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EM Clerkship

Round 31 (Altered Mental Status)

EM Clerkship

Zack Olson, MD and Michael Estephan, MD

Education, Courses, Health & Fitness, Medicine

5 β€’ 795 Ratings

πŸ—“οΈ 1 March 2022

⏱️ 22 minutes

🧾️ Download transcript

Summary

Critical Actions: Administer Naloxone Minimize Unnecessary Testing Discuss options for Rehab Offer opioid replacement therapy Provide Social Support Further Reading: Buprenorphine – EMDocs Naloxone – EMDocs Initiating Opioid Treatment in the ED – ACEP

Transcript

Click on a timestamp to play from that location

0:00.0

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.

0:11.4

This episode is sponsored by Pearson Rabbit's Insurance, my personal disability and life insurance agent, and today is round number, I believe it's round number 31 of the game. I'm starting

0:23.1

to have trouble keeping track. We're going to try another structured interviewed case today.

0:27.7

Again, for those of you who don't know, ABEM got rid of triple cases and replaced it with this

0:31.8

new format of case. Lots of back and forth questions, that kind of thing, not as much role playing.

0:50.0

And these are intended to evaluate further how the candidate is thinking about a case and not just that they know certain steps to take or like a certain protocol, but actually gets into how they think.

0:53.5

Mike will still have 15 minutes to complete this case.

0:55.1

This case was created by me.

0:59.5

They're not derived from actual ABM cases that I had, and they are not real patients.

1:00.9

Mike, how's it going?

1:01.4

You ready to go?

1:02.6

I'm ready to go.

1:03.5

Let's do it.

1:04.7

All right, let's do it.

1:09.5

Dr. Estefan, this is a structured interview case.

1:12.7

There is no role painting. I may interrupt you to move through the case, but this is not a reflection of your performance. You will have 15 minutes to

1:17.0

complete the case. Before we begin, do you have any questions? I have no questions. Let's do this.

1:23.1

All right. Let me start the timer here. Timer is started. Dr. Estefan, the patient we will be discussing is a 39-year-old female who comes in from EMS, poorly responsive.

1:35.3

EMS states that they were called when one of her friends found her in the bathroom unconscious,

1:39.7

and she was brought here.

1:41.3

She's a febrile.

1:42.5

Her heart rate is 70 beats per minute. Her respirations are

...

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