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:
- Secure the ABCs.
- Consider or give naloxone, glucose and thiamine.
- Get a pregnancy test.
- Assume the worst: rule out serious disease.
- Do not send unstable patients to radiology.
- Look for the common red flags.
- Trust no one, believe nothing (not even yourself): check lab results and rethink clinical decisions.
- Learn from your mistakes.
- Do unto others as you would your family (and that includes coworkers).
- 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