Physician essential knowledge emergency should do: a. 1. Where pain below the jaw and above the umbilicus, all do electrocardiogram. 2. Sudden tossing and turning with changes in heart rate and blood pressure (elevated or decreased) and back discomfort first consider aortic coarctation separation. 3. Make your diagnosis explain all the patient’s symptoms, signs, and ancillary findings, otherwise the correctness of the diagnosis should be questioned. 4. A comprehensive and meticulous physical examination from head to toe will prevent trauma patients from being missed and misdiagnosed. 5. The possibility of early herpes zoster should be considered if the skin is painfully allergic. 6. For trauma patients who deny their injuries and ask the same question repeatedly, there must be something wrong with the cranium. 7. Patients with cardiac arrest with tattoos should consider the possibility of drug intoxication. 8. For those who still have red lips and mouth after cardiac arrest, cyanide poisoning should be considered as a possibility. 9. Those with nocturnal episodes of dyspnea and normal cardiac ultrasound should consider the possibility of reflux esophagitis. 10. Don’t let others sway your emotions. Careful and meticulous work and sincere treatment of each patient can prevent doctor-patient disputes. Second, 1. abdominal pain at night, often gallstone biliary colic, renal stone renal colic good time, adult people have a history of more attacks; first time onset of acute appendicitis diagnosis should be noted. 2. The onset of symptoms after intravenous input of cephalosporins, alcohol consumption, pay attention to the disulfiram-like reaction. 1. Hand trauma with rupture of flexor tendon in zone 2 should be considered as possible finger nerve injury. 2. Thoracic trauma, open chest cavity are required surgery, should consider intercostal vascular injury can cause hemorrhagic shock – death! Fourth, 1. middle-aged and elderly acute abdomen, symptoms and signs and “four sides do not rely on”, abdominal distension is obvious, to think of vascular factors. 2. chest pain, back pain, as long as there is also hip pain, must think of entrapment! For women with abdominal pain, always check the HCG as long as they are 16 years old or older. V. 1. For persistent cough, always ask if the patient is taking angiotensin-converting enzyme inhibitor-type antihypertensive drugs, such as captopril. 2. The marginal nail bed must be scratched and destroyed during nail extraction for nail infection, otherwise it will recur. 3. without certain conditions (C-arm machine or several colleagues) do not easily to take the body surface foreign body, it is not as simple as you think. 4. foreign body stab wounds, must be photographed, there will be the possibility of foreign body residue in the body! VI. 1. Sudden onset of unexplained low back pain with fever and jaundice is highly supportive of hemolytic crisis. 2. No matter how old the patient is, whether it is an inpatient or an emergency first-time patient, any sudden change in consciousness that manifests itself, it is never wrong to measure a blood glucose immediately. 3. In any patient whose condition you judge to be potentially unstable, it is never wrong to establish an immediate intravenous access. 4. “After acute cardiogenic ischemic syndrome, the ECG may show huge inverted T waves with marked prolongation of the QT interval or have huge biphasic T waves, which occur for unknown reasons and may be related to extreme sympathetic excitation during an episode of cerebral ischemia. If the ECG fails to record the ECG at the onset of ventricular fibrillation, but only has huge inverted T waves, and combined with an episode of syncope or convulsion, it can also be inferred that a malignant arrhythmia triggered the cerebral ischemic syndrome”–cited in New Concept ECG (3rd ed.), Guo Jihong, ed. 5. Any adult woman with abdominal pain, regardless of her menstruation, should rule out the possibility of ectopic pregnancy. Trauma patients with a history of heart disease must have an electrocardiogram, because trauma may induce heart attack. 2. Persistent abdominal pain with no fixed pressure points and no positive results in routine ancillary examinations may be mesenteric vascular disease. 3. Patients with aortic coarctation may have no obvious chest and back pain and present with abdominal pain, caused by organ ischemia. 4. Patients with negative X-rays after trauma must be told to review, especially possible rib fractures ankles wrists some parts that may not be seen at the time, lest the patient say afterwards that you did not diagnose. 