What you must demonstrate
- Call for help early
- Prioritize airway, breathing and circulation
- Use monitoring and IV access appropriately
- Reassess after interventions
- State disposition and consultation clearly
11-minute performance map
1. Opening and immediate safety
Introduce yourself, confirm identity, explain the task, obtain consent and identify instability before routine questioning.
2. Focused assessment
Clarify onset, progression, severity, associated features, discriminating positives/negatives and the most relevant background risks.
3. Targeted examination
Perform only the examination maneuvers needed to assess severity, confirm localization and discriminate the leading diagnoses.
4. Synthesize
Give a one-sentence summary, leading diagnosis and two to four prioritized alternatives including the dangerous diagnosis you cannot miss.
5. Investigations
Choose tests that answer a specific diagnostic or safety question; state urgent tests first.
6. Immediate management
Treat instability, begin syndrome-specific care, consult early when needed and define disposition.
7. Communication and safety net
Explain the plan, check understanding, address concerns and state exact deterioration/return criteria.
Focused history prompts
Define the presentation
- Onset, chronology, triggers and progression.
- Severity and effect on function.
- Associated symptoms that support the leading diagnosis.
- Relevant negatives that reduce dangerous alternatives.
Risk context
- Relevant past medical/surgical/obstetric/psychiatric history.
- Medications, allergies and adherence.
- Family, social, substance, travel/exposure or safeguarding factors as applicable.
- Patient ideas, concerns, expectations and goals.
Dangerous alternatives to prioritize
- Ruptured ectopic pregnancy
- Hemorrhagic shock
- Severe preeclampsia/eclampsia when relevant
- Sepsis
- Fetal/maternal compromise
Targeted investigations
Immediate monitoring, bedside glucose and ECG when indicated
CBC, electrolytes/renal function, lactate, cultures, coagulation or type/screen based on threat
Time-critical imaging matched to the suspected emergency
Repeat testing/reassessment after initial stabilization
Immediate management and disposition
- Call for help early and stabilize ABCs.
- Use monitoring, IV access and time-critical treatment without delaying for a complete history/exam.
- Reassess after each intervention and escalate if response is inadequate.
- State definitive consultation and disposition.