Monday, July 18, 2011

APPROACH IN EMERGENCY MEDICINE


There were many approaches has been taught in dealing with patient presented to ED. Most of the emergency clinicians had their own way to approach certain cases. We have to understand that emergency department has their own environment which different with other disciplines. Some people said we are living in the fast lane...need quick thinking,quick decision & quick intervention within short of time. Here, i just want to share my practice that i got from my "guru" in approaching patient in ED. Only 5 steps...

step 1 : What are the chief complaints
step 2 : What are the life threatening condition
step 3 : What are the common causes
step 4 : Is it patient safe to be discharge or not
step 5 : if discharge need follow up or not

An example if patient come with the chest pain

step 1 : chief complaints chest pain
step 2 : what are the life threatening chest pain eg : AMI, Pulmonary embolism, aortic dissection
step 3 : after rule out life threatening can find the other causes of chest pain
step 4 : safe to be discharge or not
step 5 : need follow up or not.

Some clinicians used mnemonic 4C

1. complaints
2. condition
3. causes
4. complication

You can choose either one that comfortable/easy to use. I hope this sharing knowledge may help us in reducing misdiagnosis in our ED especially for young doctors.

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