An interactive exploration of how patients are evaluated, managed, and moved through the complex, high-stakes environment of emergency care. This application mirrors your symptom-based guide with a concise, clinically oriented map.
Symptom-based pathway aligned to your document: Chief Complaint → Symptoms → Screening → Consults → Diagnosis (confirmation).
| Chief Complaint | Key Symptoms | Initial Screening | Consults (pre-dx) | Likely Diagnosis → Confirmation |
|---|---|---|---|---|
| Chest Pain | Pressure/tightness, radiation to arm/jaw, diaphoresis, anxiety | Vitals; ECG ≤10 min; troponin; SpO₂; bedside glucose | Cardiology; Pulmonology (PE); Gastroenterology (esophageal) | ACS → ECG+serial troponin; PE → D-dimer → CTPA; Pericarditis → ECG+echo; GERD → response ± endoscopy |
| Shortness of Breath | Dyspnea, wheeze, orthopnea, cough, tachypnea | Vitals; SpO₂; ECG; ABG/VBG per protocol; peak flow | Pulmonology; Cardiology (HF) | Asthma/COPD → spirometry/response; HF → BNP+echo; Pneumonia → CXR ± PCR; PE → CTPA |
| Abdominal Pain | RUQ/LLQ pain, N/V, bloating, guarding | Vitals; focused abdominal exam; urinalysis; pregnancy test if applicable | General Surgery; Gastroenterology; Urology | Appendicitis → CT/US; Cholecystitis → RUQ US ± HIDA; Pancreatitis → lipase ≥3× ULN + imaging; Renal colic → CT KUB/US |
| Headache | Photophobia, neck stiffness, thunderclap onset, nausea | Vitals; focused neuro exam; fundoscopy | Neurology; Infectious Disease (meningitis); Rheumatology (GCA) | SAH → non-contrast CT ± LP; Meningitis → CSF studies; Migraine → clinical; GCA → ESR/CRP + temporal artery biopsy |
| Fever | Chills/rigors, malaise, tachycardia | Vitals; targeted system exam; sepsis screen | Infectious Disease; Hospital Medicine/Critical Care | Pneumonia → CXR/CT + microbiology; UTI/pyelo → UA + culture; Sepsis → blood cultures + SOFA/qSOFA |
| Dizziness / Syncope | Lightheadedness, brief LOC, palpitations, vertigo | Vitals; orthostatic BP; ECG; bedside glucose; Dix–Hallpike (if vertigo) | Cardiology (arrhythmia/syncope); Neurology (central vertigo/stroke); ENT | Arrhythmia → telemetry/Holter ± echo; BPPV → +Dix–Hallpike; Posterior stroke → MRI brain + vascular imaging |
| Altered Mental Status / Encephalopathy | Confusion, disorientation, lethargy, agitation | Vitals; bedside glucose; brief neuro exam; collateral history | Neurology; Critical Care; Toxicology (if exposure suspected) | Hypoglycemia → serum glucose; Hepatic → ammonia + precipitant search; Uremic → renal panel; Stroke/ICH → CT/MRI; Sepsis-associated → cultures + source |
| Back Pain | Focal tenderness, weakness, bowel/bladder change, fever | Vitals; neuro exam; red-flag screen (infection, cancer, CES, AAA) | Orthopedics/Neurosurgery; Oncology; Vascular Surgery (if AAA) | Disc herniation → MRI; Vertebral fracture → X-ray/CT; Spinal epidural abscess → MRI + ESR/CRP; AAA → bedside US → CTA |
| Extremity Injury / Limb Ischemia | Pain, swelling, deformity, pallor, paresthesia | Vitals; limb neurovascular exam (pulses, cap refill, motor/sensory) | Orthopedics; Vascular Surgery | Fracture/dislocation → X-ray ± CT; Acute limb ischemia → arterial Doppler/CTA; Compartment syndrome → clinical ± pressures |
| Alcohol / Drug Intoxication | Slurred speech, agitation, drowsiness, pinpoint/dilated pupils | Vitals; neuro exam; bedside glucose | Toxicology; Psychiatry (safety/withdrawal) | Alcohol intox → serum ethanol + course; Opioid toxicity → miosis + hypoventilation, response to naloxone; Stimulant toxicity → clinical ± tox screen |
| Dehydration | Dry mucosa, poor skin turgor, tachycardia, hypotension | Vitals; exam of mucosa/skin turgor; cap refill | Hospital Medicine; Nephrology (severe electrolyte/AKI) | Hypovolemia/dehydration → BUN/Cr ratio, electrolytes, lactate as indicated |
Initial screening only; adapt to local protocols.
