Making a medical diagnosis with limited information is at the heart of emergency medicine. Emergency physicians often have to make decisions without all of the information.  Dr Anand Swaminathan shares a case where EMS rolled into emergency with a patient who was short of breath, hypotensive, tachycardic and hypoxic. She had syncopized at a rehabilitation centre and by the time she got to emergency, she was seriously unwell and unable to provide much information. Dr Swaminathan shares the steps he took in diagnosing a patient who was too sick to go for a CT scan. His first piece of advice? Ultrasound is key. Ideally, we all want to have diagnostic closure before prescribing medication which could be harmful, however this isn’t always possible if a patient is too sick. So how do we make the call without a definitive diagnosis? Think about the exclusions, weigh up all the options and do what is right for the patient. For more head to: codachange.org/podcasts