ABPS Emergency Medicine (BCEM) cheat sheet

Cardiopulmonary arrest with shockable rhythm (VF/pVT): defibrillate immediately, then CPR; epinephrine 1 mg IV/IO every 3–5 min, amiodarone 300 mg after the 3rd shock.

Acute STEMI: door-to-balloon ≤90 min at PCI-capable centers; fibrinolysis within 30 min of arrival when PCI is unavailable and symptom onset is <12 h without contraindication.

Septic shock: 30 mL/kg crystalloid for hypotension or lactate ≥4 mmol/L, blood cultures before antibiotics, broad-spectrum antibiotics within 1 hour of recognition.

Anaphylaxis: IM epinephrine 0.3–0.5 mg (1 mg/mL) into the anterolateral thigh, repeated every 5–15 min; adjuncts (H1/H2 blockers, steroids) never replace epinephrine.

Acute ischemic stroke: IV alteplase within 4.5 h of last known well; door-to-needle ≤60 min; exclude intracranial hemorrhage by CT before thrombolysis.

Hyperkalemia with ECG changes: IV calcium gluconate or chloride for membrane stabilization, then insulin/glucose, beta-agonist, and dialysis for refractory cases.

Tension pneumothorax is a clinical diagnosis - immediate needle decompression (2nd intercostal space midclavicular or 4th–5th anterior axillary) before imaging.

Opioid overdose: naloxone titrated to adequate ventilation, not full arousal; observe for renarcotization given variable half-life.

Wells/Geneva and PERC guide pretest probability in suspected PE; high-probability plus hemodynamic instability warrants empiric anticoagulation or thrombolysis.

Structure every case presentation as: primary survey findings → resuscitation priorities → differential → investigations → disposition; state unstable findings first.

Airway decision rule: if the patient cannot maintain oxygenation/ventilation or protect the airway, escalate to definitive airway before further diagnostics.

For any shock case, name the category (hypovolemic, distributive, cardiogenic, obstructive) and the immediate intervention for that category.

Toxicology cases: state toxidrome, antidote (if any), decontamination decision, and observation/disposition rationale explicitly.

Trauma: verbalize the primary survey (ABCDE) with findings and interventions at each step before moving to adjuncts and secondary survey.

Pediatric cases: state weight-based dosing and age-specific normal ranges; mention caregiver communication and child-protection considerations when relevant.

State disposition and safety plan (admit, observe, discharge with follow-up, or transfer) with explicit criteria and reassessment interval.

When uncertain, verbalize a safe default: stabilize, consult, and document reasoning - examiners score structured reasoning, not recall speed.