Emergency and Acute Medicine
A to E assessment, resuscitation, poisoning and time-critical presentations.
- A to E Assessment The strict Airway-Breathing-Circulation-Disability-Exposure sequence for any acutely unwell patient, why you treat as you find and reassess after every step, and structuring escalation with NEWS2 and SBAR.
- Adult Advanced Life Support Shockable versus non-shockable rhythms, the exact timing of adrenaline and amiodarone, working through the 4Hs and 4Ts, and avoiding hyperoxia in post-ROSC care.
- Anaphylaxis Why IM adrenaline is the only first-line drug now that steroids and antihistamines have been dropped from the algorithm, dosing by age, and the observation periods that catch a biphasic reaction.
- Major Haemorrhage Why crystalloid-heavy resuscitation worsens the coagulopathy driving the bleed, the balanced-ratio blood products and time-critical tranexamic acid of damage control resuscitation, and permissive hypotension until the source is controlled.
- The Patient with Reduced Consciousness Excluding hypoglycaemia, opioid toxicity and hypoxia before working through the structural, metabolic, toxic and infective differential, and reading pupils and brainstem reflexes to localise the problem.
- Head Injury The NICE CT head rules and why anticoagulation alone triggers the 1-hour pathway, telling an extradural from a subdural bleed by shape, and the physiology behind preventing secondary brain injury.
- Trauma Assessment The <C>ABCDE primary survey, the six immediately life-threatening chest injuries to hunt for on breathing, the AMPLE secondary survey, and how UK major trauma networks triage.
- Burns Management Why the airway is secured before swelling makes it impossible, titrating Parkland-formula fluids to urine output, and the electrical, chemical and escharotomy decisions that don't wait for imaging.
- Hypothermia and Hyperthermia Why resuscitation continues through active rewarming in hypothermic arrest, rapid cooling over antipyretics in heat stroke, and telling neuroleptic malignant syndrome from serotonin syndrome by tone and reflexes.
- Carbon Monoxide Poisoning Why pulse oximetry reads falsely normal and carboxyhaemoglobin must be measured directly, recognising chronic low-level exposure from the improves-away-from-home pattern, and treating with high-flow oxygen.
- Drug Overdose Why activated charcoal only works in the first hour, the antidotes worth knowing cold, and using QRS width and high-dose insulin-euglycaemia therapy to manage tricyclic and beta-blocker/calcium channel blocker overdose.
- Paracetamol Overdose Reading the single treatment nomogram line since the 2012 simplification, why staggered and repeated supratherapeutic ingestion bypass the nomogram entirely, and the King's College Criteria for transplant referral.
- Hypovolaemia and Fluid Resuscitation The NICE 5 Rs framework for every fluid prescription, why balanced crystalloids beat saline for large volumes, and reassessing after each bolus rather than chasing a fixed target.
- Multi-Organ Dysfunction Syndrome Why mortality climbs steeply with each additional organ system involved, tracking the SOFA score's trend rather than a single reading, and why organ support without source control just buys time towards a worse outcome.
- Airway Assessment and Management Predicting a difficult airway with LEMON before attempting one, working up the escalation ladder from basic manoeuvres to a definitive airway, and declaring CICO early rather than repeating a failed technique.
- Sepsis Recognition and the Sepsis Six Why NEWS2 and qSOFA screen for risk rather than diagnose, delivering the three-in-three-out Sepsis Six within the hour, and the door-to-needle antibiotic target that makes neutropenic sepsis its own pathway.
- Recognising the Deteriorating Patient Why failure to rescue is usually a recognition or escalation failure rather than an unpredictable event, using NEWS2 and SBAR reliably, and the human factors - normalisation of deviance, hierarchy - that cause warnings to go unactioned.