The key to being a rock star in the ED is doing a great presentation.  The key is gathering all the information without missing anything, shortening it to just longer than a haiku, making it clear you have considered all the dangerous diagnosis and then giving your most likely diagnosis with a plan to prove it and treat it.  It’s a lot to ask.

Having a structure to your presentation helps, but the EM mindset differs from the classically taught case presentation.

Work on:

– The Bullet: “Ms. MD is a (X )y.o. woman who presents with (cc), and will require (admission, surgery, workup, likely dc, I’ve no idea?).”

The attending is a distractable meerkat-like creature, and a one-liner bullet helps frame the presentation and capture attention.

– The Story: “She began having (symptom) about (X hours/days/wks) ago, and has (worsened/improved), noting that (triggers/improving events) occur. She also reports (Y) and denies (Z).”

This is the HPI, and it includes ONLY the PMH that’s relevant, AND the pertinent positives and negatives. This gives support for your differential and reassures the attending that you’ve thought about ruling out dangerous diseases. Tell it in a timeline fashion, that will make it much easier to recall and 

–The Wrap-Up: “This could represent (X), or (Y), and less likely but possible (Z). I’d order (test, intervention, pain ctrl, consult).”

The wrap-up is the most neglected and most important part of showing that you’re thinking about management. It’s your differential (please try to include 3 things even if unlikely), and your plan. Even attempting a management plan makes it an advanced presentation.

Here is some stuff that might help you.

EMRA video on how to present –video

A 2008 paper from Academic Emergency Medicine – Article

AAEM has tips and tricks for a good presentation – Article

And a weird old poorly illustrated article – Article