Hi everyone you are listening to the Medgeeks podcast, thank you so much for joining. Today we're going to be talking about clinical documentation specifically, the SOAP note. Clinical documentation is incredibly important an essential skill for every clinician to master. Many people are not familiar with the proper way to write a SOAP note, I get sent a lot of questions on this, so that's why we're going to go over it today. Before you change the channel, I promise, there are going to be a lot of Pearls packed into this episode, so stick with me. I promise you'll like it. Let's get going. - Do you have a question you'd like for us to answer? Submit your question here (it's free) and we'll answer on our next podcast episode: https://www.askmedgeeks.com - Stay up to date with our monthly audio program; In the Know. Get a free trial: https://www.medgeek.co/in-the-know-order-form-free - Follow us on Instagram here: https://www.Instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Medgeeks Clinical Review Podcast

SOAP Notes

Greetings friends you're listening to the Medgeeks podcast. Today's episode is brought to you by Andy. Andy is a student who wrote into me at askmedgeeks.com with following question:  normal saline versus lactated ringers, which is better for the hypotensive patient? In practice, I’ve seen them used interchangeably, but which is better? This is a fantastic question and is going to be the subject of today’s podcast. So let's jump in. Do you have a question you'd like for us to answer? Submit your question here (it's free) and we'll answer on our next podcast episode: https://www.askmedgeeks.com - Stay up to date with our monthly audio program; In the Know. Get a free trial: https://www.medgeek.co/in-the-know-order-form-free - Follow us on Instagram here: https://www.Instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

NS vs LR

A 16 year old male is being seen in the ER for cellulitis and a skin abscess. He has already undergone I & D of the abscess and he's waiting to be discharged. You order a shot of Clindamycin, 600mg to be given IM prior to his discharge. Five minutes later, you're called back into the room and you see the patient is in respiratory distress and having very labored breathing. His face is puffy and his voice sounds muffled. As you consider what to do next, you are struck with a very important question. What type of hypersensitivity reaction is this again? Is it the one with IgE, type 1, type 2, I can't quite remember. Okay, not really that's really not the most important thing at the moment, you know its anaphylaxis, you know that you need to give him Epi; so you draw up 0.5mg and you give it IM, probably saving this guy's life. So I'll admit maybe the type of hypersensitivity reaction isn't the most clinically relevant information in a crisis situation, but I will say hypersensitivity reactions are high-yield in terms of board review, and they also shed light on the pathophysiology behind many common diseases. Today on the Medgeeks podcast we discuss hypersensitivity reactions. - Do you have a question you'd like for us to answer? Submit your question here (it's free) and we'll answer on our next podcast episode: https://www.askmedgeeks.com - Stay up to date with our monthly audio program; In the Know. Get a free trial: https://www.medgeek.co/in-the-know-order-form-free - Follow us on Instagram here: https://www.Instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Hypersensitivity Reactions

We recently held a live training to discuss mechanical ventilation for providers (especially for those without any experience). There are many being deployed to help, that aren't versed in vents, and so we held this to give you the basics regarding mechanical ventilation. This is the replay of that training, along with a Q&A session at the end of the training. Want to keep learning with Joe Rad PA-C? Get a free 1 month trial for In The Know - our monthly audio program designed to help you stay up to date in internal medicine and primary care. - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog. 

