Table 4-1. Examples of High-risk Situations

System Examples/diagnosis Signs/symptoms
Abdomen Abdominal pain in the elderly.
Gastrointestinal bleeding.
Severe pain, stable vital signs.
Tachycardia, vomiting blood or bright red blood per rectum.
Cardiac Chest pain.
Acute arterial occlusion.
History of angioplasty with chest pain.
Pericardial effusion.
Infective endocardititis.
Constant or intermittent, stable vital signs.
Absence of distal pulse.
Stable vital signs.
Chest pain and shortness of breath.
History of drug abuse.
General Immunocompromised patients.
Oncology patients.
Transplant (post or on waiting list).
May or may not have fever.
Genitourinary Testicular torsion.
Acute renal failure.
Sudden onset of testicular pain.
Unable to be dialyzed.
Gynecological Ectopic pregnancy.
Spontaneous abortion.
+ pregnant, severe lower quadrant pain.
Bleeding and tachycardia with stable blood pressure.
Mental Health Combative, hostile, hysterical.
Suicidal attempt/complaint.
ETOH with trauma.
Sexual assault—any.
Neurologic Rule out meningitis.
History of multiple cerebrovascular accidents.
Acute ischemic stroke.
Headache, fever, lethargy.
Motor or speech deficits.
Motor or speech deficits.
Pediatric Vomiting, diarrhea, unable to eat.
Asthma attack.
Sunken fontanel, poor skin turgor, lethargy.
Nasal flaring or use of intercostals.
Respiratory Acute epiglottitis.
Severe asthma.
Pleural effusions.
Spontaneous pneumothorax.
Severe shortness of breath.
Severe shortness of breath.
Sudden onset of shortness of breath.
Trauma Motor vehicle crash with transient loss of consciousness.
Stab wound to the groin.
History of head trauma.

Bleeding controlled, obvious stab wound.

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