Round 6 (Back Pain)
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 1 December 2019
⏱️ 53 minutes
🧾️ Download transcript
Summary
CAUTION: THESE NOTES CONTAIN SPOILERS!!!
Case Introduction
A notorious, disheveled frequent flyer presents to your emergency department for her back pain and is asking for more Dilaudid…
Initial Vitals
* Temp 99.0* HR 99* RR 18* BP 118/78* O2 99%
Critical Actions
* Ask about Red Flags for Spinal Infection* Perform a Thorough Spinal Exam* Obtain MRI Spine with Contrast* Initiate Broad Spectrum Antibiotics* Treat Pain when Pathology Identified
Final Diagnosis
Spinal Epidural Abscess
Tips and Tricks
Don’t let consultants or other members of your team talk you out of appropriate management of a patient
Additional Reading
* Basic approach to Back Pain (EM Clerkship)* Epidural Abscess Overview (AAFP Website)
Transcript
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| 0:00.0 | Hello, med students. This episode has been sponsored by Freed AI. Do you dread the thought of |
| 0:07.1 | endless charting once you become a doctor? Do you think that doctors should be spending more time |
| 0:12.4 | with our patients and less time mindlessly writing notes? Freed AI is the product for you. It is a secure, HIPAA compliance scribe that anybody can use. |
| 0:24.7 | Focus your energy on what matters, providing good patient care. |
| 0:29.5 | Use coupon code EM50 to save 50% the first month you try it, |
| 0:34.1 | and you can cancel at any time if you decide it's not right for you. You can learn more |
| 0:38.9 | at www.gitfreed.a.i. Hello, residents. My name is Zach Olson. I'm joined today by Mike |
| 0:49.7 | Estefan and thank you for downloading this month's episode of the EM Clerkship podcast. |
| 0:56.4 | This is EM Clerkship's secret residency curriculum, advanced content designed to test graduates of EM Clerkship, |
| 1:03.3 | and today is round number six of the game. |
| 1:06.2 | I'm still ahead overall, three to two, but we'll see how it goes after today. |
| 1:12.3 | Mike will need to perform today's case in real ABM oral boards format, 15 minutes to complete the full case. I'm actually |
| 1:17.7 | not going to let it accidentally run over this time like I did last time, Mike. I have an |
| 1:22.2 | obnoxious alarm that I'm sitting right now, and I'm going to set it for 14 minutes, so you'll |
| 1:26.7 | have an extra minute to wrap up once it goes off. Sound good? Sweet. Awesome. I love it. Mike does not know what this case is ahead of time. If Mike hits all of the critical actions that I've listed out beforehand, he wins. If he doesn't, or if he performs a dangerous action, I win. These cases are created by me. They're not actual ABM cases that I've |
| 1:44.8 | had. They're certainly not real patients. So let's get going here. You ready, Mike? I'm ready. Let's do this. |
| 1:52.4 | All right. Mike, take out a piece of paper and a pencil, place the paper sideways in front of you, |
| 1:58.0 | outline a human body on the left side of it. Let me know when you're |
| 2:00.9 | ready. I pre-drew it, so I am ready. All right, perfect. Dr. Estefan, this will be a single |
| 2:07.8 | patient encounter. You'll have 15 minutes to complete the case. Before we begin, do you have any |
| 2:13.7 | questions? Nope. All right. |
| 2:19.9 | Before we begin, take a look at your computer screen. |
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