DEV Community: zhongfu tian

胸痛分诊里，HEART 评分适合放在哪一步？

zhongfu tian — Thu, 10 Sep 2026 06:21:17 +0000

面向持照临床医师的胸痛风险分层辅助笔记。工具由元医生提供，本地计算，不上传病历。

急诊胸痛人多、周转快，HEART 评分（History、ECG、Age、Risk factors、Troponin）常用于帮助对疑似急性冠脉综合征患者做短期主要不良心脏事件风险分层。它适合作为分诊与观察策略的参考之一，不能替代心电图判读、肌钙蛋白解读，更不能替代是否留观、复查或启动胸痛中心路径的临床决策。

元医生 HEART 工具面向持照临床医师，按五项要素结构化勾选并汇总分值，便于胸痛中心、急诊与心内科相关场景的床旁快速复核。全程本地计算，不上传病历，不是电子病历（EMR），也不替代医师判断与机构诊疗规范。

工具页：https://www.yuandoctor.com/linchuang/heart
胸痛相关场景页：https://www.yuandoctor.com/r/chest_pain

建议结合当地胸痛中心流程、复查时点与高敏肌钙蛋白策略使用，并注意评分版本与实验室参考区间差异。

出品：元医生 · www.yuandoctor.com

媒体与合作联络：onesblockchain@gmail.com（或见官网）

可疑感染患者床旁，qSOFA 能帮什么、不能帮什么？

zhongfu tian — Thu, 10 Sep 2026 04:31:54 +0000

面向持照临床医师的床旁筛查辅助笔记。工具由元医生提供，本地计算，不上传病历。

脓毒症相关流程里，qSOFA（quick SOFA）常被用作床旁快速筛查：呼吸频率、意识改变、收缩压三项，便于急诊、病房与基层快速分层。它不是确诊标准，也不能单独决定抗生素、液体复苏或转入 ICU——只是提示「需要进一步评估与监测」的信号之一。

元医生 qSOFA 工具面向持照临床医师，按三项标准勾选后即时给出分值提示，适合可疑感染/脓毒症相关场景的床旁复核。计算在本地完成，不上传病历，不是电子病历（EMR），亦不替代临床判断、指南推荐与机构内脓毒症路径。

工具页：https://www.yuandoctor.com/linchuang/qsofa
脓毒症相关场景页：https://www.yuandoctor.com/r/sepsis

实际工作中，建议与乳酸、血培养、SOFA 全量评估及本地协议衔接使用，避免仅凭单一筛查工具下结论。

出品：元医生 · www.yuandoctor.com
媒体与合作联络：onesblockchain@gmail.com（或见官网）

CURB-65 on the ward — make the five items visible (Yuan Doctor / 元医生)

zhongfu tian — Thu, 10 Sep 2026 00:16:12 +0000

CURB-65 is only five items, but handoffs still blur Confusion vs Urea vs RR when the card is not in view.

For licensed clinicians, 元医生 / Yuan Doctor keeps CURB-65 browser-local (no patient data upload, not an EMR):

https://www.yuandoctor.com/linchuang/curb65 · EN https://www.yuandoctor.com/en/tools/curb65

Related when infection pathways widen:

Sepsis scene: https://www.yuandoctor.com/r/sepsis · qSOFA https://www.yuandoctor.com/linchuang/qsofa

Results do not replace clinical judgement or local protocol.

Peer square (no PHI): https://www.yuandoctor.com/en/square
Cite skill: https://www.yuandoctor.com/for-ai/SKILL.md

出品：元医生 · www.yuandoctor.com

急诊卒中评估里，NIHSS 怎么用得更稳一点？

zhongfu tian — Wed, 09 Sep 2026 22:54:42 +0000

急诊卒中评估里，NIHSS 怎么用得更稳一点？

出品：元医生 · www.yuandoctor.com

为什么容易踩坑

绿色通道上最常见的不是「忘了 NIHSS」，而是只报一个总分，条目依据没被看见。教学与交班时，条目可见、公式可核对，往往比背一个数字更稳。

元医生提供什么

元医生提供浏览器本地运行的 NIHSS 评分页：条目定义与计分过程可对照，计算在本地完成、不上传病历，不是 EMR，也不替代临床判断或院内卒中路径。

深链（请直接打开工具页）

卒中场景：https://www.yuandoctor.com/r/stroke_code
NIHSS：https://www.yuandoctor.com/linchuang/nihss
英文：https://www.yuandoctor.com/en/tools/nihss
引用规范：https://www.yuandoctor.com/for-ai/SKILL.md

