Trauma, resuscitation, toxicology, acute medical emergencies, and procedural skills for the emergency department.
Acute severe asthma is a medical emergency characterised by progressive airway obstruction and bronchospasm. BTS/SIGN guidelines classify severity and guide stepwise treatment from bronchodilators to ventilation.
An acute COPD exacerbation is a sustained worsening of respiratory symptoms beyond normal day-to-day variation requiring a change in treatment. It is a leading cause of emergency admission and mortality in COPD patients.
Acute coronary syndrome encompasses STEMI, NSTEMI, and unstable angina. Emergency management focuses on rapid diagnosis, antiplatelet/anticoagulant therapy, and timely reperfusion for STEMI within 120 minutes.
AKI is defined by a rise in serum creatinine or reduction in urine output per KDIGO criteria. Emergency management focuses on identifying and treating the cause, volume assessment, and recognising indications for urgent dialysis.
Acute stroke management encompasses rapid assessment, neuroimaging, reperfusion therapy for ischaemic stroke, blood pressure management for haemorrhagic stroke, and specialist stroke unit care to minimise disability.
Acute upper GI bleeding presents with haematemesis and/or melaena. Risk stratification with the Glasgow-Blatchford score guides management, with endoscopy within 24 hours and specific treatment for variceal and non-variceal sources.
Adrenal crisis is a life-threatening emergency caused by acute cortisol deficiency. It presents with hypotension, hyponatraemia, and hyperkalaemia, and requires immediate IV hydrocortisone 100mg followed by fluid resuscitation.
Advanced Life Support (ALS) is a structured approach to cardiac arrest management incorporating defibrillation, drug therapy, advanced airway management, and identification of reversible causes, following Resuscitation Council UK guidelines.
Alcohol intoxication is one of the most common emergency presentations. Management involves ABCDE assessment, excluding co-existing pathology, treating complications, and addressing alcohol use disorder on discharge.
Anaphylaxis is a severe, life-threatening systemic hypersensitivity reaction characterised by rapid onset of airway, breathing, and/or circulation compromise. Intramuscular adrenaline is the first-line life-saving treatment.
Cardiac arrest management follows the Resuscitation Council UK guidelines with structured BLS and ALS algorithms. Early high-quality CPR and defibrillation are the most important determinants of survival.
Cervical spine injury must be suspected in all trauma patients until excluded. Clinical decision rules (Canadian C-spine, NEXUS) guide imaging to identify fractures and prevent secondary cord injury.
Chest drain insertion is a core emergency procedure for pneumothorax, haemothorax, and pleural effusion. It is inserted in the safe triangle using aseptic technique with appropriate analgesia and imaging confirmation.
Diabetic emergencies include DKA and HHS. DKA requires insulin infusion, fluid resuscitation, and potassium replacement following the JBDS guidelines. HHS requires cautious rehydration over 48 hours with low-dose insulin.
Joint dislocations require prompt reduction to prevent neurovascular compromise and avascular necrosis. Shoulder (anterior) and hip (posterior) are the most common. Pre- and post-reduction neurovascular assessment and imaging are essential.
Drug intoxication from recreational substances requires toxidrome recognition, ABCDE management, specific treatments for complications, and awareness of novel psychoactive substances. TOXBASE and NPIS provide UK-specific guidance.
ENT emergencies include epistaxis, peritonsillar abscess (quinsy), epiglottitis, foreign body aspiration/ingestion, and sudden sensorineural hearing loss. Epistaxis management follows a stepwise approach from first aid to surgical intervention.
Environmental emergencies include hypothermia, heat stroke, drowning, altitude sickness, and electrical injuries. Core temperature measurement and active rewarming/cooling are critical management principles.
Eye emergencies include chemical injury (immediate irrigation), acute angle-closure glaucoma, retinal detachment, central retinal artery occlusion, and penetrating eye injury. Prompt recognition and referral preserve vision.
Major haemorrhage is life-threatening blood loss requiring activation of a massive transfusion protocol, damage control resuscitation, and urgent identification and control of the bleeding source.
Mental health emergencies include acute psychosis, suicidal crisis, severe self-harm, acute behavioural disturbance, and catatonia. Management balances patient safety, de-escalation, and appropriate use of the Mental Health Act when necessary.
Paediatric emergencies require age-appropriate assessment using the paediatric assessment triangle, weight-based drug dosing, and recognition that children compensate well before rapidly deteriorating.
Paracetamol overdose is the most common cause of acute liver failure in the UK. N-acetylcysteine (NAC) is the specific antidote, guided by a treatment nomogram starting at 100mg/L at 4 hours post-ingestion.
Pneumothorax management depends on size, symptoms, and whether primary or secondary. Tension pneumothorax requires immediate needle decompression. BTS guidelines stratify management from observation to chest drain insertion.
Poisoning and overdose management follows an ABCDE approach with toxidrome recognition, specific antidotes where available, and supportive care. TOXBASE and the National Poisons Information Service (NPIS) guide UK management.
Pre-hospital care encompasses emergency medical services (EMS) assessment and treatment at the scene and during transport. The UK system includes paramedics, HEMS (air ambulance), and structured triage to major trauma centres.
Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Early recognition, the Sepsis 6 bundle, and timely antibiotics within 1 hour reduce mortality significantly.
Severe allergic reactions range from widespread urticaria and angioedema to life-threatening anaphylaxis. Distinction from anaphylaxis determines whether IM adrenaline is required as first-line treatment.
Soft tissue injuries encompass sprains, strains, tendon injuries, and contusions. Management follows RICE/POLICE principles with appropriate imaging, analgesia, and physiotherapy referral for significant injuries.
Intravenous thrombolysis with alteplase within 4.5 hours of acute ischaemic stroke onset significantly improves functional outcome. Mechanical thrombectomy extends the treatment window to 24 hours for selected patients.
Major trauma assessment follows the ATLS systematic approach with primary survey (ABCDE), resuscitation, and secondary survey. It is the leading cause of death in adults under 40 in the UK.
TCA overdose is a life-threatening toxicological emergency characterised by anticholinergic effects, sodium channel blockade (QRS widening), seizures, and cardiovascular collapse. IV sodium bicarbonate is the key treatment.