Medical Emergencies
Core concepts
This domain spans respiratory (asthma, COPD, pulmonary edema), neurological (stroke, seizure, altered mental status), endocrine (hypo/hyperglycemia, thyroid), toxicological, and environmental emergencies. Know the recognition and initial management of anaphylaxis, opioid overdose, and severe asthma. Understand stroke assessment tools and time-critical transport to a stroke-capable facility. Be familiar with blood glucose measurement, naloxone administration, and the use of bronchodilators and epinephrine in the correct context. Recognize signs of sepsis and the importance of early recognition and transport.
Traps in questions
Common traps include treating wheezing in anaphylaxis with only bronchodilators (epinephrine is first-line), giving too much fluid in pulmonary edema, or missing hypoglycemia as a cause of altered mental status. Questions may present a stroke with a normal glucose and ask for the next step-usually rapid transport with prenotification. Be careful not to over-sedate a seizing patient before airway and glucose assessment.
Rule of thumb
For any altered mental status, check glucose early. For anaphylaxis, epinephrine IM is the first and most important drug-antihistamines and steroids are adjuncts. For suspected stroke, document last-known-well time and transport rapidly with prenotification.