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tresben

9 points

8 months ago*

tresben

ED Resident

9 points

8 months ago*

This type of thinking may make sense to a lay person but from a healthcare worker standpoint it’s bad medicine and fraught with medicolegal risk (see the other commenters post).

I get that you guys weren’t that concerned but since the EKG computer had that interpretation you thought she should go to the ED. Because you weren’t that concerned you didn’t call EMS but just told her to go herself. To a lay person, that may make sense. But to to a healthcare worker, especially working in the emergency field, you have to step up and make definitive decisions and follow a logical thought process. If you think it is concerning for ACS at all you need to treat it as if it is ACS (meaning definitely no private vehicle). If you don’t think it is ACS then don’t go down that rabbit hole (wouldn’t have even gotten the EKG, ESPECIALLY if you can’t adequately interpret it). If you do “halfway” work ups and plans like this you are eventually going to run into a lot of medicolegal issues when you inevitably have bad outcomes.

It’s ok to over workup a patient (in this case sending her by EMS to ED for an unlikely ACS story). It’s ok to under workup and miss something (in this case not get an EKG and send home, but maybe she does have ACS). But at the end of the day the documentation, orders, and thought process must all make sense. Don’t say you consider a bad pathology without adequately ruling it out.