The 12 Commandments of Emergency Medicine 

1. ER patients are guilty until proven innocent
   • Reasonably rule out the more rare but more dangerous explanation before landing on the benign one.  Think worst first
   • Although you may end up there, never trust a patient’s or a nurses benign explanation for symptoms such as “stress at work”, “indigestion” or “something I ate”
   • You are a detective not a gambler.
2. History is king
   • It is not the patient’s job to provide a good history; it is your job to elicit one
   • Listen to the patient, but when they get tangential bring back the focus
   • Know when to dig deeper, like with timing and duration for chest pain
   • Know when talking to family/staff is required: altered or non-verbal patient, suicidal patient…
3. Read the triage note
   • Do it before you see the patient and again at time of dispo to make sure all triage issues have been addressed
   • Patients/medics may have told triage nurse something important but forgot to or couldn’t tell you
   • If there is an inconsistency make sure to break the tie
4. Bounce-backs get bigger workups and/or get admitted
   • Second visit do more: testing, consult, etc
   • Third visit admit: SMV/PUD story, CSVT stories
   • FOR THE REST CLICK HERE.

EMresouce.org is an online resource for Emergency Medicine Providers

• Look it up: our Resource pages boast a documentation macro library, a list of practice-changing literature, & more
• Test you skill: check out our library of EM Case Challenges. You can subscribe to receive them weekly
• Get visual: Browse our EM Ultrasound Library: Cardiac, Aorta, OB/Gyn and much more.
• Fill your pocket: Visit our Book Store for pocket reference texts & cards, CD’s, PDF texts and more

Get One of Our Emergency Medicine Pocketbooks

• A-to-Z EM Pocket Pharmacopoeia & Antibiotic Guide, 5th edition:  Tabular, alphabetic and quick to use with side effects and contraindications for each drug.  Also has a complete empiric antibiotic guide, procedural sedation and more
• Emergency Medicine 1-Minute Consult Pocketbook, 5th edition:  Entries on every EM topic you can think of with chapters on topics from Allergies to Wilderness Medicine.  Each entry includes clinical findings, testing, treatment and disposition
• 8-in-1 Emergency Department Quick Reference, 5th edition:  Eight books in one.  Chapters on H&P, History, EKG, Lab, Imaging, Procedures, Disposition, EM Guideline, Risk management, Lawsuits, Career, Wellness and more

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TESTIMONIALS & QUOTATIONS

“Dr. Pregerson. You have no idea how many times you rescued me over the years with your exceptional handbooks. I put you in the ranks of the great ones (Like Tintinalli, Rosen, Greg Henry, etc. I love your handbooks and recommend them often to young doctors whom I mentor.”  – Gordy Leingang, DO, FACEP, FACOEP. Bismarck, ND.

“It’s not our patient’s job to prove they are sick.  It’s our job to prove they are not.”  – Yaron Ivan, MD

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