EBEEM flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Primary survey sequence

Catastrophic haemorrhage control, Airway with cervical spine protection, Breathing, Circulation, Disability (GCS, pupils, glucose), Exposure with temperature control, then reassess after every intervention.

Shock index

Heart rate divided by systolic blood pressure. A value above 0.9 in adults suggests occult hypoperfusion and predicts need for transfusion or critical care.

Adult anaphylaxis adrenaline dose

Intramuscular adrenaline 0.5 mg (0.5 mL of 1:1000) into the anterolateral thigh, repeated every 5 minutes. Antihistamines and steroids are adjuncts only and never replace adrenaline.

Adult cardiac arrest compressions

Compressions at 100-120 per minute, depth 5-6 cm, full recoil, ratio 30:2, pauses under 10 seconds. Non-shockable rhythms receive adrenaline 1 mg immediately and every 3-5 minutes.

Refractory VF/pVT treatment

After three shocks, give amiodarone 300 mg intravenous bolus. Biphasic defibrillation energy follows manufacturer recommendation, typically 150-200 J; use maximum available if unknown.

qSOFA criteria

Respiratory rate 22/min or more, altered mentation, and systolic blood pressure 100 mmHg or less. Lactate above 2 mmol/L with hypotension defines septic shock requiring fluids and antibiotics.

STEMI reperfusion timing

Obtain a 12-lead ECG within 10 minutes of first medical contact. Primary PCI is preferred within 120 minutes of diagnosis; fibrinolysis is used if PCI is unavailable and within 12 hours.

Stroke thrombolysis window

Intravenous thrombolysis is licensed up to 4.5 hours from symptom onset. Mechanical thrombectomy is used up to 6 hours, and in selected cases up to 24 hours.

Tension pneumothorax decompression

In the unstable patient, perform immediate needle decompression in the 4th-5th intercostal space at the anterior axillary line, followed by a chest drain. Do not wait for imaging.

Synchronised cardioversion indication

Used for unstable tachycardia with hypotension, ischaemic chest pain, acute heart failure, altered mental state, or shock. Stable narrow-complex tachycardia starts with vagal manoeuvres then adenosine 6 mg.

Bradycardia with adverse features

Give atropine 500 micrograms intravenously every 3-5 minutes to a maximum of 3 mg. If ineffective, use transcutaneous pacing or chronotropic drugs.

Paediatric anaphylaxis adrenaline

Intramuscular adrenaline 10 micrograms/kg (maximum 0.5 mg) into the anterolateral thigh, repeated every 5 minutes as needed. Weight-based dosing uses a length-based tape.

Paracetamol overdose antidote

N-acetylcysteine, dosed according to the Rumack-Matthew nomogram from 4 hours post-ingestion. Activated charcoal is useful within 1 hour if the airway is protected.

Glasgow Coma Scale components

Eye opening (1-4), verbal response (1-5), and motor response (1-6), total 3-15. A score of 8 or less indicates need to secure the airway.

Cauda equina syndrome features

Saddle anaesthesia, bilateral sciatica, and bladder or bowel dysfunction. It requires urgent MRI and neurosurgical referral to prevent permanent deficit.

Infant fever under 3 months

A fever of 38 degrees Celsius or more in an infant under 3 months requires full sepsis evaluation and empirical antibiotics, because clinical signs of serious infection are unreliable.

Life-threatening asthma features

Silent chest, exhaustion, cyanosis, poor respiratory effort, and altered consciousness. Severe attack includes inability to complete sentences, respiratory rate above 25, and peak flow 33-50 percent predicted.

COPD exacerbation oxygen target

Target oxygen saturation of 88-92 percent in patients at risk of hypercapnia. Add nebulised bronchodilators, systemic corticosteroids, and non-invasive ventilation for persistent hypercapnic acidosis.

Anion gap calculation

Sodium minus (chloride plus bicarbonate). Use it with the delta ratio in metabolic acidosis to distinguish causes and identify mixed disorders.

Hyperkalaemia with ECG changes

Give intravenous calcium chloride or gluconate for membrane stabilisation, then insulin-glucose and salbutamol to shift potassium intracellularly. Dialysis is used for refractory cases.

Emergency dialysis indications

Refractory hyperkalaemia, pulmonary oedema, severe acidosis, and uraemic encephalopathy or pericarditis. These are the classic urgent indications in acute kidney injury.

Sodium correction rate

Correct sodium no faster than 8-10 mmol/L in 24 hours to avoid osmotic demyelination. Severe hyponatraemia with seizures is treated with hypertonic saline.

Major incident triage categories

Priority P1 immediate, P2 urgent, P3 delayed, and P4 expectant or deceased. Use a validated sieve and sort system such as START or a national equivalent.

Organophosphate poisoning antidote

Atropine titrated to secretions plus pralidoxime. Decontaminate the patient and protect staff, because absorption through skin and inhalation can affect rescuers.

Paediatric fluid bolus

Give 10-20 mL/kg crystalloid in shock and reassess after each bolus. Maintenance fluids use the Holliday-Segar 4-2-1 rule based on body weight.

Postpartum haemorrhage management

Uterine massage, oxytocin, tranexamic acid, and escalation to further uterotonics or surgery. Pre-eclampsia with severe features needs magnesium sulphate for seizure prophylaxis.

Reversible causes of arrest

The 4 Hs and 4 Ts: hypoxia, hypovolaemia, hypo/hyperkalaemia and metabolic disorders, hypothermia; thrombosis, tension pneumothorax, tamponade, and toxins.

Post-resuscitation care targets

Targeted temperature management for comatose survivors, oxygen saturation 94-98 percent, treatment of the precipitating cause, and controlled ventilation to avoid hyperoxia and hypocapnia.

Capacity assessment

The patient must understand, retain, weigh, and communicate a decision. If capacity is absent, act in best interests and choose the least restrictive option.

Parkland burn formula

4 mL/kg per percent burn of crystalloid in 24 hours, half given in the first 8 hours from injury time. It is a starting point, and fluids are titrated to urine output.

Compartment syndrome signs

Pain out of proportion, pain on passive stretch, and a tense compartment. Pulselessness is a late sign; urgent fasciotomy is the definitive treatment.

CURB-65 score

Confusion, urea above 7 mmol/L, respiratory rate 30 or more, low blood pressure, and age 65 or more. A score of 2 or more suggests hospital-level care.