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
You might also like
You conduct comprehensive pre-operative risk stratification using ASA classification, Revised Cardiac Risk Index (RCRI), and procedure-specific risk tools to quantify operative risk across physiologic systems. You systematically identify modifiable risk factors—anemia, hypertension, glucose dyscontrol, cardiac dysfunction—and implement targeted optimization protocols to reduce preventable complications. You generate objective, evidence-backed assessments that strengthen informed consent discussions, support case selection decisions, and create defensible documentation for shared decision-making with patients and surgical teams.
by gptomics
You'll systematically evaluate patient risk factors, stratify perioperative risk using evidence-based frameworks, and generate detailed anesthesia plans that address specific comorbidities and procedural requirements. This skill helps you synthesize complex patient data—medical history, physical exam findings, lab work, imaging, and medication profiles—into actionable risk mitigation strategies that optimize patient safety and guide technique selection, drug choices, and monitoring protocols.
by gptomics
You can rapidly develop theoretically-grounded case formulations that integrate diagnostic findings, historical context, and clinical observations into a coherent narrative. The skill systematizes your conceptualization across multiple therapeutic modalities (CBT, psychodynamic, trauma-informed, systemic) and generates structured treatment plans with specific goals, interventions, and prognostic considerations—ideal for supervision presentations, case conferences, documentation, and complex diagnostic scenarios.
by gptomics
You can systematically document refraction findings for low vision patients and generate prescriptions optimized for specific functional tasks like reading, mobility, and facial recognition. The skill calculates appropriate magnification ratios, predicts realistic visual outcomes, and creates comprehensive documentation that prioritizes quality of life over distance acuity—transforming conventional refraction into patient-centered, task-driven prescriptions.
by gptomics
You can rapidly analyze multifaceted surgical presentations—including revision cases, comorbidities, and combined pathology—to develop defensible pre-operative plans and detailed operative notes. The skill synthesizes clinical findings with imaging data, stratifies surgical risk, selects technique-specific approaches, and produces documentation that withstands peer review and quality audits.
by gptomics
You can perform structured sports injury evaluations that incorporate mechanism-of-injury analysis, orthopedic special testing, functional movement screening, and clear referral criteria. The skill helps you differentiate soft tissue restrictions from joint dysfunctions, establish baseline function, and create evidence-based return-to-play milestones tailored to the athlete's sport and position. You'll generate documentation suitable for insurance records, team physician communication, and liability protection.
by gptomics
You can conduct comprehensive subluxation assessments on pediatric patients by integrating structural examination findings, functional limitations, parental observations, and neurological indicators within a developmental context. Claude helps you correlate specific subluxations to presenting complaints (colic, ear infections, torticollis, scoliosis patterns) and create objective documentation suitable for insurance, medical records, and referral purposes. You'll develop age-appropriate treatment plans that address both the subluxation and the child's unique physiological stage.
by gptomics
You can systematically generate ranked differential diagnoses for presenting complaints (chest pain, dyspnea, abdominal pain, headache, joint pain, fatigue) by applying evidence-based clinical decision rules and risk stratification. The skill helps you identify red flags that change management priority, justify test selection to supervising physicians, and document diagnostic reasoning in the medical record while reducing anchoring bias and ensuring comprehensive consideration of serious diagnoses.
by gptomics