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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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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