Emergency, Acute and Urgent Care
Emergency, acute and urgent care tests safe assessment of undifferentiated presentations in primary care and urgent settings, including sepsis, anaphylaxis, chest pain, stroke, asthma, trauma and triage. The exam prioritises ABCDE, time-critical diagnosis and appropriate referral.
Core rules
- Start with ABCDE and call for help early; do not complete a history before treating airway, breathing or circulation.
- Anaphylaxis: intramuscular adrenaline into the anterolateral thigh, oxygen, fluids and urgent transfer.
- Sepsis: use a structured screen, take cultures when appropriate and give antibiotics within the recommended time.
- Chest pain: ECG within 10 minutes; aspirin if not contraindicated; assess troponin and refer suspected ACS.
- Stroke: use FAST and record onset time; urgent imaging and thrombolysis eligibility depend on time.
- Acute asthma: assess severity, give oxygen and bronchodilators, and add steroids early.
Worked example
A 60-year-old man has central chest pain and sweating. ABCDE, IV access, ECG within 10 minutes, aspirin and analgesia; arrange urgent transfer. A normal ECG does not exclude ACS. Reasoning: symptom pattern and time-critical pathway drive action.
Traps
Waiting for investigations before referral; missing hypoglycaemia; using a normal ECG to exclude ACS; and failing to document time of onset in stroke.