How to Think Like an Emergency Physician Part 4

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

In emergency medicine we use a top-down approach. What does the patient need? Not, what does the patient have?  4 Responsibilities of the Emergency Physician:  Resource stewardship – Not a lot of control over this variable  Customer service – Evidence based medicine doesn’t equal good customer service. You must be able to communicate well with your patients and manage expectations appropriately.  Symptom relief – Don’t forget to address the pain or symptom that the patient came in for while thinking through DDX and orders.  Patient safety – Most of our time is spent here.  Patient safety is resuscitation and identifying dangerous conditions  Dr. Strayers system:  Identify patients needing resuscitation and triage appropriately  Identify dangerous conditions using HPI, physical exam, testing. This list is narrowed down by each step in the process.  Have a plan for a negative workup as a positive work up will usually dictate a plan on its own.  Run the board frequently and after seeing new patients.  Place orders before charting  Manage interruptions with a method that works for you. Multitasking isn’t possible.  Expand work up if the HPI and physical exam are limited. Huge thanks to Reuben Strayer! Check out his website EMUpdates.com

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