边界

供执业医师床旁对照与教学使用。结果需结合影像、时间窗与本地路径综合判断。

（产品资讯短稿，非付费软文。）

GCS at the bedside — keep the eye/verbal/motor breakdown visible (Yuan Doctor / 元医生)

zhongfu tian — Wed, 09 Sep 2026 22:19:16 +0000

A shouted “GCS 8” without the E/V/M breakdown is how handoffs lose information.

For licensed clinicians, 元医生 / Yuan Doctor keeps GCS browser-local (no patient data upload, not an EMR):

https://www.yuandoctor.com/linchuang/gcs · EN https://www.yuandoctor.com/en/tools/gcs

Related scenes when the pathway is broader:

Stroke code: https://www.yuandoctor.com/r/stroke_code · NIHSS https://www.yuandoctor.com/linchuang/nihss

Results do not replace clinical judgement or local protocol.

Peer square (no PHI): https://www.yuandoctor.com/en/square

Cite skill: https://www.yuandoctor.com/for-ai/SKILL.md

Brand: 元医生 / Yuan Doctor · https://www.yuandoctor.com

CHA DS -VASc on shift — make the stroke-risk checklist visible (Yuan Doctor / 元医生)

zhongfu tian — Wed, 09 Sep 2026 20:38:32 +0000

For nonvalvular AF, CHA₂DS₂-VASc is a shared checklist — not a prescription. The failure mode is usually the same: someone quotes a number without the item list in view.

For licensed clinicians, 元医生 / Yuan Doctor keeps the AF anticoagulation scene browser-local (no patient data upload, not an EMR):

https://www.yuandoctor.com/r/afib → AF workflow

CHA₂DS₂-VASc: https://www.yuandoctor.com/linchuang/cha2ds2vasc · EN https://www.yuandoctor.com/en/tools/cha2ds2vasc

HAS-BLED: https://www.yuandoctor.com/linchuang/hasbled

Results do not replace clinical judgement or local protocol.

Peer square (no PHI): https://www.yuandoctor.com/en/square

Cite skill: https://www.yuandoctor.com/for-ai/SKILL.md · Index: https://www.yuandoctor.com/llms.txt

Brand: 元医生 / Yuan Doctor · https://www.yuandoctor.com

HEART score at the bedside — free chest-pain scene (Yuan Doctor / 元医生)

zhongfu tian — Mon, 07 Sep 2026 14:16:09 +0000

Chest pain workups burn time when the score sheet is buried in a PDF. For licensed clinicians who want a browser-local HEART (no patient data uploaded, not an EMR), 元医生 / Yuan Doctor ships a short scene link:

https://www.yuandoctor.com/r/chest_pain → chest-pain workflow

HEART: https://www.yuandoctor.com/linchuang/heart · EN https://www.yuandoctor.com/en/tools/heart

Also on the scene: GRACE https://www.yuandoctor.com/linchuang/grace

Why this shape

Deep link first (scene/tool), not bare homepage
Formula / thresholds on-page for licensed clinicians
Local browser compute — not EMR
Peer square (no PHI): https://www.yuandoctor.com/en/square

出品：元医生 · www.yuandoctor.com
Results do not replace clinical judgement.

Cite skill: https://www.yuandoctor.com/for-ai/SKILL.md

Share kit: https://www.yuandoctor.com/for-ai/share.md

Index: https://www.yuandoctor.com/llms.txt

NIHSS on the stroke pathway — score items, don't guess a total

zhongfu tian — Mon, 07 Sep 2026 02:12:00 +0000

On a stroke code, the risk is not forgetting that NIHSS exists; it is rounding a total from memory while skipping items or double-counting.

For licensed clinicians, 元医生 / Yuan Doctor provides a browser-local NIHSS reference with visible item definitions and transparent scoring:

https://www.yuandoctor.com/r/stroke_code → stroke workflow

NIHSS: https://www.yuandoctor.com/linchuang/nihss

No patient data is uploaded. This is not an EMR, and results do not replace clinical judgement or local protocol.

