ACEM Fellowship Written cheat sheet

Cardiac arrest in adults: high-quality chest compressions at 100-120/min, depth 5-6 cm, full recoil, minimise interruptions to under 10 seconds; ratio 30:2 before an advanced airway, then continuous compressions with ventilations every 6 seconds.

Defibrillation: biphasic 150-200 J (or manufacturer recommendation) for VF/pVT; a single shock strategy is reasonable in the ED setting. Shockable rhythms receive adrenaline 1 mg IV/IO every 3-5 cycles; non-shockable rhythms receive adrenaline 1 mg immediately.

Reversible causes of arrest (4 Hs and 4 Ts): hypoxia, hypovolaemia, hypo/hyperkalaemia and metabolic, hypothermia; tension pneumothorax, tamponade, toxins, thrombosis (coronary and pulmonary).

Peri-arrest hyperkalaemia: calcium chloride 10% 10 mL or calcium gluconate 10% 30 mL IV, then insulin 10 units with 50 mL of 50% glucose, plus salbutamol nebulised; consider sodium bicarbonate if acidotic.

Shock classification: hypovolaemic, cardiogenic, distributive (septic, anaphylactic, neurogenic) and obstructive. Narrow pulse pressure and cool peripheries suggest low cardiac output; warm vasodilated peripheries suggest distributive shock.

Anaphylaxis: adrenaline 0.5 mg IM (1:1000) into the anterolateral thigh, repeat every 5 minutes as needed; fluid bolus 500-1000 mL crystalloid in adults; adjuncts (antihistamine, steroid) do not treat airway or circulatory compromise.

Post-ROSC care: target SpO2 94-98% and normocapnia (PaCO2 35-45 mmHg), avoid hypotension (MAP at least 65 mmHg), 12-lead ECG, and targeted temperature management with avoidance of fever.

Sepsis: recognise organ dysfunction via qSOFA (RR 22 or more, altered mentation, SBP 100 or less) and lactate; give broad-spectrum antibiotics within 1 hour for septic shock and 30 mL/kg crystalloid for hypotension or lactate 4 mmol/L or more.

Massive transfusion: give balanced ratios approximating 1:1:1 (packed cells:plasma:platelets), limit crystalloid, and use tranexamic acid 1 g IV within 3 hours of trauma with ongoing bleeding.

Tension pneumothorax is a clinical diagnosis: immediate decompression (finger thoracostomy or needle decompression), followed by intercostal catheter; do not wait for imaging in the unstable patient.

TBI: avoid hypoxia and hypotension (SBP at least 110 mmHg in adults), keep PaCO2 35-40 mmHg, elevate head 30 degrees, and use hypertonic saline or mannitol for signs of herniation.

Paracetamol overdose: use the Rumack-Matthew nomogram from 4 hours post-ingestion; N-acetylcysteine is most effective within 8 hours; treat with NAC if the level is at or above the treatment line or the time of ingestion is unknown with significant ingestion.

Toxidromes: anticholinergic (dry, hot, flushed, mydriasis, delirium), cholinergic (SLUDGE plus bronchorrhoea), opioid (pinpoint pupils, bradypnoea), sympathomimetic (tachycardia, hypertension, agitation).

Salicylate toxicity: mixed respiratory alkalosis with metabolic acidosis, tinnitus, altered mental state; treat with sodium bicarbonate to alkalinise urine and serum, glucose, and haemodialysis for severe features.

Carbon monoxide poisoning: measure carboxyhaemoglobin, give high-flow oxygen; consider hyperbaric oxygen for loss of consciousness, neurological signs, ischaemia, or pregnancy with significant exposure.

Heat stroke: core temperature above 40 C with CNS dysfunction; immediate cold-water immersion or evaporative cooling, and monitor for rhabdomyolysis, DIC and hepatic injury.

Acute coronary syndrome: obtain a 12-lead ECG within 10 minutes of arrival; ST-elevation MI requires reperfusion (primary PCI within 90 minutes of first medical contact where available) plus aspirin 300 mg and a P2Y12 inhibitor.

Acute pulmonary oedema: sit upright, high-flow oxygen or non-invasive ventilation, IV nitrates if systolic BP above 100 mmHg, and loop diuretic; treat precipitants such as arrhythmia, ischaemia and hypertension.

Atrial fibrillation with rapid ventricular response and instability (hypotension, ischaemia, pulmonary oedema) requires synchronised cardioversion; stable patients may be rate-controlled with a beta-blocker or calcium channel blocker.

Aortic dissection: sudden tearing chest or back pain with pulse deficit or blood pressure differential; CT angiography is diagnostic; analgesia and heart-rate control (target SBP 100-120 mmHg) precede definitive repair.

Acute severe asthma: continuous nebulised salbutamol with ipratropium, systemic corticosteroids, and IV magnesium sulfate 2 g over 20 minutes for poor response; consider IV salbutamol and ketamine in life-threatening attacks.

COPD exacerbation: controlled oxygen to target SpO2 88-92%, nebulised bronchodilators, systemic steroids, antibiotics if increased sputum purulence, and non-invasive ventilation for respiratory acidosis (pH under 7.35 with hypercapnia).

Pulmonary embolism: use Wells score and D-dimer in low/intermediate probability; CT pulmonary angiography for diagnosis; anticoagulate, and consider thrombolysis for haemodynamic instability (systolic BP under 90 mmHg).

Hypertensive emergency: severe blood pressure elevation with acute end-organ damage (encephalopathy, aortic dissection, pulmonary oedema, AKI); reduce MAP by no more than 20-25% in the first hour with titratable IV agents.

Acute ischaemic stroke: non-contrast CT excludes haemorrhage; IV thrombolysis with alteplase or tenecteplase within 4.5 hours of onset for eligible patients, and endovascular thrombectomy for large vessel occlusion up to 24 hours in selected cases.

Status epilepticus: benzodiazepine first-line (IV lorazepam 4 mg or midazolam IM 10 mg), repeat once, then second-line IV levetiracetam, valproate or phenytoin; refractory cases need intubation and anaesthetic agents.

Diabetic ketoacidosis: IV crystalloid resuscitation, insulin infusion at 0.1 units/kg/hour, potassium replacement once K under 5.5 mmol/L, and add 10% glucose when glucose falls below 15 mmol/L; continue insulin until ketones clear.

Severe hypoglycaemia: IV glucose (50 mL of 50% dextrose or 100 mL of 10% glucose) or IM glucagon 1 mg if no IV access; recheck glucose and provide sustained carbohydrate plus investigation of cause.

