Emergency Medicine (EM) is one of the most dynamic, fast-paced, and life-saving branches of healthcare. It deals with the immediate assessment, stabilization, and treatment of patients with acute illnesses or injuries. Whether a patient arrives with chest pain, shortness of breath, trauma, poisoning, or unconsciousness, the emergency department (ED) must act quickly — often within seconds.
This comprehensive guide explains the foundational principles of emergency medicine in a simple, classroom-friendly tone suitable for MBBS, nursing, and allied-health students.
The article blends universal emergency principles with terminology from your uploaded PDF glossary on emergency medicine basics .
What Is Emergency Medicine?
Emergency Medicine is a medical specialty focused on rapid decision-making, resuscitation, and early management of patients with unpredictable and time-sensitive conditions.
Emergency physicians work across a wide spectrum of illnesses such as:
- trauma (head injury, fractures, bleeding)
- cardiac conditions (chest pain, arrhythmias)
- respiratory failure (asthma, COPD, pneumonia)
- neurological emergencies (stroke, seizures)
- abdominal emergencies (appendicitis, perforation)
- infections (sepsis, meningitis)
- metabolic issues (DKA, electrolyte imbalance)
- environmental injuries (hypothermia, heat stroke)
- poisoning and toxicology
- obstetric & gynecological emergencies
In emergency departments, no two minutes look the same. The ability to make fast, accurate, structured decisions saves lives.
Primary Survey: The ABCDE Approach
Every emergency begins with ABCDE, regardless of the presenting complaint.
A – Airway
Check if the patient’s airway is open and protected.
- Is the patient speaking? → Airway is patent.
- Is there obstruction (tongue, vomit, blood, foreign body)?
- Use jaw thrust or head-tilt-chin-lift if needed.
- Insert airway adjuncts (OPA/NPA) if the patient cannot maintain their airway.
Red Flags:
- Stridor
- Gurgling
- Facial trauma
- Burns around mouth
B – Breathing
Evaluate:
- Respiratory rate
- Work of breathing
- Chest symmetry
- Wheezing, crackles, absent breath sounds
- Oxygen saturation
Interventions:
- Give oxygen
- Nebulizers (for asthma/COPD)
- Assist ventilation (bag-valve-mask)
- Consider tension pneumothorax decompression
C – Circulation
Assess:
- Pulse rate
- Blood pressure
- Perfusion (capillary refill)
- Skin color
- Active bleeding
Interventions:
- Control bleeding
- Large-bore IV access
- IV fluids
- Prepare for blood transfusion
ABCDE is repeated continuously until the patient is stable.
Secondary Survey
Once the patient is stable, proceed with:
- Full history (AMPLE: Allergies, Medications, Past illness, Last meal, Events)
- Head-to-toe examination
- Focused investigations
- Early diagnosis and treatment
- Documentation
Triage in Emergency Medicine
Triage is the system of prioritizing patients based on the severity of their condition.
Common triage levels:
1. Red (Immediate): Life-threatening (airway obstruction, shock, major trauma)Good triage ensures:
- fastest care for the sickest patient
- efficient resource use
- prevention of avoidable deaths
Vital Signs Interpretation
Vital signs are the ED’s compass.
Heart Rate (HR)
- Normal: 60–100 bpm
- Tachycardia → fever, dehydration, sepsis, shock
- Bradycardia → hypoxia, drugs, heart block
Blood Pressure (BP)
- Hypertension → stroke risk, hypertensive emergency
- Hypotension → shock, bleeding, sepsis
Respiratory Rate (RR)
- Most sensitive indicator of deterioration
- High RR → distress, metabolic acidosis, PE
Temperature
- Fever (>38°C) → infection/inflammation
- Hypothermia (<35°C) → environmental or metabolic causes
Oxygen Saturation
- <94% requires oxygen
- <90% is critical
Pain Score
Essential for analgesic management.
