Resuscitation and Emergency Management
Core concepts
Master the advanced life support algorithm: high-quality chest compressions, early defibrillation for shockable rhythms, airway management, and medications. Know the reversible causes of cardiac arrest (hypovolemia, hypoxia, hydrogen ion, hypo/hyperkalemia, hypothermia, tension pneumothorax, tamponade, toxins, thrombosis). Understand the management of anaphylaxis (epinephrine, fluids, airway), local anesthetic systemic toxicity (lipid emulsion), and malignant hyperthermia (dantrolene). Know the principles of trauma resuscitation and massive transfusion. Recognize the presentation and management of airway emergencies, including foreign-body obstruction and angioedema.
Traps in questions
- Delaying defibrillation for shockable rhythms while giving medications.
- Forgetting that epinephrine is the first-line drug in anaphylaxis and that intramuscular dosing is preferred initially.
- Missing that lipid emulsion is the specific treatment for severe local anesthetic toxicity.
- Overlooking that dantrolene is the specific treatment for malignant hyperthermia.
- Assuming a patient in cardiac arrest with a non-shockable rhythm should receive a shock.
Worked example / rule of thumb
A patient develops urticaria, hypotension, and bronchospasm after antibiotic administration: give intramuscular epinephrine, fluids, and oxygen, and prepare for airway management. Rule of thumb: in shockable arrest, defibrillate early and resume compressions immediately; in non-shockable arrest, focus on high-quality compressions and reversible causes.
Exam framing
Questions often test the first drug or intervention in a crisis. Match the specific antidote or intervention to the diagnosis, and remember that high-quality compressions and early defibrillation save more lives than any single medication.