Mechanical Ventilation 101 For Providers

Hello everybody Welcome to the Medgeeks podcast, this is your host Eric Gordon and today we're talking about COVID-19. This is going to be an update, you know we did the earlier COVID episode about a month ago now, a lot has changed since that time. When I recorded the last show there were about 100,000 cases worldwide and 164 confirmed cases in the US. Today those numbers are 1.8, million, and 556,000, obviously from a numbers standpoint, things have increased dramatically as somewhat expected.  Everyone listening to this right now has been affected by COVID-19, whether it's because you are a hospital or a critical care provider, seeing these patients caring for them daily. Maybe you work in Rheumatology and you've had to shut down your office. Maybe you're taking a pay cut because you've worked in surgery and now you have to only do emergent cases.  Perhaps you've been laid off completely. I know there's a lot of students out there who listen to this podcast and I know they're being affected by this. You can't go to class right now, your clinical rotations are being put on hold, graduations are being delayed as a result. It really is a difficult, and heartbreaking situation that we're all going through and everyone's experiencing it a little bit differently.  Before we jump into the information that I wanted to cover today, I want to let y'all know that I want to use this podcast to grow our community, bring us together through this, as you probably know, we use the website askmedgeeks.com for you to submit questions that you want answered here on the podcast. I’d like to utilize that website in a little bit of a different way.  I want to hear from you all about your experiences with COVID. If it's you personally, maybe a co-worker, a friend that you know that works in healthcare, I'd really like to hear a story about how it's affecting you guys. What we as healthcare workers are going through and doing in response to COVID-19, so if you have a story that you would like for me to share here on the podcast just to kind of bring us all together please send that to askmedgeeks.com, it's gonna say “what's your question for the podcast?”, but for this just send me some information. I want to hear from y'all, and of course, let me know if you feel comfortable with me, utilizing your name, when I do read the story or not.   As far as what we're going to talk about today, you know, last time we kind of talked about background information, the biology of SARS coronavirus 2. Today let's start by talking about some Updated STATs, and then we're going to talk about a little bit more of a deeper dive into treatment.    So this data was pulled from April 13, just like last time these numbers are going to be outdated almost immediately but this from April 13.  The worldwide number of cases is about 1.8 million, and the worldwide death count is 117,000. In the United States there are 566,000 cases and approximately 23,000 deaths. New York State has 10,000, of those deaths.  Over the past several days, the number of new hospitalizations and ICU admissions has slowed down a little bit in New York City however the daily death rate in New York City is at kind of a steady, yet alarmingly high plateau for the past few days, seeing over 700 deaths per day, due to COVID-19.    Do you a question you'd like for us to answer? Submit your question here (it's free) and we'll answer on our next podcast episode: https://www.askmedgeeks.com - Stay up to date with our monthly audio program In the Know. Get a free trial: https://www.medgeek.co/in-the-know-order-form-free - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog. 

COVID-19 Update

Your next patient is a 62yo M brought to the emergency department complaining of acute onset chest pain that radiates to his neck. The EKG is normal sinus rhythm (NSR) with no ischemic changes. The patient’s blood pressure is 164/92 in the right arm; and 132/78 in the left arm. What's the next step for this patient? What labs do we need? What imaging do we need? This is a patient who very well may die today if you don't do things correctly and quickly. Today on the Medgeek's podcast we discuss Aortic Dissection. - Do you have a question you'd like for us to answer? Submit your question here (it's free) and we'll answer on our next podcast episode: https://www.askmedgeeks.com - Stay up to date with our monthly audio program; In the Know. Get a free trial: https://www.medgeek.co/in-the-know-order-form-free - Follow us on Instagram here: https://www.Instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Aortic Dissection

A 19-year-old male presents the emergency department complaining of cough and fever. He states he wants to get checked out because he's worried he may have coronavirus. He has normal vital signs and he appears clinically well. There is no recent travel history nor recent known known exposure, to anyone with either confirmed or suspected COVID-19. How do you approach this patient? What are the testing guidelines and the testing capabilities? How can we as clinicians communicate with our patients effectively about COVID-19? With all the misinformation on social media and various news outlets it comes down to us to be the voice of truth for our patients. Today on the Medgeeks podcast we discuss COVID-19. -     Do you have a question you'd like for us to answer? Submit your question here (it's free) and we'll answer on our next podcast episode: https://www.askmedgeeks.com - Stay up to date with our monthly audio program; In the Know. Get a free trial: https://www.medgeek.co/in-the-know-order-form-free - Follow us on Instagram here: https://www.Instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.  

COVID-19

A 39yo F presents to you for cough that she has had for 7 months. It is a dry cough that she has assumed is related to her allergies. Nothing makes this cough go away. She takes no medications, other than Zyrtec daily and has no PMHx. Over the past 2-3 weeks she develops, fatigue, night sweats and even reports a fever. It seems this may be a bit more than simple allergies. You wisely obtain a CXR to evaluate this chronic cough with now constitutional symptoms and you believe you have your answer when you see the finding of bilateral hilar adenopathy. Now, how to manage it? What tests need to be ordered further? What advice do you give this patient? What are we going to do? On today's podcast we dive into the curious and fascinating disease known as sarcoidosis.   - Do you have a question you'd like for us to answer? Submit your question here (it's free) and we'll answer on our next podcast episode: https://www.askmedgeeks.com - Stay up to date with our monthly audio program In the Know. Get a free trial: https://www.medgeek.co/in-the-know-order-form-free - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Sarcoidosis

