ABEM ACCM key terms

A way to group aortic dissections by whether the ascending aorta is involved: type A involves the ascending aorta and needs urgent surgery, while type B spares it and is often managed with blood pressure control.

Shock caused by the heart failing to pump enough blood for the body's needs, producing low cardiac output, elevated filling pressures, and tissue hypoperfusion; acute myocardial infarction is the most common trigger in emergency and critical care.

Three bedside findings - low blood pressure, distended neck veins, and muffled heart sounds - that suggest cardiac tamponade, though all three are present in only a minority of patients, so ultrasound is more reliable.

A five-item risk tool for undifferentiated chest pain in the emergency department: history, electrocardiogram, age, risk factors, and troponin. Low scores support early discharge; high scores favor admission and stress testing.

Deeply inverted or biphasic T waves in the anterior precordial leads of a patient whose chest pain has resolved, signaling a critically narrowed left anterior descending artery and a high risk of impending infarction.

A brief bedside ultrasound performed by the treating clinician to answer narrow questions such as pericardial effusion, global systolic function, and right ventricular enlargement, guiding immediate resuscitation decisions rather than replacing a formal echocardiogram.

Acute hypoxemic respiratory failure within one week of a known insult, with bilateral opacities not explained by heart failure, and a PaO2/FiO2 ratio at or below 300 on positive pressure, graded mild, moderate, or severe.

A ventilator strategy using low tidal volumes of about 6 mL/kg predicted body weight, limiting plateau pressure and driving pressure, to reduce ventilator-induced lung injury in acute respiratory distress syndrome and other critically ill patients.

A device delivering heated, humidified oxygen at flow rates up to about 60 L/min with adjustable FiO2, providing modest positive end-expiratory pressure and better comfort than a nonrebreather, often used before deciding on intubation.

Air trapped in the pleural space that cannot escape, progressively raising intrathoracic pressure, collapsing the lung, shifting mediastinal structures, and obstructing venous return; it is a clinical diagnosis treated immediately with decompression.

Inadequate blood flow to the intestines, usually from arterial embolism, thrombosis, or venous occlusion, producing pain out of proportion to examination findings; delayed diagnosis leads to bowel infarction and high mortality.

Full-thickness, spontaneous rupture of the esophagus, typically after forceful vomiting, causing severe chest pain, subcutaneous emphysema, and mediastinitis. Prompt recognition and surgical or endoscopic repair are needed to prevent fatal sepsis.

Infection of ascitic fluid without an obvious intra-abdominal source, diagnosed when the fluid neutrophil count is at least 250 cells per microliter; it requires prompt antibiotics and is often the reason a cirrhotic patient presents with encephalopathy or fever.

Continuous seizure activity or repeated seizures without recovery lasting about five minutes or more, treated in sequence with benzodiazepines, then a second-line antiseizure drug, while searching for the cause and monitoring for hypoxia.

The pressure gradient driving blood through the brain, calculated as mean arterial pressure minus intracranial pressure; it is targeted in severe traumatic brain injury to keep the brain adequately perfused without worsening intracranial pressure.

An acute fluctuating disturbance of attention and awareness assessed at the bedside with the Confusion Assessment Method for the ICU; it is common in critically ill patients and is associated with longer stays and worse outcomes.

A strategy for hemorrhagic shock that pairs rapid hemorrhage control with balanced blood component transfusion, permissive hypotension before bleeding is controlled, and prevention of the lethal triad of hypothermia, acidosis, and coagulopathy.

The self-reinforcing combination of hypothermia, acidosis, and coagulopathy in severely injured or bleeding patients; each element worsens the others, so resuscitation aims to warm the patient, restore perfusion, and replace clotting factors early.

Resuscitative endovascular balloon occlusion of the aorta, in which a femoral catheter inflates a balloon to slow subdiaphragmatic bleeding and support blood pressure while definitive hemorrhage control is arranged; it is a bridge, not a substitute for surgery.

A recognizable cluster of vital sign and physical examination findings, such as opioid, sympathomimetic, anticholinergic, or serotonin patterns, that narrows the differential and guides early antidote or supportive treatment in a poisoned patient.

A graph plotting serum acetaminophen concentration against hours after ingestion to predict hepatotoxicity risk and guide N-acetylcysteine treatment; it applies to single acute ingestions with a known time, not to chronic or staggered overdoses.

An intravenous fat emulsion given as rescue therapy for severe toxicity from lipophilic drugs such as local anesthetics or certain antidysrhythmics, thought to act as a lipid sink and to support cardiac energetics.

A drug-induced hyper-serotonergic state with altered mental status, autonomic instability, and neuromuscular hyperactivity such as clonus and hyperreflexia, often after combining serotonergic agents; treatment is stopping the drug and giving supportive care with benzodiazepines.

Core temperature above 40 degrees Celsius with central nervous system dysfunction occurring during strenuous activity in the heat; cooling must begin immediately because the duration of hyperthermia predicts organ damage and death.

A clinical classification of hypothermia by vital signs and consciousness - stages I through IV - that guides rewarming choices, from passive external warming in mild cases to extracorporeal rewarming in severe cases with instability or arrest.

Respiratory impairment from submersion or immersion in liquid, leading to hypoxia, aspiration, and possibly cardiac arrest; the priority in resuscitation is immediate ventilation and oxygen, with cervical spine precautions only when the mechanism suggests injury.

A life-threatening form of altitude illness with ataxia, altered mental status, and headache at high elevation, caused by brain swelling; it is treated by descent, oxygen, and dexamethasone, and it may accompany high-altitude pulmonary edema.

A rapidly spreading infection of the deep fascia with necrosis and systemic toxicity, often out of proportion to skin findings and sometimes with crepitus; it requires emergent surgical debridement plus broad-spectrum antibiotics, and imaging must not delay surgery.

Elevated pressure within a closed fascial compartment that impairs perfusion, producing pain out of proportion, pain with passive stretch, and later paresthesias and weakness; diagnosis is clinical and treatment is emergent fasciotomy.

Life-threatening organ dysfunction caused by a dysregulated host response to infection, operationalized as an increase in the Sequential Organ Failure Assessment score of at least two points; qSOFA is a bedside prompt, not the definition.

A severe, rapidly developing systemic hypersensitivity reaction with airway, breathing, or circulatory compromise, or with skin and mucosal signs plus persistent gastrointestinal or respiratory symptoms; intramuscular epinephrine is the first-line treatment.

A metabolic emergency of insulin deficiency with hyperglycemia, ketonemia, and high-anion-gap acidosis, treated with fluids, insulin, and aggressive potassium replacement, with attention to the precipitant and to cerebral edema in children.

A rare, life-threatening exaggeration of thyrotoxicosis with fever, tachycardia, agitation, and multiorgan dysfunction; treatment combines beta blockade, a thionamide, iodine given after the thionamide, glucocorticoids, and supportive care.

Acute insufficiency of cortisol, often in a patient with known adrenal disease or on chronic steroids who is stressed by illness, presenting with hypotension, nausea, and weakness; treatment is immediate parenteral hydrocortisone with fluids and glucose.

Breakdown of skeletal muscle releasing myoglobin and intracellular contents into the blood, causing dark urine, elevated creatine kinase, hyperkalemia, and acute kidney injury; treatment is aggressive intravenous fluids and correction of electrolyte disturbances.

A severe withdrawal syndrome with agitation, hallucinations, autonomic hyperactivity, and clouded consciousness appearing days after heavy alcohol use stops; treatment is benzodiazepines titrated to symptoms, plus thiamine, fluids, and close monitoring.