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Emergency Medicine operates early in the course of disease when uncertainty is high and information light. We need to do things that help us cognitively offload in the care of critically ill patients.In how many specialties would you be expected to acutely manage (and possibly resuscitate) anyone who comes to you for care‚ young or old, surgical or medical, sick or not sick with limited time and information. We are constantly having to think outside the box.Consider these 4 topics when thinking outside of the box: Bougie 1st Intubation, Mechanical CPR in OHCA, HD-Guided Epinephrine Drips in OHCA, and Stroke Ambulances.What side of the discussion do you fall on in these controversial areas?