OMSB Emergency Medicine (OEEM) flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Adult compression rate and depth

Compress the adult chest at 100-120 per minute to a depth of 5-6 cm, allowing full recoil and pausing less than 10 seconds between cycles.

First-shock energy for VF

For ventricular fibrillation or pulseless ventricular tachycardia, deliver a biphasic shock at 200 J (or the manufacturer's maximum) and resume compressions immediately without a pulse check.

Adenosine dose for SVT

For stable narrow-complex regular SVT, give adenosine 6 mg rapid IV push after vagal maneuvers; if no conversion, give 12 mg, then a further 12 mg if needed.

Atropine in symptomatic bradycardia

Give atropine 1 mg IV every 3-5 minutes to a maximum of 3 mg; if ineffective, proceed to transcutaneous pacing or a dopamine or adrenaline infusion.

Anaphylaxis adrenaline dose

Give adrenaline 0.5 mg intramuscularly (0.5 mL of 1:1000) into the anterolateral thigh, repeating every 5 minutes as required; antihistamines and steroids are adjuncts only.

Septic shock antibiotic timing

In septic shock, obtain cultures and give broad-spectrum antibiotics within 1 hour, alongside 30 mL/kg crystalloid for hypotension or lactate of 4 mmol/L or more.

Stroke thrombolysis window

Intravenous alteplase at 0.9 mg/kg (maximum 90 mg) is indicated within 4.5 hours of last known well after non-contrast CT excludes intracranial haemorrhage.

Status epilepticus first-line drug

Give a benzodiazepine first: IV lorazepam 0.1 mg/kg (maximum 4 mg, may repeat once) or IM midazolam 10 mg when intravenous access is unavailable.

STEMI reperfusion targets

Primary PCI should be delivered within 90 minutes of first medical contact; if unavailable, fibrinolysis should start within 30 minutes of arrival in eligible patients.

Nitrate contraindications in chest pain

Avoid nitrates in inferior myocardial infarction with right ventricular involvement, hypotension, or recent phosphodiesterase-5 inhibitor use because of the risk of severe hypotension.

RSI induction agents

Common rapid sequence intubation sedatives are ketamine 1-2 mg/kg or etomidate 0.3 mg/kg, paired with rocuronium 1.2 mg/kg or suxamethonium 1.5 mg/kg.

Confirmation of tracheal intubation

Continuous waveform capnography is the standard confirmation of tube placement; it detects oesophageal intubation and dislodgement more reliably than auscultation alone.

Rule of nines burn estimate

Adult total body surface area: head 9%, each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%, perineum 1%; the palm of the patient's hand approximates 1%.

Parkland burn fluid formula

Give 4 mL/kg per percent total body surface area of lactated Ringer's in the first 24 hours, with half in the first 8 hours from the time of the burn.

Tranexamic acid in trauma

Give tranexamic acid 1 g intravenously within 3 hours of injury in trauma with suspected significant bleeding, followed by 1 g infused over 8 hours.

Permissive hypotension in trauma

In penetrating trauma with active haemorrhage, target a systolic pressure near 90 mmHg until surgical control, avoiding aggressive crystalloid that worsens clot disruption.

GCS threshold for intubation

A Glasgow Coma Scale score of 8 or less is the standard threshold for definitive airway management, because airway reflexes and ventilation are inadequate.

Hyperkalaemia with ECG changes

Give intravenous calcium first to stabilise the myocardium, then insulin with dextrose, nebulised salbutamol, and bicarbonate if acidotic; dialysis for refractory cases.

Paracetamol overdose antidote

N-acetylcysteine is the antidote for paracetamol overdose, most effective when started within 8 hours; use the Rumack-Matthew nomogram to guide treatment.

Opioid overdose reversal

Give naloxone 0.04-0.4 mg IV titrated to adequate respiration rather than full consciousness, repeating as needed and observing for recurrent toxicity from long-acting opioids.

Organophosphate poisoning treatment

Treat with atropine titrated to drying of secretions plus pralidoxime, and decontaminate; the toxidrome includes salivation, lacrimation, urination, diarrhoea, bronchospasm, and miosis.

Acute severe asthma treatment

Give repeated nebulised salbutamol with ipratropium, systemic corticosteroid early, and magnesium sulphate 2 g IV for refractory severe or life-threatening exacerbations.

Tension pneumothorax management

Tension pneumothorax is a clinical diagnosis; perform immediate needle decompression followed by a chest drain, without waiting for imaging in an unstable patient.

Controlled oxygen in COPD

In acute exacerbation of COPD, titrate oxygen to a target saturation of 88-92% to reduce the risk of hypercapnic respiratory failure while avoiding hypoxaemia.

Pancreatitis diagnostic criteria

Acute pancreatitis is diagnosed when two of three are present: typical epigastric pain, lipase or amylase above three times the upper limit, and characteristic imaging.

Postpartum haemorrhage first steps

Uterine massage, oxytocin, and tranexamic acid 1 g IV are the initial measures; escalate to balloon tamponade, uterine artery embolisation, or surgery if bleeding continues.

Eclampsia magnesium dosing

Give magnesium sulphate 4 g IV loading dose over 5-15 minutes, then 1 g per hour infusion, monitoring reflexes, respiratory rate, and urine output for toxicity.

Bacterial meningitis dexamethasone

Give dexamethasone 10 mg IV with or before the first antibiotic dose in suspected pneumococcal meningitis, and do not delay antibiotics for lumbar puncture.

DKA insulin initiation rule

Start a fixed-rate insulin infusion of 0.1 units/kg/hour only after potassium is confirmed above 3.3 mmol/L, and add dextrose when glucose falls below about 14 mmol/L.

Ottawa ankle rules

An ankle radiograph is indicated if there is pain near the malleoli plus bony tenderness at the posterior malleolus or navicular base, or inability to bear weight.

PERC rule use

The PERC rule excludes pulmonary embolism in low pretest probability patients when all eight criteria are negative, avoiding D-dimer testing and imaging.

Heat stroke cooling target

In exertional heat stroke, begin immediate cold-water immersion or evaporative cooling, aiming to reduce core temperature below 39 C within 30 minutes while supporting circulation.