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Episode 54: Gestalt, Thinking, and EMS

March 4, 2020 Dan Schwester
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Gestalt. You hear it in almost anything you hear or see in pre hospital as well as the majority of medical education. It’s really fancy, chic way of describing something we do every day in the field: make decisions on how and why we treat our patients. It’s been termed a hunch, a gut instinct; but it’s much more than that.

We talk about what it is, how it seems to work, and how it can be incorporated in all levels of practice, and of course, there’s some evidence to back it up!

The book that defines the thought process behind gestalt:

https://www.goodreads.com/book/show/11468377-thinking-fast-and-slow

The HEART score for cardiac risk stratification:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005932/

1st 10EM does a really great job breaking studies down for us in the FOAMed world; check them out explaining the Oliver paper:

Physician Gestalt for ACS (Oliver 2019)

Wang, et. al study:

https://onlinelibrary.wiley.com/doi/full/10.1002/clc.23325?af=R

And probably the best distillation of gestalt on the Internet: Dr. Scott Weingart’s LLS (Looks Like Sh*t) score:

https://emcrit.org/emcrit/lls-score/

https://media.blubrry.com/theoverrun/content.blubrry.com/theoverrun/Gestalt_Ding-2_25_20_2_13_PM.mp3

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Tags: Cardiology, Clinical, Emergency Medical Services, Emergency Medicine, EMS, EMT, Gestalt, HEART, paramedic
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