Learn · Guide 03
Reassessment & serial exams
You can’t always make the diagnosis at hour zero. A serial exam catches what shows up later. It only counts if you wrote down the time.
01Weak vs. real
▼ weak
“Reassessed, stable.”
▲ real
“16:05 — pain 8→2, walked the hallway, abdomen soft, tolerating fluids.”
The second one shows you went back, looked again, and the patient was better. A time and a direction.
02When to go back
- After you treat something. Did it work?
- When a result changes the picture.
- Right before they leave.
03Discharge vitals
An abnormal vital on arrival can’t still be abnormal and unmentioned when the patient walks out.1 Recheck it and say so:
▲ closed the loop
“HR 118 on arrival, from pain. 84 after analgesia, rechecked before discharge.”
Educational only. Synthetic examples. Not medical advice.
Reference
- Sklar DP, et al. Unanticipated death after discharge home from the emergency department. Ann Emerg Med. 2007;49(6):735–745.