Emergency Medicine

A

• Accidental Hypothermia — Rewarming and Complications

  Classify severity by core temperature and mental status; use active external and internal rewarming strategies and anticipate afterdrop and arrhythmias.
• Accidental Hypothermia — Rewarming Strategy

  Stage by core temperature; provide gentle handling, airway and circulation support; use passive/active external rewarming and, in severe cases, active internal or extracorporeal rewarming.
• Alcohol Withdrawal — Benzodiazepines and Adjuncts

  Use symptom triggered or fixed dose benzodiazepines; add phenobarbital or dexmedetomidine as adjuncts in selected severe cases; correct electrolytes and give thiamine.
• Alcohol Withdrawal — ED to Inpatient Management

  Use symptom triggered benzodiazepines guided by CIWA when appropriate; give thiamine before glucose; manage severe or refractory cases with phenobarbital or ICU care.
• Anaphylaxis — Recognition & Epinephrine First

  Anaphylaxis is life‑threatening; give intramuscular epinephrine immediately in the mid‑anterolateral thigh, repeat as needed, and manage airway/respiration/circulation with adjuncts and observation.

C

• Carbon Monoxide Poisoning — Diagnosis and Treatment

  Suspect with headache, dizziness, and exposure history; confirm with COHb level; give high-flow 100% oxygen and consider hyperbaric oxygen for selected indications.
• Cervical Spine Clearance — Adult Blunt Trauma

  Use validated decision rules to select imaging; CT is preferred for high risk; clear the collar after adequate imaging and exam when safe.

D

• Disaster Triage — START/JumpSTART Basics

  Use START (adults) and JumpSTART (peds) for mass‑casualty triage to rapidly categorize patients (Immediate/Delayed/Minor/Expectant) based on respiration, perfusion, and mental status.
• Drowning and Submersion Injury — ED Care

  Prioritize oxygenation and ventilation, treat hypothermia, and monitor for delayed respiratory compromise; antibiotics are not routinely indicated.
• Dyspnea — Use of POCUS (BLUE Protocol) in ED

  The BLUE protocol uses lung ultrasound profiles to differentiate causes of acute dyspnea (A‑profile, B‑profile, A’/B’ with DVT, PLAPS). Rapidly narrows diagnosis at bedside.

E

• ED Procedural Ultrasound — Nerve Blocks for Analgesia

  Ultrasound‑guided nerve blocks provide rapid ED analgesia (e.g., femoral/fascia iliaca for hip fracture, serratus/PECs for rib fractures, forearm blocks for hand injuries). Emphasize safety, dosing, and LAST prevention.
• Electrical Injury — Cardiac Monitoring and Burns

  Assess for arrhythmias, rhabdomyolysis, and occult trauma; obtain ECG and monitor when indicated; manage burns and compartment syndrome risk.
• Euglycemic DKA (SGLT2‑Associated) — Recognition and Dextrose‑Insulin Strategy

  Anion‑gap ketoacidosis with glucose often <250 mg/dL in patients on SGLT2 inhibitors, during starvation, pregnancy, or perioperatively. Stop SGLT2 agent, initiate fluids, start insulin infusion with concurrent dextrose to clear ketones, correct electrolytes, and address triggers.
• Exertional and Classic Heat Stroke — Rapid Cooling, Organ Support, and Complications

  Core temperature ≥40°C with CNS dysfunction. Begin rapid cooling immediately—prefer cold-water immersion for exertional heat stroke or aggressive evaporative cooling with ice packs if immersion unavailable. Avoid antipyretics. Manage rhabdomyolysis, DIC, AKI, and electrolyte derangements; admit to ICU for severe cases.

G

• GI Bleeding in the ED — Risk Scores & Initial Therapy

  Risk stratify upper/lower GI bleeding, resuscitate, give PPI for suspected upper GI bleed, reverse anticoagulation as appropriate, and coordinate early endoscopy/consults.