Hyponatraemia: symptomatic or severe cases need hypertonic saline with correction limits (about 8-10 mmol/L in 24 hours) to avoid osmotic demyelination; treat seizures with 3% saline boluses.

Raised intracranial pressure: head-up positioning, avoid hypoxia and hypercapnia, maintain cerebral perfusion pressure, and use osmotherapy; hyperventilation to PaCO2 30-35 mmHg is a temporising bridge only.

Paediatric resuscitation: weight-based dosing, and fluid boluses of 10-20 mL/kg with reassessment; use the formula-based or length-based tape for weight estimation and drug dosing.

Elderly and anticoagulated patients: low threshold for CT imaging after head trauma; reversal of anticoagulation (vitamin K plus prothrombin complex concentrate for warfarin, specific reversal agents for DOACs) for intracranial haemorrhage.

Rapid sequence intubation: pre-oxygenate, optimise haemodynamics, give induction agent plus neuromuscular blocker, and apply a failed airway plan; ketamine and rocuronium are common choices; confirm tube position with waveform capnography.

Difficult airway prediction uses the MOANS and LEMON mnemonics; a cannot-intubate-cannot-oxygenate scenario mandates a front-of-neck airway (scalpel-bougie-tube technique).

Arterial blood gas interpretation: use a stepwise approach (pH, PaCO2, HCO3, base excess, compensation, anion gap); raised anion gap causes include ketoacidosis, lactate, urate, toxins and renal failure.

Ultrasound in the ED: FAST for free fluid, eFAST adds thoracic windows for pneumothorax; bedside echo assesses cardiac activity, tamponade and right ventricular strain.

Procedural sedation: fasting, monitoring (ECG, SpO2, capnography), titrated agents such as ketamine or propofol, and a staff member dedicated to monitoring; document pre-sedation risk assessment.

Central venous access: ultrasound guidance reduces complications; confirm tip position and exclude pneumothorax post-procedure; femoral, internal jugular and subclavian sites each have specific risk profiles.

Disposition and risk stratification: use validated tools (HEART score for chest pain, Ottawa rules for ankle and knee imaging, Canadian CT head rules, PERC for PE) and document shared decision-making and safety-netting advice.

Analgesia and opioid stewardship: multimodal analgesia (paracetamol, NSAIDs where appropriate, regional blocks), and naloxone for opioid toxicity with titrated dosing to restore ventilation.

Structured handover uses ISBAR (identify, situation, background, assessment, recommendation); closed-loop communication reduces error in resuscitation teams.

Leadership in resuscitation: allocate clear roles, verbalise plans, use a designated timekeeper and debrief after critical events.

Documentation should record time-critical decisions, discussions of risk, capacity assessments and resuscitation status; contemporaneous notes support medico-legal defensibility.

Informed consent and capacity: assess understanding, retention, reasoning and communication; treat under best interests when capacity is absent and the intervention is urgent and necessary.

Open disclosure after adverse events: acknowledge the event, explain what happened, express regret, outline corrective steps and support the patient and clinicians involved.

Quality improvement and audit: use clinical indicators (door-to-needle times, time to antibiotics in sepsis, unplanned reattendance) and structured mortality and morbidity review.

Fatigue and safety: recognise impairment from fatigue, use structured shift design and escalation pathways, and report near-misses through incident systems.

Mandatory reporting and notifiable diseases: know local public health obligations for conditions such as meningococcal disease, measles and food-borne illness.

Undifferentiated chest pain: risk stratify with ECG, troponin and validated scores; consider life-threatening causes first (ACS, dissection, PE, tension pneumothorax, oesophageal rupture, tamponade).

Abdominal pain in the elderly or immunosuppressed may lack classic signs; use CT imaging early when the diagnosis is unclear and serial examination is unreliable.

Fever in the returned traveller: consider malaria (thick and thin films, rapid antigen test), dengue, typhoid and rickettsial disease; take a full travel and exposure history.

Electrolyte emergencies: severe hyperkalaemia with ECG changes needs immediate calcium; severe hypokalaemia with arrhythmia needs IV potassium with cardiac monitoring.

Poisoning antidote pairs: opioid-naloxone, benzodiazepine-flumazenil (caution), paracetamol-NAC, iron-desferrioxamine, cyanide-hydroxocobalamin, organophosphate-atropine plus pralidoxime.

Trauma imaging: use the major trauma pathway with CT for suspected multi-system injury; the Ottawa rules guide selective imaging of extremities to reduce unnecessary radiation.

Acute limb ischaemia: the six Ps (pain, pallor, pulselessness, paraesthesia, paralysis, perishing cold); urgent vascular surgical referral and anticoagulation; paralysis implies a threatened limb.

Delirium in the ED: screen with the 4AT or CAM; identify and treat precipitants (infection, drugs, metabolic, pain, retention) rather than sedating first-line.

Adrenaline dosing: cardiac arrest 1 mg IV of 1:10,000; anaphylaxis 0.5 mg IM of 1:1000; severe asthma or bradycardia infusions are titrated; route and concentration are critical to avoid error.

Amiodarone: 300 mg IV bolus for refractory VF/pVT, then 150 mg; for stable tachyarrhythmias use 150-300 mg over 10-20 minutes; monitor blood pressure and QT.

Adenosine: 6 mg rapid IV push followed by flush for regular narrow-complex tachycardia, then 12 mg; contraindicated in asthma and pre-excited atrial fibrillation.

Anticoagulation reversal: warfarin-vitamin K plus prothrombin complex concentrate; dabigatran-idarucizumab; factor Xa inhibitors-andexanet alfa or prothrombin complex concentrate.

Antibiotic stewardship: choose empirical therapy based on likely pathogens and local resistance, take cultures before antibiotics where feasible, review at 48 hours and de-escalate.

High-risk drug interactions: QT prolongation with ondansetron, macrolides and antipsychotics; serotonin syndrome with serotonergic combinations; NSAIDs with anticoagulants increase bleeding risk.

Renal and hepatic dosing: adjust doses of renally cleared drugs (e.g., enoxaparin, gabapentin) and avoid hepatotoxic agents in liver failure; check weight-based dosing in obesity.

Drug allergy documentation: distinguish true allergy from intolerance, record reaction type and severity, and use alternative agents or desensitisation where indicated.

Paediatric assessment uses a triangle (appearance, work of breathing, circulation); bradycardia in children is usually hypoxic in origin, so oxygenate and ventilate before compressions.

Paediatric fluid resuscitation: 10-20 mL/kg crystalloid boluses with reassessment; in septic shock, consider early inotropes if fluid-refractory.

