ABPTS ECS cheat sheet

Primary survey sequence is airway, breathing, circulation, disability, exposure (ABCDE); reassess after every intervention.

Glasgow Coma Scale: eye 1-4, verbal 1-5, motor 1-6; total 3-15; score of 8 or less generally indicates need for airway protection.

Mean arterial pressure equals diastolic pressure plus one-third of pulse pressure (systolic minus diastolic).

Shock index equals heart rate divided by systolic blood pressure; a value above 0.9 suggests occult hypoperfusion.

Cushing triad of hypertension, bradycardia, and irregular respirations signals elevated intracranial pressure.

Triage acuity scales commonly use five levels; time targets shorten as acuity rises, with immediate category requiring care on arrival.

Handoff communication uses the SBAR format: situation, background, assessment, recommendation.

Disposition planning begins at triage; boarding time is measured from admission decision to physical departure from the emergency department.

ST-elevation myocardial infarction requires ST elevation of at least 1 mm in two contiguous limb leads or 2 mm in precordial leads (or equivalent criteria).

Reperfusion target for STEMI is percutaneous coronary intervention within 90 minutes of first medical contact at a PCI-capable facility.

Cardiac arrest with shockable rhythm (ventricular fibrillation, pulseless ventricular tachycardia) is treated with immediate defibrillation plus high-quality chest compressions.

Chest compression rate is 100-120 per minute with depth 5-6 cm in adults and full recoil between compressions.

Tension pneumothorax is a clinical diagnosis; treatment is immediate needle decompression followed by tube thoracostomy, never delayed for imaging.

Asthma severity markers include inability to speak in full sentences, accessory muscle use, and peak expiratory flow below 50 percent of predicted.

Pulse oximetry below 90 percent at sea level indicates significant hypoxemia; oxygen targets in most acutely ill adults are 94-98 percent.

Well's criteria and the PERC rule stratify pretest probability for pulmonary embolism; D-dimer is most useful in low-probability patients.

Ottawa ankle rules require radiography if there is pain in the malleolar zone plus bone tenderness at the posterior malleolus, medial malleolus, or inability to bear weight.

Neurovascular status (pulses, capillary refill, sensation, motor) is documented before and after every splint or reduction.

Compartment syndrome earliest finding is pain out of proportion, worsened by passive stretch; pulselessness is a late sign.

Cincinnati Prehospital Stroke Scale items are facial droop, arm drift, and abnormal speech; any one positive finding raises stroke suspicion.

Thrombolysis window for ischemic stroke is generally up to 4.5 hours from last known well; thrombectomy may extend to 24 hours in selected patients.

Burns are sized using the Rule of Nines: each arm 9 percent, each leg 18 percent, anterior trunk 18 percent, posterior trunk 18 percent, head 9 percent, perineum 1 percent.

Parkland formula for burn resuscitation: 4 mL/kg body weight times percent total body surface area, with half given in the first 8 hours from injury.

Open fractures require tetanus status assessment, antibiotic prophylaxis, and immobilization before transfer.

Diabetic ketoacidosis criteria include glucose above 250 mg/dL, pH below 7.3, bicarbonate below 18 mEq/L, and ketonemia or ketonuria.

Corrected sodium in hyperglycemia equals measured sodium plus 1.6 mEq/L for every 100 mg/dL glucose above 100.

Anion gap equals sodium minus the sum of chloride and bicarbonate; normal range is roughly 8-12 mEq/L.

Sepsis-3 defines sepsis as suspected infection plus organ dysfunction, indicated by a SOFA score increase of 2 or more points.

qSOFA uses respiratory rate 22 or higher, altered mentation, and systolic blood pressure 100 mmHg or lower.

Anaphylaxis is treated with intramuscular epinephrine 0.3-0.5 mg of 1:1000 solution into the anterolateral thigh, repeated every 5-15 minutes as needed.

