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01.08.2015 | Leitthema | Ausgabe 5/2015

Notfall +  Rettungsmedizin 5/2015

Recognising brainstem problems in the emergency department using the rule of 4 of the brainstem

Notfall + Rettungsmedizin > Ausgabe 5/2015
FRACP Prof. P. Gates
Wichtige Hinweise
Supplementary material online:
The translated German full-text version of this article is available at SpringerLink (under supplemental


This paper describes using the rule of 4 of the brainstem to help emergency physicians readily identify patients with brainstem problems. It is a simple set of four rules that demystify the brainstem. It is not designed to discuss patients presenting with coma, of which brainstem problems are only one of the many causes. It will also discuss cerebellar infarction and haemorrhage, because although not strictly part of the rule of 4, these are medical emergencies that can, at times, easily be missed.

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