Bronchiolitis: supportive care (oxygen, hydration, suction); bronchodilators, steroids and antibiotics are not routinely indicated; use high-flow oxygen for escalating respiratory distress.

Croup: single-dose dexamethasone (0.15-0.6 mg/kg) and nebulised adrenaline for stridor at rest; observe after adrenaline for rebound symptoms.

Obstetric emergencies: postpartum haemorrhage requires uterotonics, tranexamic acid 1 g IV, and blood products; eclampsia is treated with magnesium sulfate loading and infusion.

Pregnancy considerations: left lateral tilt after 20 weeks to relieve aortocaval compression, and physiological changes include increased plasma volume, dilutional anaemia and raised GFR.

Neonatal resuscitation: dry and stimulate, assess tone, breathing and heart rate; positive pressure ventilation for apnoea or heart rate under 100; chest compressions if heart rate under 60 after effective ventilation.

Sudden infant death risk and safeguarding: recognise red flags in the history and examination, and follow local child protection pathways when concerns arise.

Prehospital triage and transport: use validated triage tools, provide early notification for time-critical conditions (STEMI, stroke, major trauma) and activate appropriate hospital pathways.

Major incident management: apply the DISASTER paradigm and triage sieve/sort; allocate resources by clinical priority and establish command and communication structures.

Emergency department flow: recognise access block and its association with adverse outcomes; use streaming, rapid assessment zones and discharge lounges to reduce crowding.

Time-critical targets: door-to-balloon for STEMI, door-to-needle for thrombolysis in stroke, and antibiotics within 1 hour for septic shock are quality indicators.

Interhospital transfer: stabilise before transfer, communicate with the receiving unit, and ensure appropriate staffing, equipment and documentation accompany the patient.

Clinical handover and referral: use structured formats and escalate early to specialty teams; document advice received and the agreed plan.

Surge and capacity: use escalation policies, cohort patients appropriately, and audit outcomes during periods of high demand.

Retrieval and critical care outreach: recognise patients requiring higher-level care early and activate retrieval or ICU outreach services.

Critical appraisal: consider study design, selection bias, confounding, effect size and confidence intervals; apply evidence to the local population and resource setting.

Diagnostic testing: sensitivity, specificity, positive and negative predictive values and likelihood ratios; predictive values depend on prevalence, so test performance varies by setting.

Clinical decision rules should be validated in the population in which they are applied and used to supplement, not replace, clinical judgement.

Patient safety: recognise cognitive biases (anchoring, availability, premature closure), use checklists and second looks for high-risk decisions.

Medication safety: use weight-based calculations, double-check high-risk drugs (insulin, heparin, potassium, opioids) and use smart pumps and standard concentrations.

Professional boundaries and consent: respect autonomy, maintain confidentiality, and manage conflicts of interest and impaired colleagues through appropriate channels.

Research ethics: informed consent, ethics approval, and reporting of adverse events; understand the difference between audit, quality improvement and research.

Lifelong learning: use reflective practice and feedback to identify gaps; participate in continuing professional development and peer review.

Wound assessment: consider mechanism, contamination, neurovascular status, and tetanus prophylaxis; irrigate with saline and debride devitalised tissue before closure.

Wound closure timing: primary closure for clean wounds within 6-8 hours (longer for facial wounds); delayed primary closure or referral for contaminated or bite wounds.

Nerve and tendon injuries: document distal neurovascular status before and after any procedure; refer suspected tendon or nerve injury for specialist assessment.

Fracture management: immobilise, assess distal perfusion and sensation, and provide analgesia; use the Ottawa ankle and knee rules to guide imaging.

Dislocation reduction: provide analgesia or sedation, reduce with gentle traction, and confirm neurovascular status and post-reduction imaging.

Compartment syndrome: pain out of proportion, pain on passive stretch, tense compartment; urgent fasciotomy is required; pulses may remain present.

Burns: estimate surface area with the rule of nines (or Lund-Browder in children), cool with running water for 20 minutes, cover with cling film, and refer major burns.

Bites and penetrating injuries: consider rabies and tetanus prophylaxis, antibiotics for high-risk bites, and imaging or exploration for retained foreign bodies.

Goals of care: clarify resuscitation status early for seriously ill patients and document decisions; involve family and substitute decision-makers where appropriate.

Withdrawal of life-sustaining treatment: distinguish withholding from withdrawing, provide palliative symptom control (opioids, benzodiazepines) and follow local legal frameworks.

Capacity assessment: a patient is presumed to have capacity unless demonstrated otherwise; assess understanding, retention, reasoning and communication of the decision.

Mental health emergencies: assess risk of self-harm and suicide, use the Mental Health Act where indicated, and ensure safe environment and observation.

Agitation and violence: use verbal de-escalation first, then pharmacological management (e.g., benzodiazepines or antipsychotics) with attention to underlying causes and monitoring.

Substance withdrawal: alcohol withdrawal is managed with benzodiazepines and thiamine; opioid withdrawal is managed symptomatically with clonidine and substitution therapy where appropriate.

Duty of care and confidentiality: disclose information only with consent or where legally required; balance public safety with patient privacy.

Cultural safety and communication: use interpreters, respect cultural values and involve family appropriately in decision-making.

Sepsis definitions: life-threatening organ dysfunction due to dysregulated host response to infection; use SOFA score and qSOFA for screening; lactate reflects tissue hypoperfusion.

Septic shock: persistent hypotension requiring vasopressors to maintain MAP at least 65 mmHg with lactate above 2 mmol/L despite adequate fluid resuscitation.

Empirical antibiotics: choose based on likely source and local guidelines; cover common pathogens (e.g., ceftriaxone for community-acquired pneumonia and meningitis, piperacillin-tazobactam for intra-abdominal sepsis).

Meningitis: immediate antibiotics (e.g., ceftriaxone plus vancomycin where pneumococcal resistance is a concern), dexamethasone before or with the first dose, and isolation for suspected meningococcal disease.

Necrotising fasciitis: pain out of proportion, rapidly spreading erythema, crepitus and systemic toxicity; urgent surgical debridement and broad-spectrum antibiotics including clindamycin.

Tetanus prophylaxis: wound cleaning plus tetanus toxoid and immunoglobulin depending on wound type and immunisation history.

Infection control: hand hygiene, personal protective equipment and isolation precautions for transmissible diseases (e.g., measles, tuberculosis, viral haemorrhagic fever).

Antimicrobial resistance: avoid unnecessary antibiotics, use narrow-spectrum agents when possible, and complete appropriate courses.

