Common Medical Emergencies - Concept Map
Medical Emergencies: Recognition, Prioritization, and Early Intervention
Related concepts
Acute Respiratory Emergencies
Sub concepts
- Respiratory Failure (hypoxia and hypercapnia)
- Asthma Exacerbation (silent chest = impending arrest)
- COPD Exacerbation
- Pulmonary Edema
- Pneumonia with Respiratory Compromise
- Pulmonary Embolism
- Signs: Tachypnea, accessory muscle use, anxiety, cyanosis, altered consciousness
Relationship to central
Life-threatening condition requiring immediate airway and breathing support
Acute Cardiac Emergencies
Sub concepts
- Acute Coronary Syndrome (ACS)
- STEMI vs NSTEMI
- Myocardial Ischemia
- Acute Decompensated Heart Failure
- Pulmonary Edema (cardiogenic)
- MONA Protocol (Morphine, Oxygen, Nitroglycerin, Aspirin)
- 12-lead ECG within 10 minutes
- Reperfusion therapy (PCI or fibrinolytics)
Relationship to central
Critical circulatory emergencies requiring rapid ECG and medication intervention
Anaphylaxis
Sub concepts
- Type I Hypersensitivity Reaction
- Airway Compromise (laryngeal edema, stridor)
- Bronchospasm and Wheezing
- Distributive Shock (vasodilation, capillary leak)
- Urticaria and Angioedema
- Rapid Onset (minutes)
- Epinephrine 0.3-0.5 mg IM (1:1000) in vastus lateralis
- Adjuncts: Antihistamines, Corticosteroids, IV fluids
- Biphasic Reaction Risk
Relationship to central
Rapidly progressive systemic allergic reaction requiring immediate epinephrine
Hypertensive Crisis
Sub concepts
- Hypertensive Urgency (no acute organ damage)
- Hypertensive Emergency (with acute organ damage)
- Target-Organ Damage Signs: Encephalopathy, acute HF, MI, aortic dissection, AKI, stroke
- Systolic >180 mmHg or Diastolic >120 mmHg
- IV Vasodilators: Labetalol, Nicardipine, Sodium Nitroprusside
- Gradual reduction (≤25% MAP in first hour)
- Avoid rapid pressure drop (stroke/infarction risk)
- Arterial line monitoring and frequent neuro checks
Relationship to central
Severe blood pressure elevation requiring controlled reduction to prevent target-organ damage
Acute Abdomen
Sub concepts
- Appendicitis
- Perforation
- Bowel Obstruction
- Mesenteric Ischemia
- Ruptured Ectopic Pregnancy
- Ruptured Aortic Aneurysm
- Warning Signs: Rigid board-like abdomen, rebound tenderness, guarding, distension, shock
- NPO Status
- IV Access and Fluid Resuscitation
- Contraindications: No heat, laxatives, enemas, or aspirin
- Nasogastric Tube for Decompression
Relationship to central
Sudden severe abdominal pain signaling potential surgical emergency
Diabetic Emergencies
Sub concepts
- Hypoglycemia (glucose <70 mg/dL)
- Rapid Onset
- Adrenergic symptoms: Shakiness, sweating, palpitations
- Neuroglycopenic symptoms: Confusion, slurred speech, seizures, coma
- Rule of 15 (conscious patients)
- IV Dextrose or IM Glucagon (unconscious patients)
- Diabetic Ketoacidosis (DKA)
- Hyperglycemic Crisis: High glucose, metabolic acidosis, ketones
- Gradual Onset (hours to days)
- Kussmaul Respirations and Fruity Breath
- Management: Fluids → Insulin → Potassium
- Hyperosmolar Hyperglycemic State (HHS)
Relationship to central
Extreme blood glucose states requiring opposite interventions
Concept connections
- Respiratory FailureAsthma ExacerbationAsthma exacerbation is one specific cause of respiratory failure with characteristic wheezing that becomes silent in severe cases
- Silent Chest in AsthmaImpending Respiratory ArrestCritical clinical sign indicating airflow obstruction is so severe that no air movement generates sound - imminent life threat
- Acute Coronary SyndromeMONA ProtocolMONA (Morphine, Oxygen, Nitroglycerin, Aspirin) is the evidence-based priority medication intervention for ACS management
- 12-Lead ECGTime-to-ReperfusionECG within 10 minutes identifies STEMI requiring urgent reperfusion therapy; delays in ECG delay reperfusion
- Acute Pulmonary EdemaAcute Decompensated Heart FailurePulmonary edema is the acute manifestation of cardiogenic pulmonary edema in heart failure decompensation
- NitroglycerinContraindications in ACSNitroglycerin is contraindicated in hypotension, after PDE-5 inhibitors (sildenafil), and in RV infarction to prevent further hemodynamic collapse
- AnaphylaxisEpinephrine IMEpinephrine is the single, priority, first-line drug for anaphylaxis - must be given immediately IM regardless of other adjuncts
- Anaphylaxis Epinephrine DosingCardiac Arrest Epinephrine DosingCritically different: anaphylaxis uses 0.3-0.5 mg IM of 1:1000 versus cardiac arrest uses 1 mg IV of 1:10,000 - confusion is a dangerous medication error
- Biphasic Anaphylactic ReactionObservation PeriodRisk of recurrent anaphylaxis symptoms hours after apparent recovery requires extended monitoring and readiness to repeat epinephrine
- Hypertensive EmergencyTarget-Organ DamageThe distinguishing feature of emergency (vs urgency) is the presence of acute end-organ damage including encephalopathy, MI, stroke, or aortic dissection
- IV Vasodilators in HTN EmergencyGradual Pressure ReductionLabetalol, nicardipine, and nitroprusside allow controlled titration to reduce MAP by ≤25% in first hour to prevent ischemic complications
