So please my EM friends, stop seeking for the easy out. SIT down. Take a good history. Do a decent exam. Obtain appropriate testing. Finally, if you have a picture of anxiety, having ruled out lethal processes, present your decision making to the patient in a way that makes it crystal clear that you don’t know for sure what’s happening. Leave space for error, change, and re-evaluation. Validate the visit. Damn near all ER visits are appropriate — it is the system that is not.
7/7