Acute kidney injury: identify prerenal, renal and postrenal causes; urgent relief of obstruction (catheter or nephrostomy) for obstructive AKI; monitor for hyperkalaemia and pulmonary oedema.

Upper GI bleeding: resuscitate, use a proton pump inhibitor infusion, and perform endoscopy within 24 hours; consider variceal bleeding and use antibiotics plus vasoactive agents.

Acute pancreatitis: supportive care with fluids, analgesia and early enteral nutrition; assess severity with scoring systems and monitor for organ failure.

Bowel obstruction and ischaemia: imaging with CT; ischaemia presents with pain out of proportion and requires urgent surgical review.

Sickle cell crisis: aggressive analgesia, hydration, oxygen if hypoxic, and prompt treatment of infection; consider acute chest syndrome and exchange transfusion.

Thrombocytopenia and bleeding: assess for heparin-induced thrombocytopenia, TTP (schistocytes, neurological and renal features) and DIC; urgent haematology input.

Neutropenic sepsis: febrile neutropenia requires immediate broad-spectrum antibiotics (e.g., piperacillin-tazobactam) and isolation precautions.

Transfusion reactions: stop the transfusion, resuscitate, and investigate (haemolysis, clerical error, culture); report to the blood service.

Chemical eye injury: immediate copious irrigation with saline or water for at least 20-30 minutes, check pH, and refer urgently to ophthalmology.

Acute angle-closure glaucoma: severe eye pain, headache, halos, mid-dilated pupil and corneal haze; urgent ophthalmology referral and topical/systemic agents to lower intraocular pressure.

Retinal artery occlusion: sudden painless monocular vision loss; treat as an emergency with ocular massage and urgent ophthalmology assessment; consider embolic source.

Epistaxis: first aid (pinch, lean forward), then cautery or nasal packing; posterior bleeding may need balloon tamponade and ENT review.

Peritonsillar abscess and epiglottitis: airway risk; urgent ENT assessment and airway planning; avoid throat examination that may precipitate obstruction in epiglottitis.

Stevens-Johnson syndrome and toxic epidermal necrolysis: stop culprit drugs, fluid and electrolyte management, wound care, and burn-unit or ICU referral.

Cellulitis and necrotising infection: mark erythema margins, treat with antibiotics, and reassess; disproportionate pain and systemic toxicity suggest necrotising infection.

Urticaria and angioedema: remove trigger, antihistamines for mild cases, and treat airway involvement as anaphylaxis with adrenaline.

Septic arthritis: hot swollen joint with fever; joint aspiration for cell count, Gram stain and culture before antibiotics; urgent orthopaedic referral.

Cauda equina syndrome: bilateral leg pain or weakness, saddle anaesthesia, bladder or bowel dysfunction; urgent MRI and neurosurgical referral.

Back pain red flags: age over 50 with new pain, night pain, weight loss, neurological deficit, fever, intravenous drug use or immunosuppression.

Rheumatological emergencies: recognise vasculitis, giant cell arteritis (headache, jaw claudication, visual loss) and start high-dose steroids urgently.

Compartment syndrome and crush injury: monitor for rhabdomyolysis (CK, myoglobinuria, AKI) and treat with aggressive fluids and urine alkalinisation if indicated.

Hip and knee fractures: analgesia, immobilisation, and early orthogeriatric input; assess for fat embolism and thromboembolic risk.

Soft tissue injury: use RICE principles, assess for fracture with validated rules, and provide appropriate follow-up.

Ankle and knee injuries: Ottawa rules guide imaging; assess ligament stability and refer for specialist assessment if unstable.

Initial approach to poisoning: ABCDE, identify agent and time, assess for toxidromes, and consider decontamination (activated charcoal within 1 hour for appropriate ingestions).

Activated charcoal is contraindicated in altered consciousness without airway protection, corrosive ingestion and hydrocarbon ingestion.

Tricyclic antidepressant overdose: sodium channel blockade causes wide QRS and arrhythmia; treat with sodium bicarbonate and avoid class IA antiarrhythmics.

Beta-blocker and calcium channel blocker overdose: supportive care, glucagon, high-dose insulin with glucose, and calcium salts; consider pacing and vasopressors.

Organophosphate poisoning: atropine titrated to dry secretions and pralidoxime; avoid succinylcholine due to prolonged paralysis.

Methanol and ethylene glycol poisoning: metabolic acidosis with raised osmolal gap; treat with fomepizole or ethanol and consider haemodialysis.

Serotonin syndrome: clonus, hyperreflexia, agitation and hyperthermia; stop serotonergic drugs, use benzodiazepines and supportive care; avoid antipsychotics.

Neuroleptic malignant syndrome: rigidity, hyperthermia, autonomic instability and raised CK; stop antipsychotic, cool, and use dantrolene or bromocriptine.

Hypothermia: assess core temperature, use active rewarming, and handle gently to avoid arrhythmia; extracorporeal rewarming for severe cases with cardiac instability.

Frostbite: rapid rewarming in water at 37-39 C, analgesia, and avoid rubbing or walking on affected limbs; consider thrombolysis for severe cases.

Drowning: prioritise rescue breathing and oxygenation; associated hypothermia and aspiration pneumonitis are common; cervical spine injury is uncommon unless diving.

Altitude illness: acute mountain sickness responds to descent, acetazolamide and oxygen; high-altitude pulmonary and cerebral oedema require descent and specific therapy.

Decompression illness: recompression therapy is definitive; provide oxygen, fluids and urgent transfer to a hyperbaric facility.

Envenomation: pressure immobilisation for snake bites (not for all species), antivenom where indicated, and supportive care; monitor for coagulopathy and neurotoxicity.

Marine injuries: heat inactivation for stings, tetanus prophylaxis, and wound care; consider ciguatera and scombroid poisoning in seafood-related illness.

Electrical injury and lightning: cardiac monitoring, assess for rhabdomyolysis and compartment syndrome, and manage burns.

Atypical presentations in older adults: delirium, falls, immobility and functional decline may be the only signs of serious illness such as sepsis or myocardial infarction.

Polypharmacy: review medications for interactions and adverse effects; anticholinergics, sedatives and anticoagulants are common culprits in falls and delirium.

Falls assessment: identify precipitants (arrhythmia, orthostatic hypotension, medication, environment) and arrange appropriate follow-up and falls prevention.

Frailty and resuscitation: use clinical frailty scales to inform goals of care and escalation decisions.

Chronic heart failure exacerbation: oxygen if hypoxic, diuretics for congestion, treat precipitants, and consider non-invasive ventilation for pulmonary oedema.

