ACEP only recommends ECG and H&P as must haves
ECG
Perform on every patient, unless trigger clearly identified (i.e. following blood draw) and no risk factors
Urine pregnancy
Perform on every patient, unless trigger clearly identified (i.e. following blood draw) and no risk factors

CBC (or POC hemoglobin) & chemistry (or POC glucose)
Troponin
Not recommended to rule out AMI in patients with isolated<unk> 
Elevated troponin predicts adverse cardiac outcome in<unk> 
May be useful for risk stratification
CXR
Orthostatics (symptomatic)
Guaiac
CT scan of head is not recommended in asymptomatic, insignificant trauma with normal neurologic examination
Part of Choosing wisely ACEP
Does PE need to be worked up?
NEJM paper by Prandoni showed that 7.14% of patients admitted for<unk>  had a pulmonary embolism and of the cohort that were not low risk with a negative d-dimer, the risk was as high as 17.3%
2018 systematic reviewed  showed 0.8% of admitted ED pts with<unk>  had PE
Also supported by 2019 study showing prevalence of 2.3% in undifferentiated patients admitted with<unk> .
Both of these two studies refute the findings of the PESIT study listed first
Bedside US
PSL view may show thickened ventricular septum
High sensitivity to rule out AAA
Not recommended to rule out AMI in patients with isolated<unk> 
Elevated troponin predicts adverse cardiac outcome in<unk> 
May be useful for risk stratification
Part of Choosing wisely ACEP
NEJM paper by Prandoni showed that 7.14% of patients admitted for<unk>  had a pulmonary embolism and of the cohort that were not low risk with a negative d-dimer, the risk was as high as 17.3%
2018 systematic reviewed  showed 0.8% of admitted ED pts with<unk>  had PE
Also supported by 2019 study showing prevalence of 2.3% in undifferentiated patients admitted with<unk> .
Both of these two studies refute the findings of the PESIT study listed first
PSL view may show thickened ventricular septum
High sensitivity to rule out AAA
Overall yield of testing is low
Cardiovascular findings and evidence of bleeding strongest predictors of adverse outcomes after<unk> 
ECG findings associated with adverse cardiac outcome in 30 days: 
Normal ECG has high NPV
May show:
ischemia
Heart block
WPW- short PR, Delta waves, wide QRS
Long QT (QTc >0.450 sec), short QT
Brugada- incomplete RBBB with ST elevations in V1-3
HOCM- LVH, ST changes, T wave inversions, lateral leads needle like Q waves and absent R waves
Arrhythmogenic right ventricular dysplasia– incomplete RBBB with T waves inversion in V1-3, epsilon wave is pathognomonic (up-notching of a terminal Q wave)
Early repolarization
low voltage/pericardial effusion
RV strain pattern
LBBB, 2nd degree Mobitz II, 3rd degree AV block, RBBB w/LAFP or LPFB
Normal ECG has high NPV
May show:
ischemia
Heart block
WPW- short PR, Delta waves, wide QRS
Long QT (QTc >0.450 sec), short QT
Brugada- incomplete RBBB with ST elevations in V1-3
HOCM- LVH, ST changes, T wave inversions, lateral leads needle like Q waves and absent R waves
Arrhythmogenic right ventricular dysplasia– incomplete RBBB with T waves inversion in V1-3, epsilon wave is pathognomonic (up-notching of a terminal Q wave)
Early repolarization
low voltage/pericardial effusion
RV strain pattern
LBBB, 2nd degree Mobitz II, 3rd degree AV block, RBBB w/LAFP or LPFB
ischemia
Heart block
WPW- short PR, Delta waves, wide QRS
Long QT (QTc >0.450 sec), short QT
Brugada- incomplete RBBB with ST elevations in V1-3
HOCM- LVH, ST changes, T wave inversions, lateral leads needle like Q waves and absent R waves
Arrhythmogenic right ventricular dysplasia– incomplete RBBB with T waves inversion in V1-3, epsilon wave is pathognomonic (up-notching of a terminal Q wave)
Early repolarization
low voltage/pericardial effusion
RV strain pattern
LBBB, 2nd degree Mobitz II, 3rd degree AV block, RBBB w/LAFP or LPFB
Syncope
Cardiovascular-mediated syncope
Laryngospasm
Dysrhythmias:
Chest pain 
WPW 
Sedation 
Long QT Syndrome/QT prolongation