My emergency medicine rotation was done at Metropolitan hospital. I looked forward to this rotation as I am interested in EM. This rotation was challenging to me in certain aspects. Each day, I would have a different perceptor which I am not accustomed to. Each preceptors’ behavior and teaching style is different. Although I still need more exposure and lessons on Ultrasound I learned how to conduct a FAST exam, renal ultrasound and do US guided IVs. The US is readily available in the ED and can help minimize the differential diagnosis. If during any moment I saw a provider …

My site evaluator was Sajid Mohamed. I had two visits and presented 3 H&Ps, pharmacology cards and an article. One of the H&Ps I presented was regarding a 44 year old female presenting with abdominal pain. She was diagnosed with nephrolithiasis and discharged home. However, an aspect that I considered in the assessment and plan but did not mention in the HPI were etiologies related with vaginal bleeding. I mentioned positive vaginal bleeding in the ROS and ovarian torsion in the assessment and plan. However, I did not in the HPI. The site evaluation was helpful as we discussed CTs …

In the particle, selected  patients received standard ACLS, including chest compression, intubation, ventilation, defibrillation, drug administration, including epinephrine and antiarrhythmic drugs if indicated, in the ED. After 10 minutes of ACLS, femoral arterial blood samples were obtained for ABGA from patients who failed to achieve ROSC. Blood samples were analyzed by a point-of-care-testing blood gas analyzer  3,000 analyzer (Patients with severe metabolic acidosis (pH <7.1 or bicarbonate <10 mEq/L) on ABGA were enrolled.   Patients fulfilling the study inclusion criteria were randomly assigned (1:1) to the study group, receiving sodium bicarbonate 50 mEq/L, or to the control group, receiving normal saline …

History Identifying Data: Name: IV Address:New York Date of Birth: 09/08/1978 Date & Time: November 21 2022, 12:00 AM Location: ER Metropolitan Hospital, Manhattan, NY Sex: Male Marital Status: Single Nationality: Hispanic Source of Information: Self Reliability: Reliable Source of Referral: Self Chief Complaint: “I am having chest pain and my heart is racing” x 1 hour  HPI 40 year old male patient with PMHx of asthma, presents to the ED with shortness of breath, palpitations, and midsternal chest pain x 1 hour after using cocaine at a party earlier this evening. Rates the pain as 7/10, is non radiating …

I plan to take the PANCE around May 20, since my rotations end on April 14. It is difficult for me to plan out how I want to study for the PANCE as I have not taken my EOC yet. However, I think by starting to study in January will help me be better prepared for the PANCE. I have three rotations left and plan to do questions on neurology, orthopedics and urology during it. I will try to do 20-30 questions daily from ROSH and Kaplan and review them as well. Repetition is what helps me recall certain topics, …

My family medicine rotation was at Dr. Devicka Persauds office. Throughout my rotation I did multiple breast exams, EKGs, venipuncture, PPDs and vaccines. I evaluated a variety of patients. I learned treatment strategies related to treated diabetic patients and prescribing different types of birth control. Majority of the patients I saw were West Indian, hence had to learn more about their culture and foods to better help treat the patients. I educated multiple patients on better diet and exercise regimen which is something I had not done as much before. I learned how to better communicate with he patients to …

My site evaluator was Fahim Sadat. I presented a case of a 23 year old female with abdominal pain for 2 days. Her physical exam was significant for tenderness, guarding on the right lower quadrant and positive Mc Burneys sign. Based on the presentation, my differential included appendicitis, IBD, UTI. Due to not having resources in the clinic to diagnose the patient, she was sent the ER. The feedback I received included how the assessment and plan should be presented in a different manner. Since, the diagnosis of appendicitis was not confirmed. Rather, then stating appendicitis, giving an explanation of …

The articles name is “The efficacy of antibiotic treatment versus surgical treatment of uncomplicated acute appendicitis: Systematic review and network meta-analysis of randomized controlled trial and was  published in the American Journal of Surgery in 2018 This network meta-analysis was conducted to assess the efficacy and safety of individual antibiotics in uncomplicated appendicitis. 9 RCTs were included . Articles that were selected included patients that were diagnosed with uncomplicated appendicitis. Articles that compared the effects of antibiotics  3rd Cephalosporin, Beta-lactamase, Penicillin, and Metronidazole/Tinidazole to open open appendectomy, and laparoscopic appendectomy/ Primary outcomes of interest were initial treatment success, recurrence and …