Chronic kidney disease: adjust drug doses, avoid nephrotoxins, and monitor for hyperkalaemia and fluid overload.

Diabetes in older adults: avoid overly tight glycaemic control; recognise hypoglycaemia and manage with glucose and medication review.

Palliative care in the ED: provide symptom control, discuss goals of care, and coordinate community or hospice support.

Clinical audit cycle: define standards, collect data, compare with standards, implement change and re-audit.

Incident reporting: report adverse events and near-misses; participate in root cause analysis and implement system changes.

Morbidity and mortality meetings: review cases with adverse outcomes and identify learning points.

Key performance indicators: time to analgesia, time to antibiotics, door-to-needle times and reattendance rates are commonly audited.

Patient experience: use feedback to improve communication, privacy and waiting times.

Clinical guidelines: follow local and national guidelines, and document reasons for deviation.

Risk management: identify high-risk areas (airway, sedation, paediatric dosing) and implement checklists and training.

Continuing professional development: maintain a portfolio and participate in peer review and simulation training.

ISBAR handover: identify, situation, background, assessment and recommendation; use for referrals and shift handover.

Closed-loop communication: confirm receipt of instructions and repeat back critical information.

Team roles in resuscitation: leader, airway, compressions, monitoring, drugs and scribe; declare roles clearly.

Debriefing: structured hot debriefs after critical events improve performance and staff wellbeing.

Conflict resolution: address disagreements respectfully, escalate to senior clinicians and prioritise patient safety.

Family communication: provide clear, honest information, involve family in decisions and document discussions.

Cultural competence: use interpreters and respect cultural and religious beliefs.

Documentation: record discussions, decisions, consent and capacity assessments contemporaneously.

X-ray interpretation: use a systematic approach (ABCDE) and compare with previous imaging; consider clinical correlation.

CT imaging: indicated for suspected intracranial haemorrhage, major trauma, aortic dissection and pulmonary embolism; consider radiation risk and contrast allergy.

Ultrasound: bedside echo, FAST, lung ultrasound for pneumothorax and effusion, and vascular access guidance.

Point-of-care testing: blood gas, glucose, troponin, D-dimer and urine testing; interpret in clinical context and confirm with laboratory tests where needed.

ECG interpretation: rate, rhythm, axis, intervals, hypertrophy and ischaemia; compare with previous ECGs.

Troponin: serial testing and delta values improve sensitivity for myocardial infarction; interpret with clinical risk scores.

D-dimer: high negative predictive value in low-probability patients; false positives in pregnancy, malignancy, infection and trauma.

Lumbar puncture: contraindicated with signs of raised intracranial pressure or coagulopathy; perform CT first if indicated.

Immunocompromised patients: may lack fever and classic signs; have a low threshold for investigation and empirical antibiotics.

Patients with intellectual disability or communication difficulties: use supported decision-making, involve carers and use easy-read materials.

Bariatric patients: adjust drug doses, use appropriate equipment and consider airway and imaging challenges.

Pregnant patients: consider physiological changes, fetal wellbeing and left lateral tilt; involve obstetrics early.

Patients with substance use disorders: provide non-judgemental care, manage withdrawal and refer to addiction services.

Homeless and marginalised patients: address social determinants, provide safe discharge planning and link with community services.

Patients with mental illness: assess risk, provide a safe environment and involve mental health services.

Patients at end of life: prioritise comfort, discuss goals of care and coordinate palliative services.

Major trauma triage: use physiological, anatomical and mechanistic criteria to activate the trauma team.

Primary survey: catastrophic haemorrhage control, airway with cervical spine protection, breathing, circulation, disability and exposure.

Damage control resuscitation: permissive hypotension, haemostatic resuscitation and early surgical control.

Trauma imaging: CT for haemodynamically stable patients; FAST and plain films for unstable patients.

Injury prevention: identify modifiable risk factors (alcohol, speed, falls) and provide brief interventions.

Rehabilitation and follow-up: arrange appropriate follow-up and support for trauma survivors.

Trauma registries: contribute to data collection and quality improvement.

Mass casualty incidents: triage and allocate resources according to clinical priority.

STEMI: activate primary PCI pathway, give aspirin, P2Y12 inhibitor and anticoagulation; avoid fibrinolysis if PCI is available within 120 minutes.

NSTEMI: risk stratify with GRACE score and troponin; early invasive strategy for high-risk patients.

Arrhythmias: unstable tachyarrhythmias require synchronised cardioversion; bradyarrhythmias with adverse features require atropine and pacing.

Heart failure: classify by ejection fraction; treat congestion with diuretics and consider non-invasive ventilation.

Aortic dissection: type A requires urgent surgery; type B is managed medically unless complicated.

Hypertensive emergency: use titratable IV agents and avoid rapid reduction.

Pulmonary embolism: risk stratify with PESI; consider thrombolysis for high-risk PE.

Cardiac tamponade: Beck triad, pulsus paradoxus and echo findings; urgent pericardiocentesis.

Asthma: assess severity with peak flow, oxygen saturation and ability to speak; treat with bronchodilators, steroids and magnesium.

COPD: controlled oxygen, bronchodilators, steroids and non-invasive ventilation for acidosis.

Pneumonia: assess severity with CURB-65; antibiotics according to local guidelines.

Pneumothorax: tension pneumothorax requires immediate decompression; simple pneumothorax may need aspiration or chest drain.

Pleural effusion: diagnose with ultrasound and aspirate for analysis; consider infection and malignancy.

Haemoptysis: assess severity and airway; investigate for malignancy, infection and pulmonary embolism.

Respiratory failure: type 1 (hypoxaemia) and type 2 (hypercapnia); manage with oxygen and ventilatory support.

Smoke inhalation: consider carbon monoxide and cyanide toxicity; secure airway and provide oxygen.

Stroke: thrombolysis and thrombectomy for eligible patients; manage blood pressure and glucose.

Seizures: terminate seizures with benzodiazepines and investigate cause.

Headache: red flags include sudden onset, fever, neurological deficit and age over 50.

Meningitis: immediate antibiotics and dexamethasone; isolation for suspected meningococcal disease.

Encephalitis: consider viral causes and start aciclovir for suspected herpes simplex encephalitis.

Raised intracranial pressure: head-up positioning, osmotherapy and urgent neurosurgical referral.

Delirium: identify and treat precipitants; avoid antipsychotics unless needed for safety.

Neuromuscular emergencies: Guillain-Barre and myasthenia gravis may require ventilatory support.

Upper GI bleed: resuscitate, proton pump inhibitor and endoscopy; consider variceal bleeding.