- Acute AbdomenSurgical EmergencyAcute abdomen often represents a surgical condition (appendicitis, perforation, ischemia, ruptured AAA) requiring NPO status and surgical preparation
- Heat, Laxatives, EnemasContraindications in Acute AbdomenThese interventions can rupture an inflamed appendix or worsen obstruction, worsening peritonitis and sepsis risk
- HypoglycemiaRapid Life ThreatHypoglycemia is more immediately dangerous than DKA because the brain is glucose-deprived within minutes, risking seizures and coma
- Rule of 15Conscious Hypoglycemic PatientFor alert patients able to swallow: give 15g fast carbohydrate, recheck in 15 minutes, repeat if needed, then provide complex carbohydrate
- IV Dextrose or IM GlucagonUnconscious Hypoglycemic PatientFor unconscious or unable-to-swallow patients, give D50 IV or IM glucagon to raise blood glucose; never give oral carbs (aspiration risk)
- DKAType 1 DiabetesDKA predominantly affects type 1 diabetics due to absolute insulin deficiency driving ketogenesis
- DKA ManagementFluids-Insulin-Potassium SequenceThe priority management order is (1) IV fluids first to correct hypovolemia, (2) IV regular insulin to stop ketogenesis, (3) potassium monitoring to prevent hypokalemia
- Kussmaul RespirationsDKA Respiratory CompensationDeep rapid respirations are the body's attempt to blow off CO2 and buffer metabolic acidosis in DKA
- HHSType 2 DiabetesHyperosmolar hyperglycemic state occurs primarily in type 2 diabetes with very high glucose but minimal ketosis (residual insulin prevents ketogenesis)
- DKA Potassium MonitoringDo Not Start Insulin if K+ Very LowInsulin drives potassium into cells; if total-body potassium is already depleted, insulin without K+ replacement causes dangerous hypokalemia
- Recognition and SpeedAll Medical EmergenciesThe unifying principle across all medical emergencies is early recognition of the pattern and speed of priority intervention before deterioration
- Continuous ReassessmentIntervention EscalationAfter every intervention, reassess the patient and escalate support if not improving (e.g., from nasal cannula to NIPPV to intubation in respiratory failure)
- RA 9173 Philippine Nursing PracticeScope of Nursing in Medical EmergenciesUnder RA 9173, nurses in emergency settings practice at advanced levels (NCM III-IV) including pharmacologic interventions and critical procedures
- Maslow HierarchyTriage Priority in Medical EmergenciesPhysiologic needs (breathing, circulation, neurologic function) take highest priority; medical emergencies threaten these fundamental needs
Diagrams
Common Medical Emergencies - Full Concept Hierarchy
Complete hierarchical mind map of all major medical emergencies covered in this chapter, showing the breakdown of each emergency type into pathophysiology, clinical signs, and priority interventions.
Acute Respiratory Emergency Assessment and Intervention
Decision tree for assessing and managing acute respiratory emergencies, emphasizing the critical significance of a silent chest in asthma (impending respiratory arrest) and guiding rapid escalation of interventions.
Acute Coronary Syndrome Management: MONA Protocol and Time-Critical Actions
Step-by-step management of acute coronary syndrome emphasizing the critical 10-minute ECG target and MONA protocol with essential contraindications check before nitroglycerin administration.
Anaphylaxis Management: Priority Intervention and Adjuncts
Critical anaphylaxis management pathway emphasizing epinephrine IM as the single priority intervention, with clear contraindications from cardiac arrest dosing and recognition of biphasic reaction risk.
Diabetic Emergencies: Hypoglycemia vs DKA Differentiation and Treatment
Decision algorithm distinguishing between rapidly-onset hypoglycemia and gradually-progressive DKA/HHS, with specific treatment protocols and the critical recognition that hypoglycemia is the more immediately life-threatening emergency.
Hypertensive Crisis: Urgency vs Emergency and Controlled Reduction
Differentiation between hypertensive urgency and emergency with emphasis on target-organ damage assessment and the critical principle of gradual pressure reduction to prevent ischemic complications.
Acute Abdomen Nursing Management: Priority Actions and Contraindications
Comprehensive acute abdomen management emphasizing NPO status and fluid resuscitation as priorities, with explicit contraindications (no heat, laxatives, enemas) that could worsen surgical conditions.
Epinephrine Dosing Comparison: Anaphylaxis vs Cardiac Arrest
Critical comparison of epinephrine dosing in anaphylaxis versus cardiac arrest, highlighting the dangerous error of confusing these protocols. This is a high-yield NLE examination point.
DKA Management Priority Sequence Distribution
Visual representation of the prioritized management sequence for DKA, emphasizing that fluid replacement takes priority before insulin to correct the profound hypovolemia from osmotic diuresis.