Step-by-step checklists for the emergencies you are first to arrive at — each one tickable as you work through it, and usable offline.
Peri-arrest tachycardiaA fast rhythm with adverse features. Supraventricular tachycardia (SVT)Monitor shows a regular, narrow-complex tachycardia, often 150–250 with abrupt onset. Paroxysmal SVT is usually well tolerated in the young but can decompensate quickly in… Fast atrial fibrillation (AF RVR)Irregularly irregular, narrow-complex tachycardia, often over 120, often with palpitations or breathlessness. Broad complex tachycardiaBroad complex tachycardia is QRS ≥120 ms. In an adult with a regular broad-complex tachycardia, treat as VT until proven otherwise. Peri-arrest bradycardiaBradycardia is dangerous when it causes shock, syncope, myocardial ischaemia or heart failure. AnaphylaxisYou will be called to see a patient with sudden-onset, rapidly progressive airway, breathing and/or circulation problems, usually with skin/mucosal changes (but these may be… Acute pulmonary oedemaUsually an acute presentation on the medical take or an unexpected deterioration you are called to on-call or overnight. Think about triggers. Acute severe asthmaSevere: PEF 33–50% of best, RR ≥25, HR ≥110, can't complete sentences. \ COPD exacerbation with T2RFTypically this will present as known or probable (hx of smoking++) COPD, SoB ± sputum, and the gas shows pCO₂ ≧ 6 kPa. The danger is narcosis creeping in while everyone watches… Opioid toxicityDrowsy, respiratory rate falling, pinpoint pupils — usually an inpatient on therapeutic opioids after a dose change, an AKI, or a forgotten patch, rather than a self-infected… HyperkalaemiaYou will be called about a high K⁺. Common causes: AKI/CKD, drugs, tissue breakdown. Severe is ≥6.5, or any level with ECG changes. A haemolysed sample is common — but if… HypoglycaemiaYou will be called about a CBG below 4. Treat as an emergency at any conscious level. Upper GI bleedHaematemesis, coffee-grounds, or melaena — the sick ones are shocked with a urea out of proportion to the creatinine. Two questions at the bedside: are they shocked, and… Diabetic ketoacidosisUsually T1DM with poor insulin compliance or intercurrent illness, also look out for pump-failure or new diagnoses. They will be dehydrated, tachycardic, possibly vomiting, drowsy… SepsisYou will be called to see a patient newly NEWSing ± febrile. The source may be obvious, or there may be multiple possibilities (a classic impression seen in medical clerkings is… Active seizure ± status epilepticusA convulsive seizure lasting 5 minutes or more is status, or recurrent seizures without recovery in between. After 5 minutes it is unlikely to stop on its own — ::ensure a… Acutely reduced GCSNew reduced consciousness is an airway emergency until proven otherwise. Treat reversible causes during A–E, establish the trajectory, then image/investigate. Do not…Emergency checklists, ward cover and on-call scenarios, and clerking plans for the medical take — an app for resident doctors, working offline on the ward.
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