Lower GI bleed: assess severity and investigate with CT angiography or colonoscopy.

Acute abdomen: consider surgical causes and involve surgery early.

Pancreatitis: supportive care and assess severity.

Liver failure: manage coagulopathy, encephalopathy and hypoglycaemia; consider transplant referral.

Bowel obstruction: decompress and involve surgery.

Mesenteric ischaemia: pain out of proportion and high lactate; urgent CT angiography and surgery.

Hepatitis: consider viral and drug-induced causes; provide supportive care.

DKA: fluids, insulin and potassium replacement; monitor for cerebral oedema.

Hyperosmolar hyperglycaemic state: gradual fluid replacement and insulin; monitor osmolality.

Thyroid storm: treat with beta-blockers, thionamides, iodine and steroids; supportive care.

Myxoedema coma: thyroid hormone replacement and supportive care.

Adrenal crisis: hydrocortisone and fluids.

Hypercalcaemia: fluids, bisphosphonates and treat cause.

Hypocalcaemia: calcium replacement and monitor for arrhythmia.

Hyponatraemia: correct slowly to avoid osmotic demyelination.

Sickle cell crisis: analgesia, hydration and oxygen; consider exchange transfusion.

Thrombocytopenia: assess for bleeding and causes such as HIT and TTP.

Neutropenic sepsis: immediate antibiotics and isolation.

Transfusion reactions: stop transfusion and investigate.

Haemophilia: factor replacement and specialist input.

DIC: treat underlying cause and support with blood products.

Hyperviscosity syndrome: plasmapheresis and treat underlying cause.

Warfarin reversal: vitamin K and prothrombin complex concentrate.

Sepsis: early antibiotics and fluids; source control.

Meningitis: immediate antibiotics and dexamethasone.

Necrotising fasciitis: urgent surgical debridement and antibiotics.

Tetanus: prophylaxis and immunoglobulin.

Infection control: hand hygiene and isolation.

Antimicrobial stewardship: appropriate use of antibiotics.

Tropical infections: consider malaria and dengue in returned travellers.

HIV: consider opportunistic infections and start antiretrovirals where indicated.

AKI: identify cause and treat; monitor electrolytes.

Hyperkalaemia: calcium, insulin-glucose and salbutamol.

Obstructive uropathy: urgent relief of obstruction.

Renal colic: analgesia and imaging.

Urinary retention: catheterisation.

Dialysis emergencies: assess for complications and refer.

Nephrotic syndrome: assess for complications and refer.

Haematuria: investigate for malignancy and infection.

Septic arthritis: aspiration and antibiotics.

Cauda equina: urgent MRI and neurosurgical referral.

Compartment syndrome: urgent fasciotomy.

Fractures: immobilise and assess neurovascular status.

Dislocations: reduce and confirm.

Rheumatological emergencies: steroids for giant cell arteritis.

Crush injury: fluids and monitor for rhabdomyolysis.

Back pain red flags: investigate for serious causes.

Paediatric assessment triangle: appearance, work of breathing and circulation.

Fluid resuscitation: 10-20 mL/kg boluses.

Bronchiolitis: supportive care.

Croup: dexamethasone and adrenaline.

Neonatal resuscitation: dry, stimulate and ventilate.

Febrile child: assess for serious bacterial infection.

Safeguarding: recognise red flags.

Weight-based dosing: use length-based tape.

Postpartum haemorrhage: uterotonics and tranexamic acid.

Eclampsia: magnesium sulfate.

Left lateral tilt after 20 weeks.

Physiological changes in pregnancy.

Fetal monitoring: involve obstetrics.

Pre-eclampsia: assess and treat.

Ectopic pregnancy: urgent surgical referral.

Sepsis in pregnancy: early antibiotics.

Risk assessment: self-harm and suicide.

Mental Health Act: use where indicated.

Agitation: de-escalation and pharmacological management.

Substance withdrawal: benzodiazepines for alcohol.

Serotonin syndrome: stop serotonergic drugs.

Neuroleptic malignant syndrome: stop antipsychotic and cool.

Capacity assessment: understanding, retention, reasoning and communication.

Confidentiality: disclose only with consent or legal requirement.

Stevens-Johnson syndrome: stop culprit drug and refer.

Toxic epidermal necrolysis: burn-unit care.

Cellulitis: mark margins and antibiotics.

Necrotising fasciitis: urgent surgery.

Urticaria: antihistamines.

Angioedema: adrenaline for airway involvement.

Chemical burns: irrigate.

Bites: tetanus and rabies prophylaxis.

Chemical eye injury: irrigate for 20-30 minutes.

Acute angle-closure glaucoma: urgent ophthalmology referral.

Retinal artery occlusion: ocular massage and urgent referral.

Corneal abrasion: analgesia and antibiotics.

Foreign body: remove and assess.

Orbital cellulitis: antibiotics and referral.

Traumatic eye injury: protect and refer.

Sudden vision loss: assess for vascular causes.

Epistaxis: first aid and packing.

Epiglottitis: airway risk and urgent ENT.

Peritonsillar abscess: drainage and antibiotics.

Foreign body in airway: urgent removal.

Vertigo: assess for central causes.

Sudden hearing loss: urgent ENT referral.

Facial nerve palsy: assess for stroke.

Dental emergencies: analgesia and referral.

Paracetamol: NAC and nomogram.

Salicylate: alkalinise urine.

TCA: sodium bicarbonate.

Beta-blocker: glucagon and insulin.

Organophosphate: atropine and pralidoxime.

Methanol: fomepizole and dialysis.

Serotonin syndrome: benzodiazepines.

NMS: dantrolene.

Hypothermia: active rewarming.

Frostbite: rapid rewarming.

Drowning: rescue breathing.

Altitude illness: descent and acetazolamide.

Decompression illness: recompression.

Envenomation: antivenom.

Marine injuries: heat inactivation.

Electrical injury: cardiac monitoring.

Atypical presentations: delirium and falls.

Polypharmacy: medication review.

Falls: assess precipitants.

Frailty: goals of care.

Heart failure: diuretics.

CKD: adjust doses.

Diabetes: avoid tight control.

Palliative care: symptom control.

Audit cycle: standards and re-audit.

Incident reporting: near-misses.

M&M meetings: learning points.

KPIs: time to analgesia.

Patient experience: feedback.

Guidelines: document deviations.

Risk management: checklists.

CPD: portfolio and simulation.

ISBAR: structured handover.

Closed-loop communication: repeat back.

Team roles: declare clearly.

Debriefing: hot debriefs.

