Hey guys,
So I recently took my USMLE Step 3 and I gathered some of this from various resources. I think this may be of some help to the beginners.
Let's get started!
In relevant emergency cases (order the ones that are relevant):
ABC:
Airway
Breathing
Circulation
P.O. ICESS:
Pulse oximetry
Oxygen
Intravenous line and fluids (Please remember to type NSS/Normal Saline or Dextrose, etc. CCS software won't take orders that are less than 3 characters!)
Cardiac monitor
ECG
Sugar (fingerstick)
Suction
For chest pain add MONA:
Morphine
Oxygen
Nitrates
Aspirin
~~~
Then order relevant Physical Exam (In Office cases, you'd want to order most physical exams and in the Emergency Department cases, you'd want to order more symptom-based system specific exam)
~~~
Laboratory orders: CBC LFT ICU PAX
Complete Blood Count (CBC), ESR
Basic Metabolic Profile (BMP)
Cardiac enzymes (if not ordered earlier)
Liver Function Tests (LFT) or Lipid profile
FOBT
TFT
Imaging (CT/MRI/USG/etc) Iron profile Immunologic tests (HIV/HepB/HepC/Rubella/etc)
Cultures (Blood/urine/fluid/etc)
Urine (routine, microscopy, culture & sensitivity)
Pregnancy test (urine) & Pap test (if female) PT/INR PTT d-Dimer PFT
Amylase ABG
Xray
~~~
You can now forward the time to get some results or decide whether the location needs to be changed
~~~
CCC
Comfort: if the patient is in pain- give NSAIDs/Morphine based on the situation; vomiting- antiemetic; etc
Cure: if you suspect a particular infection-give antibiotic; if it's an MI- angiography v/s other management options; etc
Consult: you may want to order a Psych or Surgery or OBGYN or any other relevant consult based on the case
~~~
If the patient needs to get admitted on floors or ICU: ADIC
Activity: Bed rest/ ambulation
Diet
Input/output charting
Compression stockings
So I recently took my USMLE Step 3 and I gathered some of this from various resources. I think this may be of some help to the beginners.
Let's get started!
In relevant emergency cases (order the ones that are relevant):
ABC:
Airway
Breathing
Circulation
P.O. ICESS:
Pulse oximetry
Oxygen
Intravenous line and fluids (Please remember to type NSS/Normal Saline or Dextrose, etc. CCS software won't take orders that are less than 3 characters!)
Cardiac monitor
ECG
Sugar (fingerstick)
Suction
For chest pain add MONA:
Morphine
Oxygen
Nitrates
Aspirin
~~~
Then order relevant Physical Exam (In Office cases, you'd want to order most physical exams and in the Emergency Department cases, you'd want to order more symptom-based system specific exam)
~~~
Laboratory orders: CBC LFT ICU PAX
Complete Blood Count (CBC), ESR
Basic Metabolic Profile (BMP)
Cardiac enzymes (if not ordered earlier)
Liver Function Tests (LFT) or Lipid profile
FOBT
TFT
Imaging (CT/MRI/USG/etc) Iron profile Immunologic tests (HIV/HepB/HepC/Rubella/etc)
Cultures (Blood/urine/fluid/etc)
Urine (routine, microscopy, culture & sensitivity)
Pregnancy test (urine) & Pap test (if female) PT/INR PTT d-Dimer PFT
Amylase ABG
Xray
~~~
You can now forward the time to get some results or decide whether the location needs to be changed
~~~
CCC
Comfort: if the patient is in pain- give NSAIDs/Morphine based on the situation; vomiting- antiemetic; etc
Cure: if you suspect a particular infection-give antibiotic; if it's an MI- angiography v/s other management options; etc
Consult: you may want to order a Psych or Surgery or OBGYN or any other relevant consult based on the case
~~~
If the patient needs to get admitted on floors or ICU: ADIC
Activity: Bed rest/ ambulation
Diet
Input/output charting
Compression stockings
~~~
If the patient is scheduled to undergo a procedure: ABC PIN
Antibiotics
Blood grouping and crossmatching
Consent
PT/ PTT
INR
NPO
~~~
When you get your 2-minute screen: Counsel and order follow-up labs!
You may want to counsel them on their diagnosis, lifestyle habits, medication adherence/ compliance/ side effects and so on.
Hope this helps!
Stay awesome :)
Stay awesome :)
-Rippie
Just want to say thank you! I have use a lot of the resources you have posted over time and just want to same thank you! This is hopefully going to be my last USMLE exam, all your resources that been so helpful including this. I am in residency now and I have used your resources to prep for board exams!! What are you doing now? Enjoying being an attending? :) Good luck and thanks again!
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