Paucis Verbis: Pneumonia risk stratification tools

8:10 AM in paucis verbis cards

Pneumonia is a common cause for ED visits. How do you decide on whether the patient can be managed as an outpatient or inpatient? To supplement your clinical judgment, many clinicians use the Pneumonia Severity Index (PSI) score.

Have you heard of CURB-65, supported by the British Thoracic Society? What about SMART-COP, which is meant to help you predict if your patient will need Intensive Respiratory or Vasopressor Support (IRVS)?

It's worth a quick review.

Feel free to download this card and print on a 4'' x 6'' index card.

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Paucis Verbis: Assessing patients with suicidality in the ED

3:00 AM in paucis verbis cards

Dr. Rob Orman of ERCast blog fame emailed me last week about creating a pocket card on Suicide Risk Stratification. In many community ED's, risk assessment is done by the emergency physician. I'm lucky where I work, because we have a 24/7 psychiatric ED, which consults on suicidal patients in the "medical ED".   

In the end, assessment is primarily based on physician judgment, because there's no great clinical decision tool, rules, or scores to assess risk. Rob has created his own mnemonic to help you ask the right questions in assessing a suicidal patient. This is a sneak peak into a larger article that Rob is planning to unleash on the world on suicide assessment. Based on his review of the literature and own clinical experience, the mnemonic is: TRAAPPED SILO SAFE.

TRAAPPED SILO

• "Risk factors" which increase a patient's risk for committing suicide in the near future. 

SAFE

• "Protective factors"which decrease a patient's risk for committing suicide in the near future.

Feel free to download this card and print on a 4'' x 6'' index card.
Thanks, Rob!!

* Updated 3/8/11: Added extra "A" to include "Access to Means" as a risk factor.

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