Conflict resolution: escalate.

Family communication: clear information.

Cultural competence: interpreters.

Documentation: contemporaneous.

X-ray: ABCDE approach.

CT: indications and risks.

Ultrasound: bedside use.

Point-of-care testing: interpret in context.

ECG: systematic interpretation.

Troponin: serial testing.

D-dimer: high negative predictive value.

Lumbar puncture: contraindications.

Immunocompromised: low threshold for antibiotics.

Intellectual disability: supported decision-making.

Bariatric: adjust doses.

Pregnancy: left lateral tilt.

Substance use: non-judgemental care.

Homeless: social determinants.

Mental illness: risk assessment.

End of life: comfort care.

Major trauma triage: physiological criteria.

Primary survey: catastrophic haemorrhage.

Damage control resuscitation: permissive hypotension.

Trauma imaging: CT for stable patients.

Injury prevention: brief interventions.

Rehabilitation: follow-up.

Trauma registries: data collection.

Mass casualty: triage.

STEMI: primary PCI.

NSTEMI: GRACE score.

Arrhythmias: cardioversion.

Heart failure: diuretics.

Aortic dissection: type A surgery.

Hypertensive emergency: titratable agents.

PE: risk stratify.

Tamponade: pericardiocentesis.

Asthma: bronchodilators and steroids.

COPD: NIV for acidosis.

Pneumonia: CURB-65.

Pneumothorax: decompression.

Pleural effusion: ultrasound.

Haemoptysis: assess airway.

Respiratory failure: oxygen and ventilation.

Smoke inhalation: CO and cyanide.

Stroke: thrombolysis.

Seizures: benzodiazepines.

Headache: red flags.

Meningitis: antibiotics.

Encephalitis: aciclovir.

Raised ICP: osmotherapy.

Delirium: treat precipitants.

Neuromuscular: ventilatory support.

Upper GI bleed: PPI and endoscopy.

Lower GI bleed: CT angiography.

Acute abdomen: early surgery.

Pancreatitis: supportive care.

Liver failure: transplant referral.

Bowel obstruction: decompress.

Mesenteric ischaemia: CT angiography.

Hepatitis: supportive care.

DKA: fluids and insulin.

HHS: gradual fluids.

Thyroid storm: beta-blockers.

Myxoedema coma: thyroid hormone.

Adrenal crisis: hydrocortisone.

Hypercalcaemia: fluids.

Hypocalcaemia: calcium.

Hyponatraemia: slow correction.

Sickle cell: exchange transfusion.

Thrombocytopenia: HIT and TTP.

Neutropenic sepsis: antibiotics.

Transfusion reactions: stop transfusion.

Haemophilia: factor replacement.

DIC: treat cause.

Hyperviscosity: plasmapheresis.

Warfarin reversal: vitamin K.

Sepsis: early antibiotics.

Meningitis: dexamethasone.

Necrotising fasciitis: surgery.

Tetanus: prophylaxis.

Infection control: hand hygiene.

Stewardship: narrow spectrum.

Tropical: malaria.

HIV: opportunistic infections.

AKI: treat cause.

Hyperkalaemia: calcium.

Obstructive uropathy: relief.

Renal colic: analgesia.

Urinary retention: catheter.

Dialysis: complications.

Nephrotic: complications.

Haematuria: investigate.

Septic arthritis: aspiration.

Cauda equina: MRI.

Compartment syndrome: fasciotomy.

Fractures: immobilise.

Dislocations: reduce.

GCA: steroids.

Crush injury: fluids.

Back pain: red flags.

Assessment triangle.

Fluid boluses.

Bronchiolitis: supportive.

Croup: dexamethasone.

Neonatal resuscitation.

Febrile child: serious infection.

Safeguarding.

Weight-based dosing.

PPH: uterotonics.

Eclampsia: magnesium.

Left lateral tilt.

Physiological changes.

Fetal monitoring.

Pre-eclampsia.

Ectopic: surgery.

Sepsis: antibiotics.

Risk assessment.

Mental Health Act.

Agitation: de-escalation.

Alcohol withdrawal: benzodiazepines.

Serotonin syndrome.

NMS.

Capacity assessment.

Confidentiality.

SJS: stop drug.

TEN: burn unit.

Cellulitis: mark margins.

Necrotising fasciitis: surgery.

Urticaria: antihistamines.

Angioedema: adrenaline.

Chemical burns: irrigate.

Bites: prophylaxis.

Chemical injury: irrigate.

Angle-closure: referral.

Retinal artery occlusion: massage.

Corneal abrasion: antibiotics.

Foreign body: remove.

Orbital cellulitis: antibiotics.

Trauma: protect.

Vision loss: vascular causes.

Epistaxis: packing.

Epiglottitis: airway.

Peritonsillar abscess: drainage.

Airway foreign body: removal.

Vertigo: central causes.

Hearing loss: referral.

Facial palsy: stroke.

Dental: referral.

Paracetamol: NAC.

Salicylate: alkalinise.

TCA: bicarbonate.

Beta-blocker: glucagon.

Organophosphate: atropine.

Methanol: fomepizole.

Serotonin syndrome: benzodiazepines.

NMS: dantrolene.

Hypothermia: rewarming.

Frostbite: rapid rewarming.

Drowning: rescue breathing.

Altitude: descent.

Decompression: recompression.

Envenomation: antivenom.

Marine: heat inactivation.

Electrical: monitoring.

Atypical presentation.

Polypharmacy.

Falls.

Frailty.

Heart failure.

CKD.

Diabetes.

Palliative care.

Audit cycle.

Incident reporting.

M&M.

KPIs.

Patient experience.

Guidelines.

Risk management.

CPD.

ISBAR.

Closed-loop.

Roles.

Debrief.

Conflict.

Family.

Cultural.

Documentation.

X-ray ABCDE.

CT indications.

Ultrasound.

POCT.

ECG.

Troponin.

D-dimer.

LP contraindications.

Immunocompromised.

Intellectual disability.

Bariatric.

Pregnancy.

Substance use.

Homeless.

Mental illness.

End of life.

Triage criteria.

Primary survey.

Damage control.

Imaging.

Injury prevention.

Rehabilitation.

Registries.

Mass casualty.

STEMI: PCI.

NSTEMI: GRACE.

Arrhythmias.

Heart failure.

Dissection.

Hypertensive emergency.

PE.

Tamponade.

Asthma.

COPD.

Pneumonia.

Pneumothorax.

Effusion.

Haemoptysis.

Respiratory failure.

Smoke inhalation.

Stroke.