Rapid, symptom-directed assessment to identify life-threats and narrow differentials—consistent with your uploaded guide.
Compare the focused ED exam with the comprehensive approach.
Stabilize first; diagnose second.
Condition-specific pathways using empiric therapy when appropriate—consistent with your outline.
| Step | Action |
|---|---|
| Assessment | Focused Hx (PQRST), vitals, ECG ≤10 min, risk factors. |
| Diagnostics | Serial ECGs/troponins; CXR; consider CCTA for intermediate risk; D-dimer → CTPA if PE suspected. |
| Treatment | Aspirin; anticoagulation when indicated; PCI for STEMI; oxygen only if SpO₂ < 90%. |
| Disposition | High-risk to ICU/cardiology; low-risk discharge with follow-up. |
| Step | Action |
|---|---|
| Assessment | ABC; look for stridor/wheeze/accessory muscle use. |
| Diagnostics | Pulse oximetry; CXR; ECG; POCUS; ABG if severe. |
| Treatment | O₂; bronchodilators (asthma/COPD); diuretics (HF); antibiotics (pneumonia). Consider NIV/intubation if failing. |
| Disposition | Admit if significant support required or high-risk etiology. |
| Step | Action |
|---|---|
| Assessment | Hx (onset/location/character), exam (tenderness, guarding, distension). |
| Diagnostics | CBC, LFTs, lipase, UA, hCG; US for biliary/GYN; CT for appendicitis/obstruction. |
| Treatment | IV fluids; analgesia; NPO; antibiotics if infection/perforation likely. |
| Disposition | Immediate surgical consult if acute abdomen; admit for surgical or obs needs. |
| Step | Action |
|---|---|
| Assessment | Collateral history; GCS; presume medical cause in older adults with new onset. |
| Diagnostics | Bedside glucose; electrolytes; tox; CT head; LP if meningitis suspected. |
| Treatment | Stroke alert if indicated (tPA window); treat seizures; correct metabolic derangements. |
| Disposition | Neurology consult; most require admission for workup/monitoring. |
| Step | Action |
|---|---|
| Primary Survey | ABCDE; hemorrhage control; IV access. |
| Diagnostics | E-FAST; X-rays/CT once hemodynamically stable. |
| Treatment | Tourniquets/pressure; resuscitation; antibiotics for open fractures. |
| Disposition | Immediate surgical/orthopedic consult for major trauma; usually admit. |
| Step | Action |
|---|---|
| Assessment | Verbal de-escalation; collateral history; exam for organic causes. |
| Diagnostics | Targeted testing only (tox/electrolytes) if indicated. |
| Treatment | Benzodiazepines/sedating antipsychotics if needed; calm environment. |
| Disposition | Psychiatry consult post medical clearance; admit based on risk. |
Admission decisions synthesize severity, risk, and support needs.
| Factor | Examples |
|---|---|
| Clinical Severity | Abnormal vitals, lab derangements, ESI 1–2, poor response to ED therapy. |
| Social Factors | Limited support, unsafe environment, impaired ADLs. |
| Specialty Needs | Urgent cardiology/neurology/surgery involvement. |
| System Pressures | Bed capacity, ED crowding, consult availability. |
For education only; follow institutional policies and pathways.