Evidence based decision tools

[cinapism]

---

Members don't see this ad.

Hey all.

What evidence based decision tools do you use regularly in your practice?

Im putting together some curriculum for med students going in to EM and I want to get some input.

Obviously we all use nexus criteria but do you use perc criteria, curb65, abcd2, timi scores, etc? What decision rules (validated or not) are important to you?

Thanks!

 

[WilcoWorld]

Nexus, Wells +/-PERC, Ottowa knee & ankle, PORT, strep scoring system. I also use the pediatric head CT rules that recently came out, but I can't recall the name at the moment.

Others I mention as teaching tools (moreso to confuse admitting services that are trying to block) but don't really use for my own decision making include MANTRELS and the SanFrancisco Syncope Rule (I know, I know, but read what I just wrote).

 

[docB]

I use Wells but mainly to justifiy what I want to do anyway. We use NIH for stroke and Nexus of course.

 

[kungfufishing]

ABCD2 for TIA.

 

[WilcoWorld]

ABCD2 for TIA.

I'm curious how you use this. Where I work we have an Obs Unit protocol for TIA, so I'm not too pressed to send possible TIA's home. Do you send home the 0-3 scores and admit the rest? If so, what kind of follow-up are you working out for the ones you send home?

 

[xaelia]

http://www.thennt.com/

 

[kungfufishing]

I'm curious how you use this. Where I work we have an Obs Unit protocol for TIA, so I'm not too pressed to send possible TIA's home. Do you send home the 0-3 scores and admit the rest? If so, what kind of follow-up are you working out for the ones you send home?

For low risk patients with a reliable primary I talk to the pcp and set up follow up with him/her as well as with our stroke neurology clinic. I also find scoring systems in general are an opportunity to discuss the decision making process with patients.

Well, unless they are 8 years old, get "strep every year, two or three times" and I know a discussion regarding the Centor criteria will end with a blank look and the phrase "so what antibiotics is she gonna get?". I still explain it, just not really much of an "opportunity".