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EMCrit 293 – The Jerk & Check, Functional Heuristics in Resuscitation Project (MotR)

03.03.2021 - By Scott D. Weingart, MD FCCMPlay

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What is a Heuristic?

A short cut to extended, analytical thinking that when functional provides a solution that may not be optimal but will be sufficient. When based on cognitive biases, heuristics may be dysfunctional. Wikipedia has a fairly good discussion of heuristics.

Thinking Fast and Slow

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System 1 vs. System 2

Our interview with Gary Klein

ERADs are the Action Version of Functional Heuristics

Emergency Reflex Action Drills from Lauria

Jerk & Check

Never immediately act on a heuristic. Have your kneejerk response and then use System 2 to Check

Functional Heuristics in Resuscitation

Flank Pain in Elderly is AAA until the Ultrasound

 

Severe Bradycardia/Heart Block = Hyperkalemia until you see the K

 

Slow Afib=Digoxin, Hyperkalemia, or Nodal Blockers until proven otherwise

 

Slovis' Hypokalemia = Hypomagnesemia (Hypok=HypoMAG)

 

Unexplained Hypotension gets antibiotics

 

Hypotension and Abdominal Pain in Child-Bearing Age Female is Ectopic

 

Chest Pain Plus

 

Tamponade is dissection until it is not

 

Old stay, young go

Err towards Young D/C and Old Stay and then check

Think LP/do LP

 

The diagnoses of costochondritis and gastroenteritis do not exist

 

What is going to kill this patient? (Pre-Mortem)

a adaption of Gary Klein's idea

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