ER Rapid Diagnostic Reasoning
Generate differential diagnoses and triage reasoning in emergency medicine cases within 2-3 minutes
What You Can Do
You can rapidly generate organized differential diagnoses for undifferentiated presentations (chest pain, dyspnea, altered mental status, abdominal pain) while catching cognitive biases like anchoring and premature closure. The framework helps you articulate defensible clinical reasoning, prioritize high-acuity diagnoses, and organize your thinking during time-pressured encounters with incomplete information.
Features
captures high-acuity diagnoses alongside likely etiologies within 2-3 minutes
identifies anchoring, availability bias, and premature closure in your reasoning
separates life threats, serious conditions, and common presentations by priority
suggests directed history, exam findings, and initial testing to rule in/out top hypotheses
structures reasoning for resident education and medical-legal clarity
generates hypotheses when labs/imaging are pending
handles complex cases with multiple comorbidities and atypical presentations
Example Output
Input: 55-year-old male with acute substernal chest pain, diaphoresis, no prior cardiac history, EKG pending
Output:
HIGH ACUITY (Rule out first):
- Acute coronary syndrome (STEMI/NSTEMI) — substernal, diaphoretic, risk factors
- Aortic dissection — sudden onset, can mimic ACS
- Pulmonary embolism — dyspnea possible, immobility risk
SERIOUS (Do not miss):
- Unstable angina — ischemia without infarction
- Myocarditis/pericarditis — viral prodrome, pleuritic features
COMMON:
- Musculoskeletal pain — reproducibility on exam
- Anxiety/panic — rule-outs first
BIAS CHECK: Anchoring on "chest pain = ACS" — ensure respiratory/vascular etiologies considered
NEXT STEPS: Serial troponins, repeat EKG in 10 min, CXR for widened mediastinum, consider CT angiography based on PE risk stratification
What's Included
- SKILL.md instruction file with structured reasoning framework:
- Chief complaint-specific differential templates (chest pain, dyspnea, altered mental status, abdominal pain):
- Cognitive bias checklist for emergency medicine (anchoring, availability, premature closure):
- Acuity stratification worksheet (life threats vs. serious vs. common):
- Workup prioritization guide with directed questions and exam findings:
Who It's For
- Emergency medicine physicians and residents — accelerate differential generation and catch diagnostic gaps
- Hospitalists evaluating acute undifferentiated presentations — organize thinking when specialists unavailable
- Urgent care providers managing moderate-acuity cases — structure reasoning without full ED resources
- Medical educators and residency faculty — teach diagnostic reasoning and bias recognition
- Clinical decision-makers in time-pressured settings — document reasoning for medical-legal protection
Best For
- Undifferentiated chief complaints (chest pain, dyspnea, altered mental status, abdominal pain, syncope)
- Complex cases with multiple comorbidities and atypical presentations
- Situations with incomplete initial data (labs/imaging pending) requiring early hypothesis generation
- Cases where cognitive bias mitigation improves diagnostic accuracy
- Teaching rounds and group case discussions in clinical settings
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