Emergency Differential Diagnosis & Risk Stratification
Structure emergency differentials by acuity risk and flag life-threatening diagnoses
What You Can Do
You can input a complex, multi-system emergency presentation—chief complaint, vital signs, and key clinical findings—and Claude organizes the differential diagnosis by acuity risk rather than alphabetical order. The skill prioritizes must-not-miss diagnoses, flags life-threatening conditions, anchors clinical reasoning to prevent cognitive biases, and suggests immediate diagnostic workup and disposition considerations tailored to each diagnosis tier.
Features
rank diagnoses by risk level (red-flag emergencies, high-risk, moderate, lower-acuity) rather than alphabetical order
highlight low-frequency high-consequence diagnoses (PE in dyspnea, ACS in syncope, meningitis in headache)
structure reasoning to counter pattern-recognition shortcuts and fatigue-driven cognitive errors
handle multi-system presentations that span cardiopulmonary, neuro, GI, metabolic, and trauma etiologies
suggest first-line diagnostics (labs, imaging, bedside testing) paired to each diagnosis tier
recommend ICU vs. floor admission, observation criteria, and safe discharge considerations
reduce mental-load cognitive work during night shifts, surge periods, and trainee-led evaluations
Example Output
Input: 67-year-old male, chief complaint dyspnea × 2 hours, O₂ sat 88% on RA, HR 112, BP 145/92, RRR 24. Recent hip surgery 3 days ago. Unilateral leg swelling, clear lungs. PMHx: HTN, CAD s/p stent 2020.
Output:
🔴 RED-FLAG EMERGENCIES (Must not miss):
- Pulmonary embolism — Recent immobility (post-op hip), unilateral leg swelling, hypoxia, tachycardia
- Acute coronary syndrome — Age, CAD history, dyspnea as anginal equivalent
- Pneumonia/sepsis — Tachypnea, hypoxia (though clear lungs argues against)
🟠 HIGH-RISK (Requires urgent evaluation):
- Acute heart failure — HTN, dyspnea, hypoxia; but clear lungs and no orthopnea noted
- DVT with hemodynamic impact — Leg swelling + dyspnea suggests PE risk
🟡 MODERATE RISK:
- Acute exacerbation COPD — Dyspnea, tachypnea; but no smoking hx/cough documented
Immediate Workup: ECG (stat), troponin, CBC, CMP, lactate, CXR, unilateral LE ultrasound (DVT protocol), consider CT PE protocol if LE U/S positive or high clinical suspicion. Disposition: ICU admission if ECG/troponin abnormal or oxygenation worsens; otherwise high-dependency unit pending PE imaging.
What's Included
- SKILL.md: instruction file with clinical framework, when-to-use guidance, and prompt templates
- Presentation template: structured intake checklist (vitals, systems review, PMHx, meds, timeline)
- Risk-stratification framework: tiered diagnostic organization (red-flag, high-risk, moderate, lower-acuity)
- Workup decision tree: paired diagnostics and disposition logic by diagnosis tier
- Teachable case examples: 3–4 multi-system presentations with worked differentials for training and QI review
Who It's For
- Emergency Medicine Physician Assistants — rapid differential structuring during high-volume shifts and ambiguous presentations
- Emergency Medicine residents and fellows — verify differential completeness and anchor clinical reasoning in complex cases
- Urgent care providers — manage multi-system presentations with limited diagnostic bandwidth
- ED nurses and mid-level practitioners — validate triage reasoning and flag must-not-miss diagnoses
- Medical education programs — structured case review and quality improvement teaching
Best For
- Multi-system emergency presentations (chest pain + dyspnea + altered mental status)
- Low-frequency high-consequence diagnosis recognition (PE, ACS, meningitis in atypical presentations)
- High-volume night shifts and fatigue-driven cognitive load reduction
- Trainee-led cases requiring differential completeness verification
- Post-encounter teaching cases and quality improvement/peer review
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