Emergency Medicine
Step 3 Rule
For unstable patients, treatment and diagnostic workup happen simultaneously. Do not wait for confirmatory tests when the patient is crashing.
Immediate Treatment Diagnoses
| Presentation | Do First |
|---|---|
| Anaphylaxis | IM epinephrine, airway support, fluids |
| Status epilepticus | Benzodiazepine, then antiepileptic loading |
| STEMI | Aspirin, anticoagulation, emergent reperfusion |
| Septic shock | Fluids, cultures, antibiotics, vasopressors if needed |
| Hyperkalemia with ECG changes | IV calcium, insulin/glucose, potassium removal |
| Tension pneumothorax | Needle decompression, then chest tube |
| Cardiac tamponade with shock | Pericardiocentesis |