Iran Specialty Board - Emergency Medicine key terms

Life-threatening circulatory failure caused by infection, marked by persistent hypotension needing vasopressors and lactate above 2 mmol/L despite adequate fluid resuscitation, reflecting sepsis-induced vascular and myocardial dysfunction.

The percentage fall in blood lactate over time, used to gauge adequacy of resuscitation in shock; failure to clear predicts worse outcome and prompts reassessment of perfusion and source control.

The principle that norepinephrine is the initial vasopressor for septic and most vasodilatory shock, raising mean arterial pressure with less tachyarrhythmia than dopamine and allowing early weaning from fluids.

Deliberately accepting a lower-than-normal blood pressure target during resuscitation, mainly in hemorrhagic trauma, to avoid dislodging clots and worsening bleeding until hemorrhage control is achieved.

A strategy for major hemorrhage combining early balanced blood products, minimization of crystalloid, permissive hypotension, prevention of hypothermia and acidosis, and rapid surgical or radiologic hemorrhage control.

A preplanned, protocolized delivery of large volumes of blood products with balanced ratios, rapid infusers, and laboratory monitoring, activated early in hemorrhagic shock to prevent dilutional coagulopathy and delays.

The self-reinforcing combination of hypothermia, metabolic acidosis, and coagulopathy that drives death in severe trauma; each component worsens the others, so prevention during resuscitation is a core priority.

Bedside ultrasound examining pericardial, perihepatic, perisplenic, and pelvic windows for free fluid after blunt trauma; it is rapid, repeatable, and guides operative versus observational decisions.

FAST examination supplemented by thoracic views for hemothorax and pneumothorax, increasing sensitivity for truncal injury without delaying definitive care.

Compression of cardiac chambers by accumulating pericardial fluid, producing hypotension, distended neck veins, and muffled heart sounds; bedside ultrasound shows effusion with chamber collapse and guides urgent drainage.

Cardiac arrest with organized electrical activity on the monitor but no palpable pulse; management targets reversible causes such as hypovolemia, tamponade, tension pneumothorax, thrombosis, and toxins.

Bedside cardiac and lung ultrasound during resuscitation to distinguish true asystole, detect tamponade, assess ventricular function, and identify reversible causes, while minimizing interruptions in chest compressions.

Progressive air accumulation in the pleural space causing mediastinal shift and obstructive shock; it is a clinical diagnosis requiring immediate needle decompression or finger thoracostomy before confirmatory imaging.

Acute coronary occlusion producing persistent ST elevation in contiguous leads; reperfusion by primary percutaneous coronary intervention or fibrinolysis is time-critical, with emergency department activation of the catheterization pathway.

Interval from emergency department arrival to first balloon inflation during primary percutaneous coronary intervention; it is a tracked quality metric because shorter times improve survival in ST-elevation myocardial infarction.

Tear in the aortic intima allowing blood into the media, causing severe tearing chest or back pain and pulse deficits; management hinges on rapid imaging, blood pressure and rate control, and urgent surgical consultation for type A.

Intravenous clot-dissolving therapy for acute ischemic stroke within a defined time window after excluding hemorrhage by imaging; benefit is highly time-dependent, so door-to-needle intervals are minimized.

Interval from hospital arrival to start of intravenous thrombolysis in acute ischemic stroke; a core process measure reflecting triage, imaging speed, and team coordination.

Blockage of a major intracranial artery such as the middle cerebral or basilar artery, producing severe deficits; it may require mechanical thrombectomy and often warrants urgent vascular imaging beyond plain CT.

A standardized 15-item clinical score quantifying stroke severity across consciousness, gaze, vision, motor, sensory, language, and neglect domains; it guides treatment decisions and communication between teams.

Continuous seizure activity or repeated seizures without recovery lasting about five minutes or more; it is a medical emergency requiring staged benzodiazepine and second-line antiseizure therapy while treating underlying causes.

Prolonged electrographic seizure activity without obvious motor manifestations, presenting as altered consciousness; diagnosis requires electroencephalography and a high index of suspicion in unexplained coma.

Acute inflammatory lung injury with bilateral opacities and severe hypoxemia not explained by cardiac failure, managed with lung-protective ventilation, prone positioning in severe cases, and treatment of the precipitating cause.