5. row of cervical spine x-ray must not forget the opening position. 6. Any trauma patients who may cause abdominal injury, no matter how normal the ultrasound at the time, the patient’s condition must be delivered to stay for review, it is likely that the results of the review will surprise you, or a cold sweat. 7. To use a classic line from Dr. House: “Everybody lies!” Sometimes patients provide a history or conceal or mislead, believe what you see and find out. 8. Don’t rely on the radiologist’s report, they sometimes make mistakes, so no matter how busy you are, always look at the films carefully yourself. 9. The textbook is just a statistic of what diseases are more common at what age. In reality, there are many strange and inconsistent cases in the clinic, so be open-minded, anything is possible. 10. Check blood sugar in all patients with headache, dizziness or coma, regardless of whether they have diabetes. 11. Patients with acute chest pain considering acute inferior wall myocardial infarction must have a right chest lead, because the sensitivity and specificity of V3r-V5r for diagnosing right ventricular infarction are both high, but the duration is short and many times can only be seen in the emergency room ECG. 12. Do not forget to consider pulmonary infarction when a patient suddenly develops chest tightness and shortness of breath with generalized sweating and decreased blood pressure when getting out of bed and moving around after PCI. VIII. 1. Check blood sugar in patients with convulsions. 2. Acute onset of limb weakness, check blood potassium and electrocardiogram. 3. Consider spinal cord lesions must check the spine for pressure pain. 4. Some auxiliary tests must be reviewed when necessary. The elderly should be alert to biliary pancreatitis for abdominal pain. 2. Penicillin allergy should be noted for its latency period. The “four prohibitions” that should be strictly enforced in patients with surgical emergencies without a clear diagnosis are prohibition of pain relief, prohibition of diet, prohibition of enemas, and prohibition of laxatives. 2, the manifestation of peritoneal irritation signs for abdominal pressure pain, rebound pain, abdominal muscle tension. 3, first fever followed by abdominal pain, mostly internal diseases; first abdominal pain followed by fever, mostly surgical diseases. 4, the three main symptoms of ectopic pregnancy are menopause, ** bleeding, abdominal pain. 5, the toxic effect of magnesium sulfate first manifested as the disappearance of knee tendon reflex. 6, in vivo defibrillation, mouth-to-mouth artificial respiration, chest cardiac compressions as the three elements of modern resuscitation. 7. Acute abdominal pain is a prominent manifestation of acute abdominal pain, with acute onset, rapid changes, serious and complex conditions, requiring emergency treatment and other characteristics. 8. dialysis therapy mainly hemodialysis and peritoneal dialysis two, for acute and chronic renal failure and acute poisoning, etc. 9. magnesium sulfate route of administration of intravenous and intramuscular injection, injection should pay attention to the use of long needles, deep intramuscular injection, can also add procaine in magnesium sulfate solution, to relieve pain stimulation. 10, the poison mainly through the respiratory tract, digestive tract, skin mucosa three ways to enter the body. 11, inspiratory dyspnea is manifested as inspiratory difficulty, may occur wheezing, the appearance of three concave signs, namely, supraclavicular fossa, sternum, intercostal space concave. 12.The first choice of treatment to suppress ventricular premature lidocaine intravenous 13.Atrial flutter and atrial fibrillation are generally treated with antiarrhythmic drugs and DC electric resuscitation. 14, organophosphorus pesticide poisoning patients vomit or exhaled breath has a special odor, is garlic flavor, pupil narrowing. 15, the therapeutic concentration of magnesium sulfate and poisoning concentration is similar, so the treatment should be closely observed in the toxic side effects, control the amount of intake. 16, found to have tension pneumothorax, immediately with a thick needle in the injured side of the second intercostal clavicle at the midline insert thick needle exhaust, the end of the needle connected to a rubber finger sleeve, a small cut in its top, so that it becomes a live valve exhaust needle. 17.Organophosphorus pesticide poisoning can appear as nicotine-like, central nervous system, muscarinic-like symptoms. 18.Cardiopulmonary cerebral resuscitation includes three parts: Phase I CPR, Phase II CPR and post-resuscitation life support.