Distilled Knowledge (Clinical Relevance)

A collection of notes from over 10 years of clinical practice in Emergency Medicine. There is no fluff or filler. Just simple notes and outlines for what to do when a patient is in front of you, or what to do in oddly-specific ED situations that are not so commonly encountered in real life. This is intentionally not written as a textbook or reference. TL;DR stands for “Too long, didnt read” and refers to the main principle of this resource – minimizing verbosity and cutting out the fluff.

High Speed Templates

Throughout my journey as an Emergency Doctor, I have noticed myself typing out a similar wall-of-text (spiel) for common presentations. For example, many stroke calls will present with a NIHSS score of 0. Wouldnt it be nice if there were a template written in the negative (0 for all tests) that could be copy pasted after completing your assessment? This speeds up documentation from taking 10-15 minutes to about 30 seconds.

Common Clinical Decision Making Pathways

Summaries of commonly used CDM tools. Examples include how to implement PERC, WELLS-PE, WELLS-DVT, HINTS, HEART / TIMI risk stratification, PSI / CURB65 / SMARTCOP, qSOFA / SIRS criteria, PREDICT / PECARN / CHALICE / CATCH etc. Frameworks that are copypastable in the negative are included to help speed up workflow. Important caveats and pitfalls that go beyond the original CDM tool are highlighted as well – eg, a pregnant obese woman coming off a 12 hour flight will have a PERC score of zero!

Ongoing Updates

The EM TL;DR project was originally a word document that sat on my desktop in real-life that has been updated almost weekly since I began Emergency Medicine training in 2013. It is a distillation of knowledge from over 10 years of working in the Emergency Department, focusing on real life applications of clinical medicine – I only include things that are relevant to clinical practice and I still refer to this OG document in practice as an specialist emergency physician. This site launched on 1st March 2024, and content will be added regularly as I migrate my notes into the site.

Oddly Specific Uncommon Situations

One of the interesting things about Emergency Medicine is that it is never boring, as uncommon/rare issues are encountered. For example, how would you deal with:

• snakebite, or more commonly a stickbite
• a rape victim
• thyroid storm
• methaemoglobinaemia from nangs.

The collection of oddly specific situations come from years of clinical practice and fellowship level exams (OSCEs) – distilled for your convenience, with an easy to follow template.​

Anecdotes and Pearls

Real life medicine revolves around implementing oddly specific focused knowledge. How would you differentiate a common peroneal palsy from a radiculopathy in your boring sciatica patient? Is that interocular opthalmoplegia real or is it just a medial rectus palsy? Sure, you can recite ACLS backwards, but it’s nice to have a polished script; and do you know what to do in the variants of ACLS (pregnancy, trauma, children, babies, neonates, toxicology)?. It’s also important to know when to stop! Saying No is often harder than saying Yes in medicine…