Medical Emergencies and Patient Assessment
Structured assessment
Be fluent in the sequence of history taking and physical assessment: scene size-up, primary survey, focused history (including the classic OPQRST for pain and SAMPLE for history), and secondary survey. Understand that the primary survey identifies and treats immediate threats, while the secondary survey gathers detail. Vital signs include level of consciousness (use a recognised scale such as AVPU or GCS), pulse, respiration, blood pressure, temperature, and oxygen saturation.
Common medical presentations
Know the distinguishing features of hypoglycaemia versus hyperglycaemia, stroke (sudden focal deficit, facial droop, arm weakness, speech disturbance), seizure (with post-ictal confusion), asthma versus COPD exacerbation, anaphylaxis (rapid onset, airway swelling, urticaria, hypotension), and poisoning/overdose patterns. Understand the concept of time-critical conditions where minutes matter: stroke, anaphylaxis, hypoglycaemia, sepsis, and cardiac arrest.
Altered consciousness
Approach as a differential: hypoxia, hypoglycaemia, stroke, seizure, poisoning, head injury, shock. Treat reversible causes first - oxygen and glucose where indicated.
Traps in questions
Beware answers that jump to a diagnosis before assessment. Questions often test the first assessment step or the most important finding. Do not assume a seizure is epilepsy - consider hypoglycaemia. Do not assume a stroke patient is hypoglycaemic without checking.
Rule of thumb
In any altered-consciousness patient, check and correct hypoxia and hypoglycaemia before assuming a neurological cause.