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EM Clerkship

Deep Dive MW R20

EM Clerkship

Zack Olson, MD and Michael Estephan, MD

Education, Courses, Health & Fitness, Medicine

5795 Ratings

🗓️ 16 May 2024

⏱️ 18 minutes

🧾️ Download transcript

Summary

Symptoms of stroke – weakness, facial droop, slurred speech. vision loss, vertigo, ataxia, confusion or changes to mental status.   The “typical” stroke workup – blood glucose level, CTH non-con, CTA head/neck, CT Perfusion, CBC BMP Troponin EKG CXR and Coags.  Common stroke mimics – hypoglycemia, drug/alcohol intoxication, Bell’s palsy, aortic dissection, complex migraines, and […]

Transcript

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0:00.0

Hello everyone. My name is Mike Estefan and I thank you for downloading this month's episode of the EM Clarkship podcast.

0:12.0

This episode is going to be covering acute, eschemic stroke. But before we begin, just a quick word from our sponsors over at Pearson Rabbit's

0:23.6

insurance. Pearson Rabbit's is my personal disability insurance broker. Own occupation disability

0:31.4

insurance is incredibly important to secure as a physician. You busted your ass in college to be at the top of your

0:40.5

class just to gain that acceptance to medical school. Then in medical school, you did nothing

0:47.6

but study all day, almost every day, for nearly four years, just to get through it all with decent board scores and then finally

0:57.3

in residency you worked 60 to 80 hour weeks maybe even sometimes more for at least three years

1:04.8

all to become an expert in your field you need to protect this investment in yourself. The best part of it is if you

1:15.0

obtain own occupation disability insurance as a resident, you lock in that low rate for

1:21.1

attendinghood and beyond. Don't wait until it's too late. Check out PearsonRavits at www.personravitz.com. And now, back to the episode.

1:34.1

So today, we're going to be talking about acute ischemic stroke. I'm going to break this episode

1:39.9

into two parts. Part one will cover diagnostics and stroke mimics. And part 2 will cover the treatments

1:49.0

for ischemic stroke. Part 1, Diagnostics and Stroke Mimics. I want to start this part off by simply

1:58.4

painting a picture of my general workflow for most stroke patients,

2:03.7

and then we'll dive a little deeper into the nuances. So let's say you're at work and you get an

2:09.5

EMS call for a possible stroke alert pre-hospital. I typically will meet the patient in the hallway

2:16.6

where EMS comes in to get a point of care blood sugar and do a very quick, less than 60 second examination.

2:23.9

And to quickly assess if this is somebody that I'm going to give thrombolyics to or not.

2:30.2

All in all, this takes about two minutes, which typically happens while the patient is getting

2:34.9

registered, and then off to the CT scanner they go.

2:39.4

If they are a candidate for thrombolynics, and I plan on giving them, I'll go with the patient

2:44.6

to the CT scanner.

...

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