Important Terminology in Emergency Medicine
Your uploaded file contains a high-value glossary that students must master early on. Here are a few examples extracted from the PDF :
AAA: Abdominal Aortic AneurysmMastering abbreviations allows you to understand notes, formulate plans, and communicate with the team quickly.
Understanding Common Emergency Presentations
Below is a simplified overview of some emergency conditions (inspired by topics visible in your table of contents and glossary pages).
1 Chest Pain (CP)
Chest Pain is one of the most dangerous and common ED complaints.
Life-Threatening Causes:
- Acute Coronary Syndrome (MI)
- Pulmonary Embolism (PE)
- Aortic Dissection
- Pneumothorax (PTX)
- Pericarditis/Tamponade
- Pneumonia
Approach:
- EKG within 10 minutes
- Troponins
- CXR
- Oxygen, Aspirin (unless contraindicated)
- Rule out ACS first
2 Shortness of Breath (SOB)
Possibilities include:
- Asthma/COPD exacerbation
- Pneumonia
- Heart Failure
- PE
- Anaphylaxis
- Pneumothorax
Management depends on the cause but begins with:
- oxygen
- airway assessment
- bronchodilators
- treating underlying pathology
3 Headache & Neurological Emergencies
Serious differentials:
- Subarachnoid hemorrhage (SAH)
- Meningitis
- Encephalitis
- Temporal arteritis
- Stroke/TIA
Red flags:
- “Worst headache of life”
- Neck stiffness
- Sudden onset
- Fever
- Focal neurological deficit
4 Altered Mental Status (AMS)
Use the AEIOU TIPS acronym (appears in your PDF) for differential diagnosis:
- A: Alcohol
- E: Electrolytes
- I: Insulin/Hypoglycemia
- O: Opiates
- U: Uremia
- T: Trauma
- I: Infection
- P: Poisoning
- S: Stroke
Always check:
- Fingerstick glucose
- Oxygen saturation
- Pupils
- Trauma signs
5 Abdominal Pain
Abdominal pain varies from benign to life-threatening.
Serious causes include:
- Appendicitis
- Cholecystitis
- Perforated ulcer
- Pancreatitis
- Mesenteric ischemia
- Ruptured AAA
- Ovarian/testicular torsion
Initial approach:
- Keep patient NPO
- CBC, LFT, lipase
- Urinalysis
- USG/CT
- Analgesia
- Early surgery consult if needed
6 Trauma Basics
Trauma assessment follows:
Primary Survey: ABCDE
Secondary Survey: Full exam, history, imaging
Critical injuries:
- airway compromise
- shock
- brain injury
- spinal injury
- uncontrolled hemorrhage
Use the Glasgow Coma Scale (GCS) to assess neurological status (included in your file’s head injury page).
7 Sepsis
Sepsis is life-threatening organ dysfunction caused by infection.
Warning signs:
- Fever or hypothermia
- Tachycardia
- Hypotension
- AMS
- High respiratory rate
Management includes:
- IV fluids
- Broad-spectrum antibiotics
- Blood cultures
- Lactate measurement
- Source control
Essential Emergency Medicine Skills for Students
1. Taking a Focused History
Emergency history = brief + targeted
Use “OPQRST” for pain assessment.
2. Rapid Physical Examination
Look for life threats.
Avoid perfection — look for what will kill the patient first.
3. Basic Airway Skills
- OPA/NPA insertion
- Mask ventilation
- Suction
4. Basic Procedure Familiarity
Students must understand the indications for:
- suturing
- IV cannulation
- ECG placement
- oxygen delivery systems
- splinting
- wound irrigation
Your PDF’s laceration page describes suturing principles and wound care (page 22) .
5. Communication
Use clear, concise, structured language.
SBAR (Situation–Background–Assessment–Recommendation) format is ideal.
6. Teamwork
EM is multidisciplinary — nurses, residents, technicians, consultants.
7. Documentation
Accurate notes protect patients and clinicians.
