Resuscitation and Cardiovascular Emergencies
Core concepts
Master the reversible causes of cardiac arrest (the Hs and Ts), high-quality CPR metrics (rate 100-120/min, depth 5-6 cm, full recoil, minimal interruptions), and defibrillation timing. Know the ACLS algorithm branches: shockable (VF/pVT) versus non-shockable (asystole/PEA). Understand post-arrest care including targeted temperature management and hemodynamic goals.
For acute coronary syndrome, know that STEMI is defined by ST elevation in contiguous leads with reciprocal changes; time is myocardium, so reperfusion decisions hinge on symptom onset and PCI availability. Recognize aortic dissection, pulmonary embolism, and pericardial tamponade as lethal mimics of ACS. In heart failure and dysrhythmias, distinguish stable from unstable: unstable patients get synchronized cardioversion (or unsynchronized for VF/pVT).
Traps
Questions love to test whether you recognize an unstable patient before reaching for drugs. Another trap is misinterpreting PEA: it is a rhythm, not a diagnosis - always hunt for the cause. Watch for hyperkalemia masquerading as wide-complex bradycardia and for tamponade after penetrating chest trauma.
Worked example / rule of thumb
If a patient with chest pain and ST elevation also has a widened mediastinum and tearing back pain, think dissection before giving thrombolytics. Rule of thumb: "shock it if it's shockable; if not, find the cause and keep compressing."