Short explanations of core ED screening tests—fast, low-complexity checks used to triage, rule-out life-threats, and guide next tests.
Tip: Screening = quick, sensitive, directional. Diagnostic = confirmatory and specific (see separate page).
What: Electrical snapshot of the heart taken within minutes of arrival.
How: Skin electrodes detect voltage changes across 12 leads.
Looks at: Ischemia/infarct (ST/T changes), arrhythmias, conduction blocks, pericarditis.
What: Blood protein released with myocardial injury.
How: Serum assay at baseline and serially (e.g., 0/1–3 hr).
Looks at: Myocardial damage; supports ACS rule-in/out with ECG.
What: Vitals supine → sitting/standing.
How: Measure BP/HR after position changes.
Looks at: Volume depletion/autonomic dysfunction contributing to syncope/dizziness.
What: Non-invasive oxygen saturation estimate.
How: Finger/ear probe uses light absorption.
Looks at: Hypoxemia severity; guides O₂ therapy.
What: Oxygenation/ventilation & acid–base.
How: Arterial or venous sample; rapid cartridge analyzers.
Looks at: pH, PaCO₂, HCO₃⁻, lactate; respiratory failure, metabolic derangements.
What: Airway obstruction screen.
How: Handheld meter after max inhale/forceful exhale.
Looks at: Bronchospasm severity and bronchodilator response.
What: Capillary blood sugar.
How: Fingerstick with enzymatic strip.
Looks at: Hypo/hyperglycemia as reversible cause of AMS/seizure.
What: Rapid screen of CN, motor, sensation, speech, gait.
How: Bedside maneuvers & brief mental status.
Looks at: Focal deficits (stroke), encephalopathy patterns.
What: Positional vertigo provocation test.
How: Rapid supine head-turn maneuver.
Looks at: Posterior canal BPPV (torsional up-beating nystagmus).
What: Risk screen for infection + organ dysfunction.
How: Uses vitals/mental status (e.g., RR, SBP, mentation).
Looks at: Need for cultures, early antibiotics, escalation.
What: Multiplex NAAT for respiratory/GI/CNS pathogens.
How: Swab/stool/CSF on cartridge platform.
Looks at: Pathogens to guide isolation/antibiotics.
What: Dipstick + microscopy of urine.
How: Chemical pads & microscopic sediment review.
Looks at: Infection (LE/nitrite), blood, protein, ketones; dehydration.
What: Detects hCG.
How: Urine (qual) or serum (quant) immunoassay.
Looks at: Confirms/quantifies pregnancy; key in abdominal pain/bleeding.
What: Electrolytes, glucose, renal function.
How: Serum chemistry analyzer.
Looks at: Na/K/HCO₃⁻, BUN/Cr; dehydration, AKI, DKA clues.
What: Hgb/Hct, platelets, WBC profile.
How: Automated hematology counter.
Looks at: Infection/inflammation, anemia, thrombocytopenia.
What: Tissue hypoperfusion marker.
How: Point-of-care or central lab assay.
Looks at: Shock, sepsis severity; resuscitation response.
Differentiate contractile vs inert sources of pain using Active ROM → Passive ROM with Overpressure → Resisted Isometrics. Non–joint-specific, designed for ED triage.
Stop if sharp/neurovascular symptoms or suspected fracture/dislocation.
| AROM | PROM+OP | Isometrics | Implication |
|---|---|---|---|
| Pain/limited | Pain/limited (similar) | Painless/strong | Inert tissue (capsule/ligament/cartilage/bursa) |
| Painful | Painless/near normal | Painful and/or weak | Contractile lesion (muscle–tendon) |
| Painful end-range | Firm end-feel pain | Varies | Synovitis/capsulitis likely |
| Pain in all directions | Pain in all directions | Painful/weak | High irritability → image/consult |
Stop / Refer Now if: