AOBEM Emergency Medicine key terms

Life-threatening organ dysfunction caused by a dysregulated host response to infection, with persistent hypotension requiring vasopressors to maintain mean arterial pressure and elevated lactate despite adequate fluid resuscitation.

Bedside screening score for sepsis using respiratory rate 22 or more, altered mentation, and systolic blood pressure 100 mm Hg or less; two or more points prompt further evaluation for organ dysfunction.

Percentage decline in serum lactate between serial measurements, reflecting improved tissue perfusion; failure to clear predicts higher mortality in sepsis and shock states.

Five clinical criteria for clearing the cervical spine without imaging: no midline tenderness, no focal neurologic deficit, normal alertness, no intoxication, and no distracting painful injury.

Validated decision instrument allowing cervical spine imaging to be avoided in alert, stable trauma patients who lack high-risk features, have a low-risk factor permitting safe range of motion, and can rotate the neck 45 degrees.

Pregnancy-related disorder marked by hemolysis, elevated liver enzymes, and low platelets, often presenting in the third trimester with right upper quadrant pain, nausea, and hypertension.

Hypertensive disorder of pregnancy with blood pressure 160/110 or higher or end-organ findings such as thrombocytopenia, renal insufficiency, pulmonary edema, or neurologic symptoms, requiring urgent treatment and delivery planning.

Adverse effect of magnesium therapy causing loss of deep tendon reflexes, respiratory depression, and cardiac conduction abnormalities; treated with calcium gluconate and drug discontinuation.

Clinical prediction rule estimating pretest probability of pulmonary embolism using signs of deep vein thrombosis, heart rate, immobilization or surgery, prior thromboembolism, hemoptysis, and malignancy.

Eight-item rule used in low pretest probability patients to exclude pulmonary embolism without testing when all criteria are negative: age under 50, heart rate under 100, oxygen saturation 95 percent or more, no hemoptysis, no estrogen use, no prior thromboembolism, no unilateral leg swelling, and no recent surgery or trauma.

Strategy raising the D-dimer threshold with advancing age (age times 10 micrograms per liter in patients over 50) to improve specificity for pulmonary embolism while preserving sensitivity.

Controlled cooling or maintenance of normothermia after cardiac arrest to limit reperfusion injury, with avoidance of fever for at least 72 hours and treatment of shivering.

Structured set of interventions after return of spontaneous circulation including oxygenation and ventilation targets, hemodynamic support, coronary evaluation when indicated, neurologic prognostication, and temperature control.

Eight-item screening tool for obstructive sleep apnea risk based on snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, and gender.

Structured sequence guiding management when mask ventilation, supraglottic placement, or intubation fails, emphasizing limiting attempts, calling for help, and proceeding to a surgical airway when oxygenation cannot be maintained.

Emergency surgical or percutaneous opening of the cricothyroid membrane to establish a definitive airway when other methods fail in a patient who cannot be oxygenated.

Process of sorting injured patients by acuity and survivability to allocate limited resources, commonly using color-coded categories from immediate to expectant.

Simple triage and rapid treatment system for adult mass casualty incidents that assigns categories using respirations, perfusion, and mental status assessed in under a minute per patient.

Pediatric adaptation of mass casualty triage accounting for higher normal respiratory rates and use of the pediatric assessment triangle, with special provision for apneic children who breathe after airway positioning.

Concept that trauma outcomes improve when definitive care or surgical intervention occurs within roughly one hour of injury, motivating rapid transport and early hemorrhage control.

Field decision to limit on-scene interventions and transport immediately because the patient has a time-critical condition such as uncontrolled hemorrhage or impending airway compromise.

Official classification of hospitals by capability to care for injured patients, from level I comprehensive centers to level IV facilities providing stabilization and transfer.

Noninvasive positive pressure ventilation delivered by EMS for respiratory distress from pulmonary edema or obstructive disease, reducing intubation rates when the patient can protect the airway.

Manual positive pressure ventilation using a self-inflating bag and mask, requiring two-person technique and airway adjuncts for effective delivery in apneic or inadequately breathing patients.

Resuscitation approach emphasizing compression depth and rate, minimal interruptions, full recoil, early defibrillation, and team choreography to maximize coronary perfusion during cardiac arrest.

Device that delivers automated chest compressions, useful during prolonged resuscitation or transport but not shown to improve neurologic outcomes over high-quality manual compressions.

Constellation of vital sign and physical examination findings that suggests a specific class of poisoning, such as anticholinergic, cholinergic, opioid, sympathomimetic, or sedative-hypnotic patterns.

Syndrome of dry flushed skin, mydriasis, urinary retention, decreased bowel sounds, tachycardia, and agitated delirium caused by agents blocking muscarinic receptors.

Excessive acetylcholine effect producing salivation, lacrimation, urination, diarrhea, bronchorrhea, bradycardia, miosis, and muscle fasciculations from organophosphate or carbamate exposure.

Escalating intravenous atropine dosing used to reverse bronchorrhea and bradycardia in organophosphate poisoning, titrated until secretions dry rather than to a fixed maximum dose.

Reversible acetylcholinesterase inhibitor that crosses the blood-brain barrier and can reverse central anticholinergic delirium, used cautiously because of risk of bradycardia and seizures.

Drug-induced excess serotonergic activity causing autonomic instability, neuromuscular hyperactivity such as clonus and hyperreflexia, and altered mental status, often from serotonergic drug combinations.

Idiosyncratic reaction to dopamine antagonists marked by rigidity, hyperthermia, autonomic instability, and elevated creatine kinase, distinguished from serotonin syndrome by lead-pipe rigidity and bradyreflexia.

Competitive opioid receptor antagonist used to reverse opioid-induced respiratory depression, titrated to restore adequate breathing rather than full alertness to avoid withdrawal and agitation.

Pattern of depressed mental status, pinpoint pupils, and hypoventilation produced by opioids, reversed with naloxone and supported with airway and ventilation assistance.

Dose-dependent hepatic injury from acetaminophen mediated by toxic metabolite accumulation when glutathione stores are depleted, treated with N-acetylcysteine based on timed serum levels.

Plot of serum acetaminophen concentration against time since ingestion used to decide whether N-acetylcysteine treatment is indicated after a single acute overdose.

Glutathione precursor and antioxidant that detoxifies the reactive acetaminophen metabolite, most effective when started early after overdose and given intravenously or orally.

Impaired or altered function of related components of the somatic system, identified by tissue texture change, asymmetry, restricted motion, and tenderness, forming the basis for osteopathic manipulative treatment.

Systematic regional assessment of the musculoskeletal system for asymmetry, range of motion restriction, tissue texture abnormality, and tenderness to guide manipulative treatment decisions.

Somatic tissue changes such as tenderness or restricted motion that accompany visceral disease through shared spinal cord segments, used as an adjunctive diagnostic clue.

Small, firm, tender nodules in specific fascial and lymphatic tissue locations associated with visceral dysfunction, used diagnostically and treated with lymphatic techniques.

Osteopathic manipulative method in which the patient performs voluntary muscle contractions against a counterforce in a specific direction while the physician stabilizes the body, improving motion and reducing pain.

Manipulative thrust applied at the end of available motion to restore joint motion, requiring screening for contraindications such as fracture, malignancy, or instability before use.

Hands-on technique applying sustained light pressure and traction to fascial tissues to reduce restriction and improve motion, often used for musculoskeletal complaints in the emergency setting.

Rhythmic compression and release of the thoracic and abdominal regions to promote lymphatic flow and venous return, used adjunctively in conditions with edema or respiratory congestion.