Ventilator strategy using low tidal volumes, limited plateau pressures, and appropriate positive end-expiratory pressure to reduce ventilator-induced injury in acute respiratory distress syndrome and other severe lung disease.

Placing a ventilated patient face down for prolonged periods to improve oxygenation and survival in moderate-to-severe acute respiratory distress syndrome; requires trained teams and attention to pressure areas and lines.

Coordinated administration of a sedative and neuromuscular blocker to secure the airway rapidly while reducing aspiration risk; it includes preoxygenation, hemodynamic optimization, and a planned rescue strategy.

A structured, rehearsed sequence of escalating airway plans used when intubation fails, emphasizing oxygenation over repeated laryngoscopy attempts and early transition to supraglottic or surgical rescue.

Emergency surgical or needle access through the cricothyroid membrane to establish oxygenation when a cannot-intubate, cannot-oxygenate situation arises; it is a rescue procedure in the difficult airway pathway.

Fall in blood pressure after induction and positive-pressure ventilation, caused by vasodilation, hypovolemia, or reduced venous return; it requires prompt fluid, vasopressor, or sedative adjustment to prevent arrest.

Suspected systemic infection in a young infant with fever, prompting age-based evaluation and empirical antibiotics because clinical signs are unreliable and serious bacterial infection risk is high in the youngest.

A bedside scoring tool combining vital signs and observational items to flag hospitalized children at risk of deterioration, triggering escalation of care before overt clinical collapse.

Excessive blood loss after delivery, most often from uterine atony; management proceeds through uterine massage, uterotonics, tranexamic acid, and escalating mechanical or surgical measures while resuscitating.

Implantation of the embryo outside the uterine cavity, typically in a fallopian tube; it can rupture causing hemoperitoneum and shock, so pregnancy testing and pelvic ultrasound are central in abdominal pain of reproductive-age patients.

Hypertensive disorder of pregnancy with proteinuria or end-organ dysfunction such as thrombocytopenia, liver enzyme elevation, renal impairment, or neurologic symptoms; management includes magnesium sulfate and timely delivery.

A recognizable constellation of clinical signs suggesting a specific class of poisoning, such as anticholinergic, cholinergic, opioid, sympathomimetic, or sedative-hypnotic patterns, guiding empiric treatment before laboratory confirmation.

Competitive opioid receptor antagonist used to reverse opioid-induced respiratory depression; titrated doses restore breathing while avoiding abrupt withdrawal and recurrent sedation from short duration of action.

Drug-induced excess serotonergic activity causing agitation, clonus, hyperreflexia, and hyperthermia; treatment is supportive with cessation of offending agents, benzodiazepines, and cooling in severe cases.

Idiosyncratic reaction to dopamine antagonists causing rigidity, hyperthermia, autonomic instability, and elevated creatine kinase; management includes stopping the drug, supportive care, and sometimes dantrolene or bromocriptine.

Rapid sorting of casualties by physiologic and anatomic criteria into treatment priorities so limited resources save the most lives; it is repeated as patients change and must be simple and practiced.

The ability of a health system to expand staff, space, supplies, and services beyond normal operations during a disaster or mass casualty event, planned in advance through escalation tiers and memoranda of understanding.

A standardized command structure assigning roles for operations, planning, logistics, and finance during emergencies, enabling clear authority, communication, and coordination with external agencies.

Obtaining permission for treatment after explaining risks, benefits, and alternatives; emergency exceptions permit lifesaving care when the patient cannot consent and no surrogate is available.

A patient's ability to understand information, appreciate consequences, reason about options, and communicate a choice; it is assessed for specific decisions and is distinct from legal competence.

Systematic comparison of current practice against agreed standards, followed by feedback and re-measurement to close the gap; it is a core quality improvement method in emergency departments.

Iterative improvement method in which a small change is planned, tested, studied for effects, and acted upon, then scaled or revised; it supports rapid, low-risk learning in clinical systems.

The number of patients who must receive an intervention for one additional patient to benefit, calculated as the reciprocal of absolute risk reduction; it translates trial results into practical clinical impact.

A range of values around an estimate that is likely to contain the true effect with a stated probability; its width conveys precision and helps judge whether findings are clinically meaningful.

A team summoned by ward staff when a patient meets deterioration criteria, bringing critical care expertise to the bedside early; it aims to prevent cardiac arrest and unplanned intensive care admission.