title: [When should a patient with malaise be referred to the emergency ward?].
abstract: General physicians (GPs) and emergency doctors are regularly called upon to deal with cases of "malaise" or sudden unforeseen feelings of debility. As highly disparaged as this designation may be, it remains commonly used in everyday life, enabling patients to express a general sensation of ill-being, accompanied by various non-specific symptoms. The lack of a preliminary case history and clinical analysis makes difficult to swiftly determine the severity of the situation, let alone its etiology. GPs are expected to rapidly detect any possibly serious risk factors; the decision to either hospitalize the patient or allow him to return home, is in their hands. The following article sets forth algorithms to assist with the diagnostic process and general handling of such cases.
authors.affiliation: Service des urgences et SMUR, Département de médecine interne, Hôpital neuchâtelois-Pourtalès, 2000 Neuchâtel. sebastien.geering@ne.ch
authors.forename: Sébastien
authors.initials: S
authors.lastname: Geering
authors.forename: Walter
authors.initials: W
authors.lastname: Hanhart
authors.forename: Reza
authors.initials: R
authors.lastname: Kehtari
mesh_terms: D000465:Algorithms; D001247:Asthenia / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D006801:Humans; D010821:Physicians, Family; D012017:Referral and Consultation / Q000592:standards*; D014474:Unconsciousness / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology