint of vomiting.
1:19.5	Okay.
1:21.3	I walk into the room.
1:22.0	What do I see?
1:26.4	You see a father there with his three-year-old son.
2:07.6	The son looks like he's not feeling too well. Okay. I introduce myself. Hi, my name is Dr. Estefan. I am one of the doctors that will be taking care of your son. Can you tell me what is going on today? Oh, yeah. Hey, Doc. Yeah, he just, he's just, you know, he doesn't look right. He's just not feeling too good. He woke up this morning. He just started vomiting. It's just not doing. I don't know. He doesn't look right to me. Okay. All right. Can we please ask the nurse in the room to get a set of vital signs, please? Sure. The temperature is 98.6. the heart rate is 50. The respiratory rate is 20. The blood pressure is 95 over 55. The O2 saturation is 100%. Got it. And before I move on, can we please check an acucheck? Sure. You check an accheck. It's 100.
	...

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