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 Rabbit's Insurance, my personal, independent life and disability insurance agent. We will talk more about Pearson Rabbits later in this episode. Let's get into it.

Today is round number 34 of the game. Next month will be Mike's final case as a resident.

I am so excited, but today Mike will still just need to perform a case in real ABM oral boards

format. He has 15 minutes to complete the full case. He does not know

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. Mike, good morning. How are you doing?

I'm doing pretty well, Zach. How are you? I am doing well also. I'm just so excited to these final few cases here, and I'm really excited for next month.

So that's the one I'm most excited for.

I was going to say, the way you introduced next month case already has me a little terrified, to be honest.

Yeah, I mean, like, what's the worst that can happen? What's the worst that could happen? What's the worst that can happen? Let me know when you're ready. My gingerbread man is all pre-drawn. I am ready. Let's do it. All right. So it sounds like you've already taken out a piece of paper and a pencil. You place the paper sideways in front of you. You've outlined the body on the left side of it. Dr. Estefan, this will be a single patient

encounter. You'll have 15 minutes to complete the case. Before we begin, do you have any questions?

I have zero questions. Okay, Dr. Estefan, you are working at Clerkship General. It's your new attending job.

It's a slow, quiet shift. You actually have two third-year EM residents that accidentally got double-scheduled on your shift, and they're doing all your work.

You have your favorite nurse practitioner with 30 years experience sitting at your side literally what is the worst

that could happen when you get a text from your director hey dr estafon heads up the chief nursing

officer is checking in stay frosty next patient gets put in your rack and it is a 70 year old male

with shortness of breath and it sounds like you're going to have to actually do some work bud

all right um i walk into the room. What do I see? So you see a 70-year-old male. He's a little bit modeled. He looks short of breath. Okay. Can we get an opening set of vital signs? Sure. His temperature is 98. His respiratory rate is 28. His heart rate is

36. His blood pressure is 80 over 35. His O2 saturation is 82%. Sorry, his O2 sat was 82%. Yep.

All right. Let's stick this guy on a non-re breather for now. Is he able to, well, let's get two large bore ivies in him and get him on the monitor.

And let me talk to him real quick.

And while I'm talking to him, can we have the nurse get an EKG stat, please?

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