Hypoglycemia is defined as glucose below 70 mg/dL; below 54 mg/dL is clinically significant and requires immediate treatment.

Serotonin syndrome features include clonus, hyperreflexia, agitation, and hyperthermia; neuroleptic malignant syndrome features rigidity and bradyreflexia.

Needle decompression of tension pneumothorax is performed at the second intercostal space midclavicular line or fourth-fifth intercostal space anterior axillary line.

Endotracheal tube depth in adults is approximately 21 cm at the incisors for men and 19 cm for women; confirm with waveform capnography.

Defibrillation energy for biphasic devices is typically 120-200 J; monophasic devices use 360 J.

Intraosseous access is indicated when intravenous access fails or delays care; the proximal tibia is the most common site in adults.

Tourniquet application for extremity hemorrhage is placed 5-7 cm proximal to the wound and tightened until bleeding stops.

Rapid sequence intubation pairs a sedative induction agent with a neuromuscular blocker; preoxygenation precedes both.

Synchronized cardioversion for unstable tachycardia delivers energy timed to the QRS complex, typically 50-100 J for atrial fibrillation.

Central venous catheter placement sites are ranked by complication profile; ultrasound guidance reduces arterial puncture and pneumothorax risk.

Mass casualty triage sorts patients into immediate, delayed, minimal, and expectant categories; treatment resources are directed to those most likely to survive.

START triage uses respirations, perfusion, and mental status; patients who do not breathe after airway repositioning are categorized as expectant or deceased.

Surge capacity planning distinguishes conventional, contingency, and crisis standards of care, each with progressively greater deviation from usual practice.

Hospital incident command system assigns roles including incident commander, operations, planning, logistics, and finance/administration.

Personal protective equipment doffing order removes the most contaminated items first; hand hygiene follows each glove removal.

Evacuation decision-making weighs patient acuity, transport mode, distance, and available receiving capacity; critical patients require advanced life support transport.

Decontamination precedes treatment for patients exposed to hazardous materials unless life-saving intervention is required first.

Chemical exposure with pinpoint pupils and bronchorrhea suggests organophosphate poisoning; nerve agent antidotes include atropine and pralidoxime.

Emergency Medical Treatment and Labor Act requires screening examination and stabilization for anyone presenting to an emergency department regardless of ability to pay.

Informed consent requires decision-making capacity, disclosure of risks and alternatives, comprehension, and voluntariness.

Decision-making capacity is assessed clinically by ability to understand, appreciate, reason, and express a choice; it is not the same as legal competence.

Minors generally require parental consent except for emancipated minors, emergencies, and specific statutory exceptions such as reproductive health.

Mandatory reporting duties commonly cover suspected child abuse, elder abuse, and certain communicable diseases; requirements vary by jurisdiction.

Advance directives and durable power of attorney for health care take effect when the patient lacks capacity; a living will states preferences directly.

HIPAA permits disclosure for treatment, payment, and operations, and for public health and safety exceptions defined in the rule.

Documentation should record objective findings, time stamps, and clinical reasoning; late entries are labeled as amendments with the correct time.

Sensitivity equals true positives divided by true positives plus false negatives; specificity equals true negatives divided by true negatives plus false positives.

Positive predictive value depends on prevalence, so it falls when disease prevalence in the tested population is low.

Number needed to treat equals the reciprocal of absolute risk reduction; lower values indicate greater clinical benefit.

A p value of 0.05 means a 5 percent probability of observing the result if the null hypothesis were true, not the probability the null is true.

Confidence intervals convey precision; a 95 percent interval excluding the null value corresponds to statistical significance at alpha 0.05.

Level I evidence includes systematic reviews of randomized controlled trials; Level V includes expert opinion and case reports.

Likelihood ratios above 10 or below 0.1 substantially change pretest to posttest probability; values near 1 change little.

Randomization reduces selection bias; blinding reduces measurement and performance bias; intention-to-treat analysis preserves randomization benefits.