I85PREP
⌘ K
CAQ-EM study materials
CAQ-EM study resources

CAQ-EM: Emergency Medicine

CAQ-EM · Work through your exam, one topic at a time.

All guide sections

Emergency Medicine

Emergency Medicine: What the Exam Tests

This domain tests rapid prioritization and resuscitation under uncertainty. Expect items on airway, breathing, circulation, neurologic emergencies, toxicology, trauma, and pediatric/obstetric adaptations. The exam rewards guideline-concordant first actions and penalizes delayed escalation. Items are vignette-based and ask for the next best step.

Core Rules

  • Resuscitate before diagnose: in undifferentiated shock, start with ABCs (or CAB in cardiac arrest), obtain IV/IO access, and give oxygen only if hypoxemic.
  • Sepsis: measure lactate; for septic shock or lactate ≥4 mmol/L, give 30 mL/kg crystalloid and broad-spectrum antibiotics within 1 hour; start norepinephrine for MAP <65 mmHg after fluids.
  • ACS: obtain 12-lead ECG within 10 minutes; give aspirin 162–325 mg chewed; activate cath lab for STEMI with door-to-balloon ≤90 min at PCI centers.
  • Stroke: check glucose; noncontrast CT within 20–25 min; alteplase eligible within 3–4.5 h of last known well if no contraindications.
  • Trauma: control external hemorrhage, permissive hypotension (SBP ~90) until hemorrhage control in penetrating torso trauma, and tranexamic acid within 3 h of injury.
  • Anaphylaxis: IM epinephrine 0.3–0.5 mg (1:1000) into anterolateral thigh; repeat every 5–15 min; fluids for hypotension.
  • Reassess after each intervention: repeat vital signs, mental status, and perfusion; document the response and escalate early.

Worked Example

A 58-year-old presents with fever, confusion, BP 82/50, HR 124, lactate 4.2 mmol/L. Reasoning: this is septic shock. Start 30 mL/kg crystalloid immediately, draw blood cultures, and give broad-spectrum antibiotics within 1 hour. If MAP remains <65 mmHg after fluids, start norepinephrine. Do not wait for imaging or culture results before antibiotics.

Traps

  • Treating blood pressure as the only trigger for shock; cool extremities, altered mentation, and lactate matter.
  • Forgetting pregnancy test in reproductive-age women before CT or giving teratogenic drugs.
  • Delaying epinephrine in anaphylaxis while giving antihistamines or steroids first.
  • Missing an ECG in chest pain because the patient is young or has atypical symptoms.