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The Eleven Commandments of Emergency Medicine

  • Typical diseases never present typically & atypical diseases will only present when you don't suspect them.
  • You'll never be sued for good communication with the staff or your patients.
  • a. Lacerations always cut through tendons, nerves and arteries until proven otherwise.
  • b. Chest pains are cardiac until proven otherwise.
  • c. Headaches are subarchnoid hemorrages until proven otherwise.
  • d. Serious illness is present until proven otherwise - that's why we call it Emergency Medicine.
  • Specialists are always awake at 3 am. Remember to call them for consultations.
  • Patients who return to the ER after visiting earlier in the day usually have something seriously wrong. A "bounce back" is a red flag.
  • Always talk to everyone - nurses, paramedics, family. They're great information sources in the search for the truth about what occurred or why the patient's there.
  • Patients are usually quite smart about their own diseases. Give them the benefit of the doubt - and believe what they say.
  • When in doubt, admit the patient.
  • Senior citizens are always sicker than they appear or state.
  • Teenagers are always pregnant and usually will deny it until asked three times.
  • If you think of doing a particular test - Do It. You'll regret not having done it later that night when you go home - and the worry just isn't worth it.

* The above work by John Levin, M.D., Emergency Medicine & Family Practice, was provided by the Technical Assistance Bureau, Inc.

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