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EM Clerkship

Round 35 (Pediatric Trauma)

EM Clerkship

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

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

4.9 β€’ 816 Ratings

πŸ—“οΈ 1 July 2022

⏱️ 36 minutes

🧾️ Download transcript

Summary


You are working at *rural* Clerkship General when you receive a radio call from EMS – 7yo male from a severe bus accident with a large scalp laceration, unable to control the hemorrhage.



Initial Vitals



* HR: 136* RR: 22* BP: 80/35* O2%: 100%* Temp: 98F



Critical Actions:



* Perform ATLS Algorithm* Control Hemorrhage* Transfuse pRBCs* Replete Factor VIII with correct dosing (100% replacement)* Diagnose supracondylar fracture on XR and splint appropriately



Further Reading:



emDOCs – Managing Hemophilia in the ED



CoreEM – Supracondylar fracture in the ED

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.

0:09.3

This episode is sponsored by Pearson Ravits Insurance, my personal independent life and disability insurance agent.

0:15.5

We will talk more about Pearson Ravits later in this episode. Now let's get into it.

0:20.1

Today is Mike's final case.

0:23.2

There will be no mercy.

0:25.7

Unlike ABEM, this case is actually designed to make him fail.

0:29.6

To be very clear, he's not going to pass.

0:33.6

How excited are you, Mike, for today's case?

0:36.0

Scale of 1 to 10.

0:40.7

I'm hoping that you say like 11.

0:52.1

Negative, negative 7, negative 8. I'm kind of nervous to get fully roasted in front of thousands of listeners, but let's do it.

0:55.1

Now, I will say it is, in theory, doable.

0:56.7

It's a difficult case.

1:02.0

It, I think, pulls together a few things that maybe we'll see if you can pull out or not.

1:06.2

The originally, I'm going to just giving a little background.

1:08.5

So there is originally going to be a triple case.

1:10.4

But since I don't do triple cases, that's gone.

1:12.9

So I just have to make a really difficult single case.

1:17.4

So, anyways, it's going to be, this is going to be a good time, man.

1:18.4

This is going to be a good time.

1:26.0

Mike will have strict 15 minutes to complete the full case or I'm going to cut him off. He does not know what the case is ahead of

1:27.7

time. If Mike hits all the critical actions that I have listed out beforehand, he wins. And if he doesn't or if he performs a dangerous action, I win. These cases were created by me. They're not dry from actual e-m cases that I had. They're not real patients. Dr. Estefan, take out a piece a paper and a pencil, place the paper sideways in front of you.

...

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