Diagnostics in Emergency Medicine
Laboratory tests:
- CBC
- BMP
- Liver function tests
- Cardiac enzymes
- Coagulation profile
- Lactate
- Urinalysis
Imaging:
- X-ray
- Ultrasound (FAST, lung, abdominal)
- CT scan (head, chest, abdomen)
- ECG
Students should learn to interpret basic CXR and ECG findings related to emergency conditions.
Disposition: Admit, Observe, or Discharge?
The final decision in the ED is disposition, meaning:
1. Admit to hospital/ICUFactors considered:
- severity
- comorbidities
- social support
- risk scores (HEART, Wells, PERC, Ottawa rules)
The Role of Documentation
EM documentation must include:
- arrival condition
- vitals
- history
- exam findings
- interventions
- response to treatment
- differential diagnosis
- disposition
Clear documentation is critical for quality care and medicolegal safety.
Emergency Medicine Glossary
Based on the glossary provided in your uploaded PDF (page 3) , here is a consolidated, student-friendly version:
| Abbrev. | Meaning |
|---|---|
| AAA | Abdominal Aortic Aneurysm |
| ABx | Antibiotics |
| APAP | Acetaminophen / Tylenol |
| ASA | Aspirin |
| BMP | Basic Metabolic Panel |
| BCx | Blood Cultures |
| CXR | Chest X-ray |
| CP | Chest Pain |
| CT-A | CT Angiography |
| CVA | Stroke |
| DM | Diabetes Mellitus |
| DTR | Deep Tendon Reflex |
| EtOH | Alcohol |
| FND | Focal Neurological Deficit |
| FOBT | Fecal Occult Blood Test |
| FSBS | Finger Stick Blood Sugar |
| HA | Headache |
| HR | Heart Rate |
| ICP | Intracranial Pressure |
| IIH | Idiopathic Intracranial Hypertension |
| JVD | Jugular Venous Distention |
| LOC | Loss of Consciousness |
| MAP | Mean Arterial Pressure |
| N/V | Nausea / Vomiting |
| NPO | Nothing by Mouth |
| OCP | Oral Contraceptive Pills |
| PTX | Pneumothorax |
| PUD | Peptic Ulcer Disease |
| SAH | Subarachnoid Hemorrhage |
| Sx | Symptoms |
| TIA | Transient Ischemic Attack |
| VBG | Venous Blood Gas |
| VSS | Vital Signs Stable |
Tips for Students Entering Emergency Medicine
- Stay calm even in chaotic settings.
- Focus on ABCDE first.
- Never skip vitals.
- Always reassess patients.
- Learn to recognize life-threatening patterns.
- Practice procedures under supervision.
- Communicate clearly.
FAQs About Basics of Emergency Medicine
1. What is the first step when a patient arrives in the emergency department?
The first step is the primary survey using the ABCDE approach to identify and treat life-threatening conditions.
2. Why is triage important in emergency medicine?
Triage ensures that the most critically ill patients receive care first, improving survival rates.
3. How do you quickly assess breathing in an emergency?
Check respiratory rate, chest movements, oxygen saturation, and lung sounds.
4. What is the most important test in chest pain evaluation?
An ECG within 10 minutes is crucial for identifying heart attacks.
5. When should a patient with abdominal pain get a CT scan?
If the pain is severe, persistent, involves fever, vomiting, peritoneal signs, or if dangerous causes like appendicitis or perforation are suspected.
6. What does “NPO” mean in emergency medicine?
“NPO” means Nothing by Mouth — used to prevent aspiration and prepare for possible surgery.
7. What is the difference between AMS and unconsciousness?
AMS = confusion, disorientation;
Unconsciousness = unresponsive, cannot protect airway.
8. How does emergency medicine differ from other specialities?
It is time-critical, unpredictable, and requires rapid decisions under pressure, often without full information.
9. Which conditions commonly cause shortness of breath in ED?
Asthma, COPD, pneumonia, PE, heart failure, trauma, and anxiety.
10. Why are abbreviations used so frequently in EM?
They allow fast communication, especially in critical and time-sensitive situations.
