Extended Walk Test: Help Your Patients Discharge Themselves
TORONTO, ONTARIO – Dr. Thurow, veteran emergency physician at Tertiary Hospital has been credited with developing a revolutionary test that is redefining what it means to practice emergency medicine: the extended walk test or eWALK.
Dr. Thurow recalls the case that inspired development of this advanced physical exam maneuver. “EMS brought in a febrile 67 year old male complaining of tearing chest pain, dark stools, urinary retention, a pulseless limb, and the worst headache of his life. My shift was ending in 30 minutes and after reading the triage note I knew that it wouldn’t be worthwhile to explore all of these vague problems.”
After firmly anchoring himself to a diagnosis of ‘Abdominal Pain’, Dr. Thurow had his stroke of ingenuity. “I started off with the classic walk test and after the patient took a few unsteady steps, I just told him to keep going!”
Dr. Thurow explains that he walk tested this patient all the way to the parking lot before waving goodbye and hopping into his car. “It was the smartest thing I’ve ever done” exclaimed Dr. Thurow. “I didn’t have to take any history, wait on any imaging, or coerce consultants into seeing the patient. I know my treatment plan worked because this patient hasn’t been seen in the ED since his visit 4 years ago”.
Dr. Thurow has been advocating for uptake of this advanced physical exam maneuver: quicker disposition, lower costs, and supposedly happier patients. Emergency physicians around the nation are taking note.
Since learning about the eWALK, Dr. Paulson, an emergency physician at University Hospital, tells us that he has made the eWALK a part of his routine physical exam for all pregnant, pediatric, and geriatric patients. “In fact, anyone taking more than two medications, having any chronic conditions, or any previous hospitalizations will probably benefit from the eWALK. This test allows me maintain good department flow and focus on what matters – outwitting drug seeking patients”. In particularly challenging patients, Dr. Paulson admits to enlisting medical students, janitorial staff, or security for help with preforming the eWALK.
In the wake of eWALK’s success, Dr. Thurow has revealed that he is in the process of validating a modified version of the eWALK test, named the ePUSH for wheelchair bound, immobile, and unconscious patients.