Emergency Medicine
Emergency Medicine tests rapid recognition and resuscitation of time-critical conditions: anaphylaxis, ACS, stroke, sepsis, trauma, poisoning, and airway emergencies. The exam rewards prioritisation and safe disposition.
Core rules
- Primary survey: catastrophic bleeding, airway, breathing, circulation, disability, exposure.
- Anaphylaxis: IM adrenaline into the anterolateral thigh, oxygen, fluids, and remove the trigger.
- Stroke: check glucose, onset time, and NIHSS; activate stroke pathway for thrombolysis or thrombectomy assessment.
- Poisoning: treat ABCDE first; use naloxone for opioid toxidrome and check paracetamol levels.
- Do not delay definitive care for non-essential tests.
Worked example
A 25-year-old develops urticaria, wheeze, stridor, and hypotension minutes after a bee sting. The reasoning is: anaphylaxis with airway and circulatory compromise. Give IM adrenaline immediately, high-flow oxygen, IV fluids, and monitor. Antihistamines and steroids are adjuncts, not first-line.
Traps that cost marks
- Giving IV adrenaline instead of IM in a non-arrested patient.
- Waiting for imaging before treating tension pneumothorax.
- Missing hypoglycaemia as a stroke mimic.
- Forgetting paracetamol level and delayed toxicity.
- Discharging chest pain without serial ECG and troponin pathway.