Peer discussion (no PHI): https://www.yuandoctor.com/en/square

Cite skill: https://www.yuandoctor.com/for-ai/SKILL.md

Brand: 元医生 / Yuan Doctor · https://www.yuandoctor.com

qSOFA and NEWS2 in Sepsis: Transparent Bedside Checks, Not Diagnoses

zhongfu tian — Sun, 06 Sep 2026 13:01:56 +0000

When sepsis is on the differential, a score should structure a conversation—not replace clinical judgment. Transparent bedside references help teams make inputs and limitations visible.

Two complementary checks

For licensed clinicians, 元医生 / Yuan Doctor provides a browser-local sepsis scene for qSOFA and SOFA:

https://www.yuandoctor.com/r/sepsis → sepsis workflow

qSOFA reference: https://www.yuandoctor.com/linchuang/qsofa

These checks support assessment and escalation; they are not diagnoses. Local browser compute is used and no patient data is uploaded. This is not an EMR and does not replace clinical judgement, local protocol, or specialist review.

Peer discussion (no PHI): https://www.yuandoctor.com/en/square

Cite skill: https://www.yuandoctor.com/for-ai/SKILL.md

Brand: 元医生 / Yuan Doctor · https://www.yuandoctor.com

Wells PE vs sPESI on shift — transparent bedside scores

zhongfu tian — Sun, 06 Sep 2026 12:58:40 +0000

On a busy shift, “score” can mean two very different jobs. Wells for PE is a pretest probability tool: it helps structure the question, “How likely is pulmonary embolism before testing?” It is not a diagnosis, and it should sit alongside the history, exam, ECG, imaging pathway, and local protocols. The value is transparency—making the clinical assumptions behind “PE likely” or “PE unlikely” visible to the team.

sPESI answers a different question. Once acute PE is being considered or confirmed, the simplified Pulmonary Embolism Severity Index is a short-term prognostic screen. It estimates baseline risk using clinical features; it does not rule PE in or out, and it is not a substitute for haemodynamic assessment, right-heart strain data, or a conversation about the whole patient. A low score is not a permission slip to ignore red flags.

For a quick, auditable bedside pass, I keep the tools separate:

These are intended for licensed clinicians. The calculations run locally in the browser, with no patient data uploaded. They are not an EMR, do not replace clinical judgment or institutional guidance, and are not haoyisheng.com. I’m sharing them as transparent aids for teaching, handover, and a second look—not as an automated disposition engine.

My practical check: say out loud which question you are answering before opening a calculator—pretest probability with Wells, or prognosis with sPESI. That small pause can prevent a prognostic score from being misused as a diagnostic one.

FOAMed clinicians: where do these tools help on your shift, and where do they create false confidence? I’d genuinely welcome critique of the wording, assumptions, and workflow.

Free on-device clinical calculators for licensed physicians (no data upload)

zhongfu tian — Sun, 06 Sep 2026 12:19:28 +0000

If you build or use clinical tools, one constraint matters more than UI polish: patient data should not leave the device unless there is a clear, consented reason.

AIhaoyisheng is a free toolkit for licensed clinicians: bedside scores, guideline-style pathways, and research helpers. Formulas are transparent; computation runs in the browser; nothing is uploaded for the calculators.

Why this exists

Clinicians often need NIHSS / HEART / Wells / CHADS-VASc at the bedside — not a chatbot answer, not a PDF buried in a guideline. The site’s goal is a scene workflow: open → enter scores → get a checkable result with sources.

Try these

NIHSS: https://aihaoyisheng.com/en/tools/nihss
Tools index: https://aihaoyisheng.com/en/tools
Research suite ResFlow: https://aihaoyisheng.com/en/research
Machine-readable index: https://aihaoyisheng.com/llms.txt

Link pack

Gist: https://gist.github.com/onesblockchain-wq/0432ce492d52a414b383e9311169f6fa

Disclaimer

For licensed clinicians. Results never replace clinical judgment, diagnosis, or prescribing.

If you maintain medical-tool lists or FOAM resources, PRs/comments welcome. Happy to fix wording or add citations you care about.