Thank you to Reuben Strayer for allowing me to reproduce his awesome content here. Check out his website at emupdates – return if worse for more emergency medicine content. Email me with comments or questions at Aaron@PracticalEMS.com
Quick tips:
Resuscitation
Does the patient need resuscitation?
- Vitals
- AMS
-Neuro deficits
- Sick appearing
- Threat to self or others
Prioritize patient appropriately and/or call for appropriate resources
Identifying dangerous conditions
- This is most of our ED patients
- Review RN/triage notes before seeing patient
- Prior visits/discharge summaries/ems runsheet
- Ask "What medical problems are you known for?"
- Ask for changes in medications
- Med non-compliance
- Social questions
- Ask last "Why have you come to the ED on this fine evening?"
- Have you ever had these symptoms before?
- Plan: what else need to be ruled out with imaging/lab work?
- Plan on what will happen with negative results, before they come back
- Positive results will usually dictate the plan
Run your board frequently
- What are we waiting on?
- Patient improving or getting worse
- Should I offer update, food, pain meds
- Update charting
- Always place orders before charting
Find a method for managing interruptions that works for you
If HPI and physical exam are difficult or limited - expand your work up
Don't make waste basket diagnosis such as costochondritis, gastroenteritis, GERD, anxiety
Follow key cases
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care.
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
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