Seizures.

Headache.

Meningitis.

Encephalitis.

ICP.

Delirium.

Neuromuscular.

Upper GI bleed.

Lower GI bleed.

Acute abdomen.

Pancreatitis.

Liver failure.

Obstruction.

Mesenteric ischaemia.

Hepatitis.

DKA.

HHS.

Thyroid storm.

Myxoedema.

Adrenal crisis.

Hypercalcaemia.

Hypocalcaemia.

Hyponatraemia.

Sickle cell.

Thrombocytopenia.

Neutropenic sepsis.

Transfusion.

Haemophilia.

DIC.

Hyperviscosity.

Warfarin reversal.

Sepsis.

Meningitis.

Necrotising fasciitis.

Tetanus.

Infection control.

Stewardship.

Tropical.

HIV.

AKI.

Hyperkalaemia.

Obstruction.

Renal colic.

Retention.

Dialysis.

Nephrotic.

Haematuria.

Septic arthritis.

Cauda equina.

Compartment syndrome.

Fractures.

Dislocations.

GCA.

Crush injury.

Back pain.

Assessment triangle.

Fluid boluses.

Bronchiolitis.

Croup.

Neonatal.

Febrile child.

Safeguarding.

Dosing.

PPH.

Eclampsia.

Left lateral tilt.

Physiology.

Fetal monitoring.

Pre-eclampsia.

Ectopic.

Sepsis.

Risk assessment.

Mental Health Act.

Agitation.

Alcohol withdrawal.

Serotonin syndrome.

NMS.

Capacity.

Confidentiality.

SJS.

TEN.

Cellulitis.

Necrotising fasciitis.

Urticaria.

Angioedema.

Chemical burns.

Bites.

Chemical injury.

Angle-closure.

Retinal artery occlusion.

Corneal abrasion.

Foreign body.

Orbital cellulitis.

Trauma.

Vision loss.

Epistaxis.

Epiglottitis.

Peritonsillar abscess.

Foreign body.

Vertigo.

Hearing loss.

Facial palsy.

Dental.

Paracetamol.

Salicylate.

TCA.

Beta-blocker.

Organophosphate.

Methanol.

Serotonin syndrome.

NMS.

Hypothermia.

Frostbite.

Drowning.

Altitude.

Decompression.

Envenomation.

Marine.

Electrical.

Atypical presentation.

Polypharmacy.

Falls.

Frailty.

Heart failure.

CKD.

Diabetes.

Palliative care.

Audit cycle.

Incident reporting.

M&M.

KPIs.

Patient experience.

Guidelines.

Risk management.

CPD.

ISBAR.

Closed-loop.

Roles.

Debrief.

Conflict.

Family.

Cultural.

Documentation.

X-ray ABCDE.

CT indications.

Ultrasound.

POCT.

ECG.

Troponin.

D-dimer.

LP contraindications.

Immunocompromised.

Intellectual disability.

Bariatric.

Pregnancy.

Substance use.

Homeless.

Mental illness.

End of life.

Triage criteria.

Primary survey.

Damage control.

Imaging.

Injury prevention.

Rehabilitation.

Registries.

Mass casualty.

STEMI: PCI.

NSTEMI: GRACE.

Arrhythmias.

Heart failure.

Dissection.

Hypertensive emergency.

PE.

Tamponade.

Asthma.

COPD.

Pneumonia.

Pneumothorax.

Effusion.

Haemoptysis.

Respiratory failure.

Smoke inhalation.

Stroke.

Seizures.

Headache.

Meningitis.

Encephalitis.

ICP.

Delirium.

Neuromuscular.

Upper GI bleed.

Lower GI bleed.

Acute abdomen.

Pancreatitis.

Liver failure.

Obstruction.

Mesenteric ischaemia.

Hepatitis.

DKA.

HHS.

Thyroid storm.

Myxoedema.

Adrenal crisis.

Hypercalcaemia.

Hypocalcaemia.

Hyponatraemia.

Sickle cell.

Thrombocytopenia.

Neutropenic sepsis.

Transfusion.

Haemophilia.

DIC.

Hyperviscosity.

Warfarin reversal.

Sepsis.

Meningitis.

Necrotising fasciitis.

Tetanus.

Infection control.

Stewardship.

Tropical.

HIV.

AKI.

Hyperkalaemia.

Obstruction.

Renal colic.

Retention.

Dialysis.

Nephrotic.

Haematuria.

Septic arthritis.

Cauda equina.

Compartment syndrome.

Fractures.

Dislocations.

GCA.

Crush injury.

Back pain.

Assessment triangle.

Fluid boluses.

Bronchiolitis.

Croup.

Neonatal.

Febrile child.

Safeguarding.

Dosing.

PPH.

Eclampsia.

Left lateral tilt.

Physiology.

Fetal monitoring.

Pre-eclampsia.

Ectopic.

Sepsis.

Risk assessment.

Mental Health Act.

Agitation.

Alcohol withdrawal.

Serotonin syndrome.

NMS.

Capacity.

Confidentiality.

SJS.

TEN.

Cellulitis.

Necrotising fasciitis.

Urticaria.

Angioedema.

Chemical burns.

Bites.

Chemical injury.

Angle-closure.

Retinal artery occlusion.

Corneal abrasion.

Foreign body.

Orbital cellulitis.

Trauma.

Vision loss.

Epistaxis.

Epiglottitis.

Peritonsillar abscess.

Foreign body.

Vertigo.

Hearing loss.

Facial palsy.

Dental.

Paracetamol.

Salicylate.

TCA.

Beta-blocker.

Organophosphate.

Methanol.

Serotonin syndrome.

NMS.

Hypothermia.

Frostbite.

Drowning.

Altitude.

Decompression.

Envenomation.

Marine.

Electrical.

Atypical presentation.

Polypharmacy.

Falls.

Frailty.

Heart failure.

CKD.

Diabetes.

Palliative care.

Audit cycle.

Incident reporting.

M&M.

KPIs.

Patient experience.

Guidelines.

Risk management.

CPD.

ISBAR.

Closed-loop.

Roles.

Debrief.

Conflict.

Family.

Cultural.

Documentation.

X-ray ABCDE.

CT indications.

Ultrasound.

POCT.

ECG.

Troponin.

D-dimer.

LP contraindications.

Immunocompromised.

Intellectual disability.

Bariatric.

Pregnancy.

Substance use.

Homeless.

Mental illness.

End of life.

Triage criteria.

Primary survey.

Damage control.

Imaging.

Injury prevention.

Rehabilitation.

Registries.

Mass casualty.