How to make decisions in the emergency department

  • First, when you walk into a room, mentally say to yourself, “is this patient going to die right in front of me?” If the answer is “yes,” then go into ABC/ACLS/ATLS/PALS(EPLS) mode.
  • If the answer above is “no,” then ask yourself, “is this patient sick enough to be admitted, or well enough to go home?”
  • If the patient is going to be discharged, then figure out what the worst possible conditions that could harm/kill the patient based on the patient’s chief complaint, and come up with a way to systematically cross them off the list so you can feel warm and fuzzy about discharging them home.
  • If they are going to be admitted, then figure out what tests to order so you can initiate lifesaving treatment.

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