H

• Heat Stroke — Exertional and Classic

  Core temperature ≥40°C with CNS dysfunction; immediate whole-body cold water immersion for exertional cases; evaporative cooling for others; avoid antipyretics.
• Heat Stroke — Rapid Cooling (Ice‑Water Immersion) and Complication Management

  Hyperthermia with CNS dysfunction requires immediate whole‑body cold‑water immersion (exertional) or aggressive evaporative cooling; target core 39°C. Manage airway, fluids, rhabdomyolysis, DIC, and organ failure; avoid antipyretics.
• Heat Stroke — Rapid Cooling and Organ Support

  Life threatening hyperthermia with CNS dysfunction; initiate whole body cold water immersion or other rapid cooling and support airway, circulation, and complications.
• Hyperkalemia in the ED — Rapid Stabilization

  Treat ECG changes and K≥6 promptly: stabilize myocardium (calcium), shift K intracellularly (insulin/dextrose, β‑agonist, bicarbonate if acidotic), and remove K (diuresis, binders, dialysis).
• Hyperkalemia — Emergency Management

  Stabilize myocardium with IV calcium for ECG changes or K ≥6.5; shift K intracellularly (insulin/dextrose, β2-agonist, bicarbonate if acidemic); remove K (diuretics, binders, dialysis).
• Hypertensive Emergency — IV Titration, Targeted Goals, and Etiology-Specific Nuance

  BP with acute target‑organ injury (encephalopathy, ACS, APE, aortic dissection, AKI). Reduce MAP by ~20–25% in the first hour (except aortic dissection/ischemic stroke with unique targets) using IV agents (nicardipine, clevidipine, labetalol). Identify/ treat precipitating cause and avoid rapid overcorrection.

P

• Pain Management — Opioid‑Sparing Strategies in ED

  Use multimodal analgesia and regional anesthesia to reduce opioid exposure while achieving adequate pain control; provide safe prescribing when opioids are necessary and arrange follow‑up.
• Poisoned Patient — Toxidrome Approach

  Identify toxidromes (anticholinergic, cholinergic, opioid, sedative‑hypnotic, sympathomimetic, serotonin syndrome). Stabilize ABCs, decontaminate judiciously, give antidotes when indicated, and involve poison control early.
• Procedural Sedation in the ED — Safety Checklist

  Preprocedure assessment, fasting considerations, appropriate agent selection, continuous monitoring, and postprocedure recovery criteria reduce complications.
• Psychiatric Holds — Medical Clearance & Legal Basics

  Ensure medical stability, assess decision‑making capacity and suicide/homicide risk, and follow jurisdictional laws for involuntary holds; document thoroughly and coordinate with psychiatry/social work.

R

• Rhabdomyolysis — Crush Injury, Hyperkalemia, and Renal Protection

  Muscle breakdown with CK elevation causes electrolyte derangements and AKI. Treat with early, high-volume isotonic fluids, correct hyperkalemia, and consider urine alkalinization in select cases; avoid nephrotoxins and monitor urine output/CK trends.
• Rhabdomyolysis — Early Aggressive Fluids, Electrolyte Management, and Renal Protection

  Muscle injury with marked CK elevation leads to myoglobin-induced AKI and electrolyte disturbances. Initiate early aggressive isotonic fluids, monitor and treat hyperkalemia and hypocalcemia, and consider urine alkalinization selectively; identify and remove precipitating factors.

S

• Sepsis — Early Recognition & ED Bundles

  Identify sepsis early with suspected infection and organ dysfunction. Start broad‑spectrum antibiotics and balanced fluids promptly; obtain cultures and lactate; reassess frequently and source control.
• Severe Alcohol Withdrawal and Delirium Tremens — High‑Dose Benzodiazepines, Phenobarbital, and ICU Care

  High‑risk patients with autonomic instability, hallucinations, agitation, or seizures need aggressive benzodiazepine therapy (symptom‑triggered or front‑loaded), early phenobarbital adjunct in refractory cases, thiamine before glucose, electrolyte repletion, and ICU monitoring.
• Syncope — ED Risk Stratification

  Obtain ECG and orthostatic vitals on all; identify high-risk features for admission; avoid routine head CT in uncomplicated syncope; tailor workup to suspected cause.

T

• Tension Pneumothorax — Immediate Decompression

  Clinical diagnosis in unstable patients; perform immediate decompression with finger or needle thoracostomy followed by chest tube.
• Tension Pneumothorax — Immediate Decompression and Chest Tube

  Clinical diagnosis of life-threatening obstructive shock. Do not wait for imaging: perform immediate needle decompression followed by definitive tube thoracostomy; in monitored settings, prefer finger thoracostomy. Address underlying trauma or barotrauma and reassess ventilation.
• Thunderclap Headache — SAH Evaluation

  Sudden severe headache peaking within seconds to minutes requires evaluation for subarachnoid hemorrhage with early noncontrast CT and LP or CTA when indicated.