Round 9 (Seizure)
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 1 March 2020
⏱️ 39 minutes
🧾️ Download transcript
Summary
CAUTION: THESE NOTES CONTAIN SPOILERS!!!
Case Introduction
The nurse brings back a young adult male from the lobby who is having a seizure…
Initial Vitals
* Temp 98.8* HR 90* RR 10* BP 120/80* O2 92%
Critical Actions
* Verbalize ABCs on a Critical Patient* Obtain Immediate Blood Glucose Level* Give Benzodiazepine* Initiate Workup of New-Onset Seizures* Give Pyridoxine (Vitamin B6)
Final Diagnosis
Isoniazid Toxicity
Tips and Tricks
When the patient is unable to provide history, attempt to obtain the information from external sources
Additional Reading
* Isoniazid toxicity overview (Life in the Fast Lane)* Basic approach to seizures (EM Clerkship)* Basic approach to status epilepticus (EM Clerkship)* Ketamine for refractory status epilepticus (PubMed)
Corrections
Ketamine not Keppra as potential induction agent for status epilepticus (32:40)
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 |
| 0:11.9 | time with our patients and less time mindlessly writing notes? Freed AI is the product for you. It is a |
| 0:20.4 | secure, hippocompliant 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 |
| 0:49.6 | Estefan and thank you for downloading this month's episode of the EM Clerkship podcast. Today is round number. I just had to count nine of the game. We are currently tied, I believe. Is that right, Mike? I think we're tied right now. I think it's 4-4. I'm pretty sure. I think we are. Anyways, so this is going to be an interesting round. Mike, you're currently malnourished. Is that correct? That's what I've heard. That's what you said. Pretty much. Because your dental, your dental issues. Okay. Well, Mike will need to reform today's case in real ABEM oral boards format. He has 15 minutes to complete the full case. He does not know what the case is ahead of time. |
| 1:27.9 | If he hits all of the critical actions that I've listed out beforehand, he wins. |
| 1:32.4 | And if he doesn't, or if he performs a dangerous action, I win. |
| 1:35.7 | These cases were created by me. |
| 1:37.3 | They are not actual ABM cases or real-life patients. |
| 1:41.0 | All right, Mike, you ready to go. |
| 1:42.3 | Let's do this. |
| 2:01.5 | Dr. Estefan, take out a piece of paper and a pencil. Outline a human body on the left side of it and let me know when you're ready. I'm all ready for you. Let's do it. Okay. This is going to be a single patient encounter. You have 15 minutes to complete the case before we begin. Do you have any questions? |
| 2:07.3 | I just want to say that the day that you say this is going to be a double patient encounter, |
| 2:12.9 | I'm going to crap my pants, but for now I'm good. Well, there's not actually double patient encounters. It's single or triple? It's singles or triples. Oh, interesting. |
| 2:17.8 | Singles or triples. |
| 2:18.9 | Maybe we'll just do doubles, though. |
| 2:20.1 | I don't know. |
| 2:20.5 | Because that way you're not ready. No, it's, well, maybe, maybe, I don't know. Maybe when you're a second year. Maybe we'll do some triples in your second year. Or maybe when you're a first year. When you least expect it, I don't know. Maybe never. |
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