SDEC PROJECTClinical working reference
Assess. Decide. Act today.
A seven-part structure for focused assessment, safe same-day decisions and a clear plan when admission is needed.
At the point of review
The seven-part SDEC assessment
01
Clinical impressionState what is happening and how concerning it is.
02
Prioritised differentialsLikely explanation first; keep dangerous alternatives visible.
03
Red flags to excludeAsk, examine and review observations for threats to life or function.
04
Focused investigationsOrder tests that can change today's treatment or disposition.
05
Management nowStart necessary treatment, review response and involve seniors early.
06
Admission vs dischargeGive an explicit decision with criteria and reasons.
07
Practical plan for todayName who reviews results, follow-up, safety-netting and driving advice when relevant.
Disposition check
Can this patient go home safely?
Discharge is an active clinical plan. Confirm all four before they leave:
- Serious causes have been assessed appropriately.
- Symptoms, observations and function support discharge.
- Pending results and follow-up have a named owner.
- The patient understands treatment, return advice and how to get help.
If risk remains unresolved, escalate or arrange an appropriate monitored pathway. Consider frailty, support at home and ability to return.
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