In trauma, there is a concept called the tertiary survey. When the dust has settled from the initial resuscitation and the patient is in their hospital bed or you are rerounding the next morning, you recheck the patient from head to toe. Range every joint, inquire about pain, check their meds, etc. The same concept should be applied to the medical critically ill patient. Now that patients are staying in the ED for a day or days, we need to do this exam in the ED.
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