A 43 year old male presents to the emergency department with right wrist pain after falling on his outstretched right hand. You obtain an  x-ray of the wrist, which demonstrates no acute fracture or dislocation. The patient is neurovascularly intact, you decided to discharge the patient home with instructions to treat with: ice, rest, and some naproxen. 14 months later, you're being sued by this very same patient, apparently, after you saw the patient their wrist pain never got better and in fact it persisted for over 8 months before they were finally seen again at another facility. They were then referred on to hand surgery where the diagnosis of a Scaphoid Fracture with Osteonecrosis due to non-union was made.  The patient is suing you because they say you missed the fracture and now they have chronic wrist pain and limited functionality of the hand, so they're unable to make a living as a plumber, and their quality of life has dropped significantly. This is a fictional story, but very very common. Today we're going to talk about how to diagnose and how to not get burned by Scaphoid Fractures. - Do you a question you'd like for us to answer? Submit your question here (it's free) and we'll answer on our next podcast episode: https://www.askmedgeeks.com - Stay up to date with our monthly audio program In the Know. Get a free trial: https://www.medgeek.co/in-the-know-order-form-free - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog. 

Scaphoid Fracture

You have two patients. One is a 53 year old male with a past medical history of diabetes, and he's presenting to the emergency room with an abscess on his upper back, it has been growing larger for the past four days. His vitals are significant for a heart rate of 108 and temp of 99.9. Meanwhile down the hall, you're also seeing a 25 year old female who recently gave birth three weeks ago, she complains of chills, fatigue, and back pain. She has normal vital signs aside from tachycardia of 131. I saw both of these patients during a recent shift, and today I want to go over each case as a way to discuss a very important topic and how we as providers, communicate with, and ultimately care for our patients. Today we're talking about shared decision making. - Do you have a question you'd like for us to answer? Submit your question here (it's free) and we'll answer on our next podcast episode: https://www.askmedgeeks.com - Stay up to date with our monthly audio program In the Know: https://medgeeks.samcart.com/products/in-the-know - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.  

Shared Decision Making

A 36 year old man presents to your Urgent Care complaining of progressively worsening left eye pain. It started as a scratchy feeling three days ago but now it's worse. He can barely even open it, due to the pain and the light sensitivity. When you examine the eye it's red, and there is purulent drainage. Is this pinkeye? Could it be something worse? Today let's discuss pathology relating to the cornea.   Do you a have question you'd like for us to answer? Submit your question here (it's free) and we'll answer on our next podcast episode: https://www.askmedgeeks.com - Stay up to date with our monthly audio program In the Know: https://medgeeks.samcart.com/products/in-the-know - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Cornea Pathology

Private group tutoring for the boards ends soon. Learn more here: https://www.medgeek.co/private-group-training1 - We're going to be continuing this month of December with cardiology. The first two weeks we discussed murmurs and this week we'll be discussing atrial fibrillation.  Believe it or not, but atrial fibrillation is the most common arrhythmia. This is going to be characterized as an irregular rate of the atria. So, let's dive into presentation, EKG findings, and management. We'll also be hitting a little atrial flutter as we go. - Enrollment for group coaching to work with us live to help you pass the boards ends soon; learn more here: https://www.medgeek.co/private-group-training1 - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Atrial Fibrillation

Free cardiology replay training: https://www.medgeek.co/cardio - Today, we'll be breaking down the various valvular lesions and murmurs, including mitral stenosis, mitral regurgitation, aortic stenosis, and aortic regurgitation. If you want to keep learning cardiology with us, then make sure to catch our free cardiology training here: https://www.medgeek.co/cardio - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Stenosis and Regurgitation

Join our free cardiology training: https://www.medgeek.co/cardio - After doing private tutoring with students and clinicians, we've realized that cardiology is a major sticking point! After all, it's the biggest section on most board exams! Understanding murmurs has also given a ton of pain to students. So today, we'll be simplifying things for you! If you want to keep learning cardiology with us, then make sure to register to our live training December 12, 2019 6 pm PT. Register free here: https://www.medgeek.co/cardio - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Murmurs

Welcome to the medgeeks podcast, this is Eric Gordon and we are going to be finishing up our conversation on anemia today. If you haven't done so already be sure and check out our two previous episodes on anemia. Part One was microcytic anemia and Part Two normocytic. Today we are finishing up with part three and that is macrocytic anemia. We're talking B12, we’re talking folate, we're talking alcohol. We're going to get into the workup to figure out what's causing a macrocytic anemia and of course we will talk about treatment as well. So let's get into this.   Do you have a question you'd like for us to answer? Submit your question here (it's free) and we'll answer on our next podcast episode: https://www.askmedgeeks.com -Stay up to date with our monthly audio program In the Know: https://medgeeks.samcart.com/products/in-the-know - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Anemia Part 3- Macrocytic Anemia

Our goal is to change the way students and clinicians learn medicine. We are dedicated to providing the best medical content to help clinicians get through school, the boards, and to excel in clinical practice.

hubhopper

Medgeeks Clinical Review Podcast

hubhopper