Decision Making in the ED

As part of our daily work as Emergency Physicians we are required to make multiple decisions which effect the treatment and care our patients receive. However, the process by which we make decisions is fallible and can lead to misjudgements and errors causing patient harm. Understanding the limitations of our personal decision making processes and being aware of those situations which predispose us to making an error can go some way to supporting safe decision making.

Diarrhoea and vomiting is a recognised but unusual presentation of an ectopic pregnancy, and the inexperience of the junior doctors involved in this case probably played a significant role in the outcome. However, even the most senior clinicians make errors.

Considering the case above describe factors which may have adversely influenced the decisions made by the Emergency Physician when the patient returned for the 2nd time?

Thinking about the factors discussed in question one, describe strategies that you could employ under similar circumstances?