Emergency medicine is all about time. We come in at the start of your shift and suddenly we’re in a whirlpool of events, rarely getting a chance to sit down and think. That’s why we love checklists, scales and scores, repeating those mantras in our heads whether it’s an intubation, a GI bleed or a patient with syncope. It helps us focus; it helps us avoid making a critical error, although it can also make us forget the ground basics. I came across a set of fundamental truths that were published in 1991 by Wrenn and Slovis and called The Ten Commandments of Emergency Medicine. Take a look:

1. Secure the ABCs.
2. Consider or give naloxone, glucose and thiamine.
3. Get a pregnancy test.
4. Assume the worst: rule out serious disease.
5. Do not send unstable patients to radiology.
6. Look for the common red flags.
7. Trust no one, believe nothing (not even yourself): check lab results and rethink clinical decisions.
8. Learn from your mistakes.
9. Do unto others as you would your family (and that includes coworkers).
10. When in doubt, err on the side of the patient.

It might be worth a while to run through them from time to time, to get ready for the unpredictable at the next shift.

Share your mantras in the comments – what’s playing in your head at the bedside?

SM gyd. rez. Elžbieta Žemaitytė