ABEM EM flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

qSOFA criteria

Respiratory rate 22/min or greater, systolic blood pressure 100 mmHg or less, and altered mentation. Two or more positive criteria prompt further assessment for sepsis and organ dysfunction.

PERC rule

Eight criteria (age under 50, HR under 100, SpO2 95% or more, no hemoptysis, no estrogen use, no prior DVT/PE, no unilateral leg swelling, no surgery/trauma requiring hospitalization) that exclude PE in low-risk patients.

Age-adjusted D-dimer

For patients over 50 years, the D-dimer threshold is age multiplied by 10 mcg/L FEU. Using it improves specificity while maintaining sensitivity for pulmonary embolism in low-to-moderate risk patients.

Anaphylaxis epinephrine dose

Intramuscular epinephrine 0.01 mg/kg of the 1:1000 concentration, maximum 0.5 mg, given in the anterolateral thigh. Repeat every 5 to 15 minutes as needed for persistent symptoms.

Hyperkalemia treatment sequence

Give IV calcium first for membrane stabilization when ECG changes are present, then insulin with glucose and inhaled beta-agonist to shift potassium intracellularly, then remove potassium with diuretics, binders, or dialysis.

Stroke thrombolysis window

Intravenous thrombolysis is indicated within 4.5 hours of last known well for eligible acute ischemic stroke. Mechanical thrombectomy may extend to 24 hours in selected large-vessel occlusion.

TXA in trauma

Tranexamic acid given within 3 hours of injury reduces mortality in bleeding trauma patients. Give a 1 g loading dose followed by 1 g infused over 8 hours.

Pediatric weight estimate

A rapid estimate is (age in years plus 4) multiplied by 2 kilograms. Length-based tapes are preferred when available for accurate dosing and equipment sizing.

MyEMCert purpose

MyEMCert is the American Board of Emergency Medicine continuing-certification pathway using focused online modules and attestations, replacing a single high-stakes recertifying examination for most diplomates.

MyEMCert module design

Modules are topic-based online assessments completed within a defined window. They provide immediate feedback and references and emphasize applied clinical judgment over factual recall.

APP pathway

The Advanced Practice Provider pathway allows eligible physician assistants and nurse practitioners to sit a focused examination and hold a defined credential distinct from physician certification.

Certification cycle length

Emergency medicine certification runs in five-year cycles with required activities distributed annually. Missing deadlines can lapse certification until requirements are completed.

Improvement in Medical Practice

A required certification component in which diplomates complete a data-driven quality improvement activity relevant to their practice and document a measured outcome.

MyEMCert item mapping

Each module item is mapped to a clinical topic and a clinical-reasoning model. Items undergo peer writing and psychometric review before appearing in a module.

Module passing standard

Each MyEMCert module is scored against a defined passing standard. Incorrect responses may require a brief learning activity before the module is completed.

Attestation requirements

Diplomates must attest to professionalism and practice-improvement activities each cycle. Falsified attestations can result in loss of certification or disciplinary action.

PDSA cycle

Plan states the aim and prediction, Do tests the change on a small scale, Study compares results to the prediction, and Act decides to adopt, adapt, or abandon the change.

Aim statement elements

A measurable aim names the population, the specific metric, the direction and magnitude of desired change, and the time frame for achievement.

Special-cause variation

Variation from an identifiable, non-random source. On a control chart it appears as a point beyond control limits or a run of six or more consecutive points on one side.

Process versus outcome measures

Process measures capture what clinicians do and respond quickly to change. Outcome measures capture patient results and are influenced by many factors outside the intervention.

Balancing measure

A measure that detects unintended consequences of an improvement change on other parts of the system, reported alongside the primary measure to guard against harm.

Root cause analysis

A structured review of a system failure using a causal diagram and repeated why questions. Its purpose is to identify system fixes rather than to assign individual blame.

Run chart shift rule

Six or more consecutive data points on the same side of the median indicates a non-random shift. This signals special-cause variation requiring investigation.

MOC Part IV requirement

The Improvement in Medical Practice component requires a documented quality activity with measured data relevant to the diplomate's own practice and a reported outcome.

Informed consent elements

Valid informed consent requires patient capacity, disclosure of risks, benefits, and alternatives, patient understanding, and voluntary agreement without coercion.

Emergency exception to consent

Treatment may proceed without consent when immediate intervention is needed to prevent serious harm, the patient lacks capacity, and no surrogate decision maker is reasonably available.

EMTALA core duty

A participating hospital must provide a medical screening examination and stabilizing treatment regardless of insurance or ability to pay before considering transfer.

EMTALA transfer requirements

Transfer requires a medical benefit rationale, an accepting facility that agrees, qualified transport and personnel, and transmission of records and imaging.

Mandatory reporting duties

Physicians must report suspected child abuse or neglect, elder and dependent-adult abuse, and specified communicable diseases and injuries such as gunshot wounds in many jurisdictions.

Impaired colleague reporting

A colleague unable to practice safely due to impairment should be reported to the appropriate physician health program or authority. Patient safety takes precedence over collegiality.

Boundary violation versus crossing

A boundary crossing may be benign and context-dependent, such as a home visit in a small community. A boundary violation harms the patient and is always reportable.

Professional standing elements

Professional standing requires an unrestricted license, current board certification, completion of required continuing education, and compliance with credentialing and institutional requirements.