Emergency Medical Care and Critical Conditions
What candidates must know
Emergency care questions test structured assessment and time-critical decisions. Master the ABCDE approach (airway, breathing, circulation, disability, exposure) and the primary versus secondary survey. Know the management of cardiac arrest (high-quality compressions, early defibrillation for shockable rhythms), anaphylaxis (intramuscular epinephrine first-line), status epilepticus, acute asthma exacerbation, and opioid overdose. Understand shock classification - hypovolemic, cardiogenic, distributive, obstructive - and initial fluid strategy. Learn triage categories and mass-casualty principles, plus the recognition of life-threatening conditions: tension pneumothorax, cardiac tamponade, and severe hyperkalemia.
Traps in questions
A common trap is offering a diagnostic test when an immediate intervention is required; in unstable patients, the answer is usually a bedside action. Another trap is the sequence of drugs in cardiac arrest - epinephrine timing differs by rhythm, and amiodarone follows defibrillation in refractory ventricular fibrillation. Anaphylaxis questions often include antihistamines as a distractor; intramuscular epinephrine into the lateral thigh remains first-line. Watch for stems asking what to do first versus next.
Worked example: rule of thumb
A patient with sudden dyspnea, unilateral absent breath sounds, and hypotension after chest trauma: the answer is immediate needle decompression, not chest radiography. Rule of thumb: for the four lethal chest conditions (tension pneumothorax, tamponade, massive hemothorax, flail chest), intervene before imaging. In shock, give a bolus of isotonic crystalloid and reassess; persistent hypotension after fluids prompts vasopressors and a search for obstructive causes.