Setting priorities

Sometimes, there is a difference between the most important choice and what should be first choice. Depending on time pressures, there may be something that you might do first, but it may not be the most important action.

For example in a near-drowning, you might be faced with the choice of getting the victim out of the water or applying rescue breaths. If you are close to the dock, it may be more practical to get the victim out of the water first so you can be more effective in all your subsequent measures: rescue breaths, cardiac compressions etc. But if you are further out in the water, you might choose to attempt some rescue breaths in the water as you are making your way towards the boat.

This is an extreme example but the ability to prioritize is important in a crisis situation and is worth assessing. For a slightly tongue in cheek example of this, take a look at our Camping 2 case, where you have to assign priorities in a snake-bite case.

When we ran this case with a bunch of experienced rural docs, we had some interesting discussions, driven by the graphs generated in OpenLabyrinth's 4R report structure, which shows not just the most popular choice, but the order in which choices were made.

As you can see from this graph, 'push IV fluids' was the most popular choice, but the most common first choice was 'apply ice packs to wound'.

Check out the 'Rapid Reporting of Real-time Results' (4R) format in OpenLabyrinth if you want to explore this further.