ACEM Fellowship Written key terms

The process of rapidly sorting patients by urgency so that limited resources are directed first to those with immediately life-threatening conditions, using physiological and presenting-complaint criteria.

A structured, sequential assessment of airway, breathing, circulation, disability and exposure designed to identify and treat immediately life-threatening problems before secondary assessment begins.

The set of interventions, from positioning and suction to supraglottic devices and intubation, used to maintain or restore a patent airway and adequate oxygenation and ventilation.

The coordinated administration of a sedative and a neuromuscular blocker in quick succession to facilitate emergency tracheal intubation while minimising aspiration risk and time without airway protection.

Pharmacological paralysis of skeletal muscle, used to facilitate intubation or procedures, which abolishes respiratory effort and mandates immediate control of the airway and ventilation.

A state of inadequate tissue perfusion and oxygen delivery relative to metabolic demand, producing cellular dysfunction that may progress to organ failure and death if not reversed promptly.

The average arterial pressure across the cardiac cycle, estimated as one-third systolic plus two-thirds diastolic pressure, used to gauge adequacy of organ perfusion.

The controlled administration of intravenous crystalloid or blood products to restore intravascular volume and perfusion in haemorrhage, dehydration or distributive shock states.

A strategy in major haemorrhage combining permissive hypotension, early balanced blood component transfusion and rapid control of bleeding, limiting large-volume crystalloid that worsens coagulopathy.

A pre-defined, rapidly activated system for delivering large volumes of balanced blood components with laboratory support, used in severe haemorrhage to prevent dilutional and metabolic complications.

A metabolite measured in venous or arterial blood that rises with anaerobic metabolism and impaired clearance, serving as a marker of hypoperfusion and a guide to resuscitation response.

Life-threatening organ dysfunction caused by a dysregulated host response to infection, identified clinically by an acute rise in organ dysfunction scores in a patient with suspected infection.

A subset of sepsis with persisting hypotension requiring vasopressor therapy to maintain adequate mean arterial pressure and with elevated lactate despite adequate fluid resuscitation.

A drug that constricts blood vessels to raise systemic vascular resistance and blood pressure, used when fluid administration alone fails to restore adequate perfusion pressure.

A spectrum of myocardial ischaemia presentations, including unstable angina, non-ST-elevation and ST-elevation myocardial infarction, requiring urgent risk stratification and reperfusion decisions.

Acute myocardial infarction with characteristic ST-segment elevation on electrocardiography, indicating transmural ischaemia and prompting emergency reperfusion by primary angioplasty or thrombolysis.

A cardiac muscle protein released into blood when myocytes are injured, measured serially to detect myocardial infarction, with interpretation requiring attention to timing, assay type and alternative causes.

Administration of a fibrin-dissolving drug to restore perfusion in an occluded vessel, used in selected myocardial infarction, stroke and massive pulmonary embolism when definitive therapy is unavailable or delayed.

Sudden focal neurological deficit from vascular causes, either ischaemic or haemorrhagic, requiring urgent neuroimaging and time-critical decisions about reperfusion or haemostatic therapy.

A scored assessment of eye opening, verbal response and motor response that quantifies level of consciousness and supports serial monitoring and prognostication in neurological injury.

Prolonged or repeated seizures without recovery between them, treated as a medical emergency with staged anticonvulsant therapy alongside investigation of precipitants and airway protection.

A severe, rapidly developing multisystem hypersensitivity reaction involving airway, breathing or circulation, treated immediately with intramuscular adrenaline and supportive measures.

Rapid accumulation of fluid in the lungs causing severe breathlessness and hypoxia, commonly from cardiac failure, managed with oxygen, ventilation support, diuresis and treatment of the precipitant.

Delivery of positive pressure through a tight-fitting mask to support breathing without an artificial airway, used in selected respiratory failure and pulmonary oedema while the patient remains cooperative.

Toxicity from exposure to a drug, chemical or biological substance, assessed by history, toxidrome recognition and targeted investigations, with treatment ranging from observation to antidotes and decontamination.

A recognisable constellation of clinical features, such as cholinergic, anticholinergic, opioid or sympathomimetic patterns, that suggests a class of poisoning and guides early management.

A substance that specifically counteracts the toxic effect of a particular poison, for example naloxone for opioids, used alongside supportive care rather than as a substitute for it.

Breakdown of skeletal muscle releasing myoglobin and intracellular contents into circulation, risking acute kidney injury and electrolyte disturbance, treated with aggressive intravenous fluids and monitoring.

Systemic consequences of prolonged muscle compression, including rhabdomyolysis, hyperkalaemia and hypovolaemia, which may worsen acutely when the compressing force is released.

Abnormally high serum potassium that destabilises cardiac conduction and can cause fatal arrhythmia, managed with membrane stabilisation, intracellular shifting and definitive potassium removal.

A rapid bedside ultrasound examination of pericardial, pleural and peritoneal spaces to detect free fluid or blood, used to guide resuscitation and operative decisions in injured patients.

A systematic head-to-toe examination and history taken after the primary survey and initial stabilisation, aiming to identify all remaining injuries and comorbidities.

A validated tool combining history, examination and test findings to estimate the probability of a condition and support decisions about investigation, treatment or discharge.

The use of scores and clinical features to categorise patients by likelihood of adverse outcome, guiding disposition, intensity of monitoring and choice of investigation or treatment.

The proportion of people with a condition who are correctly identified by a test, reflecting its ability to rule out disease when negative and its usefulness for screening.

The proportion of people without a condition who are correctly identified as negative by a test, reflecting its ability to rule in disease when positive.

The framework of accountability, standards, audit, incident review and education through which a health service assures and improves the quality and safety of the care it delivers.