EM Educator Series: Found down – No History Available

Authors: Alex Koyfman, MD (@EMHighAK) // Edited by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome to this week’s EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. 

Case:

A 62-year-old male is found down by bystanders on a sidewalk. EMS brings him to your ED with VS: HR 110, BP 90/48, RR 12, Sats 93% RA, T 98 F, and D-stick 160. What do you need to consider?

Considerations:

1. How do you organize the room?
2. What’s in your differential?
3. What’s in your systematic approach to patient with limited history available, and what are several important considerations?
4. What cognitive stop points are recommended, and if your initial evaluation does not turn anything up, what are your next steps?
5. How do you manage cognitive load in the busy ED?

Suggested Resources:

• Articles:
  • emDOCs – Mindset of the Resuscitationist: Organizing the Room
  • Resus.Me – Making Things Happen
  • emCrit – Podcast 177 – Chris Hicks on the Fog of War: Training the Resuscitationist Mindset
  • emDOCs – Cognitive Load and the Emergency Physician
• Podcast:
  • EM Basics – Altered Mental Status
    • AMS Show Notes
  • Videos:
    • EM in 5 – Approach to: Altered Mental Status