Approach to the Critical Patient

Immediate priorities

Stabilization sequence

High risk phenotype recognition

Immediate monitoring

Early actions

First line symptom control

Early bedside tests

Consult triggers

Specialty escalation

Legal and safety escalation

History

Presentation pattern

Typical clinical vignette

Time course

Key elements

Substance exposure details

Co exposures

Symptom inventory

Medical risk modifiers

Physical Exam

Vital signs and toxidrome

Sympathomimetic findings

Mental status spectrum

Focused system exam

Cardiovascular

Respiratory

Neurologic

Musculoskeletal and skin

PITFALLS

Common misses

Differential Diagnosis

Immediately life threatening

Cardiovascular emergencies

Neurologic emergencies

Hyperthermic syndromes

Mimics and complications

Psychiatric and toxicologic

Infectious

Metabolic

Laboratory Tests

Core labs

Baseline safety panel

Rhabdomyolysis assessment

Acid base and perfusion

Cardiac labs

Myocardial injury evaluation

Targeted tests

Co ingestion and alternate diagnosis screening

Toxicology testing limitations

Diagnostic Tests

Scoring Systems

Risk stratification tools

MRI

Brain MRI use cases

MRI limitations in acute stimulant toxicity

CT

Head CT indications

Chest imaging

Abdominal CT for body packer concern

Ultrasound

Cardiac point of care ultrasound

Lung ultrasound

Vascular ultrasound

Disposition

Level of care

ICU criteria

Step down or monitored bed criteria

Observation and discharge pathways

ED observation suitability

Discharge criteria

Transfer

Transfer triggers

Treatment

Environmental and de escalation

Low stimulation care

Sedation and agitation control

Benzodiazepines first line

Antipsychotic adjuncts

Severe agitation escalation

Hyperthermia management

Rapid cooling bundle

Temperature targets

Cardiovascular management

Chest pain and suspected vasospasm

Hypertension and tachycardia

Dysrhythmias and seizures

Wide QRS or ventricular dysrhythmia from sodium channel blockade

Seizure management

Fluids and rhabdomyolysis

Volume resuscitation

Electrolyte management

Evidence and guideline notes

Evidence alignment summary

Special Populations

Pregnancy

Pregnancy considerations

Geriatric

Older adult considerations

Pediatrics

Pediatric considerations

Background

Epidemiology

Population patterns

Pathophysiology

Mechanisms

Therapeutic Considerations

Treatment principles

Patient Discharge Instructions

copy discharge instructions

Discharge instructions bundle

References

Clinical Guidelines

Guideline sources

Evidence-Based Sources

Toxicology and emergency medicine references

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.