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Clinical Wiki & Shift Reference 100% Offline Capable Med Students • Residents • Attendings

Emergency Medicine Command Center

The high-yield bedside companion built to rival WikEM, LITFL, and EM:RAP. Rapid resuscitation algorithms, interactive clinical calculators, weight-based drug dosers, POCUS atlas, and definitive disposition criteria.

Bedside Doser

Rapid Sequence Intubation (RSI) Doser

kg
Etomidate (0.3 mg/kg) 21 mg
Ketamine (1.5–2 mg/kg) 105–140 mg
Rocuronium (1.2 mg/kg) 84 mg
Succinylcholine (1.5–2) 105–140 mg

*Administer induction agent immediately followed by high-dose paralytic. Verify no hyperkalemia or denervation before succinylcholine.

Educational simulation only. Not for acute clinical management or unverified bedside dosing. See Full Disclaimer.

Code Arrest Doses

ACLS Code Cart Quick Push

  • Epi (1:10,000): 1 mg IV/IO q3–5m
  • Amiodarone: 300 mg bolus, then 150 mg
  • Lidocaine: 1–1.5 mg/kg, then 0.75 mg/kg
  • Calcium Chloride: 1 g IV push (Hyperkalemia)
  • Sodium Bicarb: 50 mEq (1 amp) IV (TCA / Acidosis)

Study reference only. Follow hospital ACLS resuscitation protocols.

Clinical Imaging Open Atlas

Emergency Ultrasound (POCUS) Clinical Atlas

Interactive bedside schematics, acoustic window positioning, and normal vs acute pathology comparisons: eFAST, RUSH Shock Protocol, Ocular POCUS for elevated ICP, and 2-Point DVT Compression.

eFAST RUSH Protocol Ocular ONSD DVT Compression
Board Exam Simulation 8,400+ Pool

Emergency Medicine Shelf & Board Drills

Simulate authentic NBME Emergency Medicine Shelf and COMLEX Level 1–3 board scenarios with immediate rationale, tutor feedback, and deficit tracking.

Shift Calculators Evidence-Based Risk Stratification

Interactive Bedside Decision Tools

Multi-tool calculator suite with instant disposition and diagnostic guidance.

Chest Pain Risk

HEART Score for Major Cardiac Events

Score 0
Risk Category: Low Risk (0.9–1.7% 6-week MACE)

Candidate for early discharge from ED with outpatient follow-up.

Clinical Reference Library 21 Core Shift Modules

Emergency Protocols by System

Select any module for the full resuscitation pathway, drug dosing tables, and disposition criteria.

Gastrointestinal Emergencies

Acute Abdominal Pain & Surgical Emergencies

Emergency triage of the acute abdomen: bedside aorta ultrasound, CT angiography for mesenteric ischemia, upright chest X-ray for free air, and antibiotic coverage for intra-abdominal sepsis.

Key Pearl: In elderly patients with severe abdominal pain out of proportion to physical exam, assume Acute Mesenteric Ischemia until ruled ou...
Open Clinical Protocol
Psychiatry & Toxicology

Acute Agitation, Excited Delirium & Psych Emergencies

Critical emergency psychiatry: rapid de-escalation, rapid chemical restraint algorithms (B52, Droperidol, Ketamine IM), NMS vs Serotonin Syndrome diagnostic criteria and antidotes, acute dystonic reactions, and medical clearance.

Key Pearl: In violent, uncooperative agitation with excited delirium, Ketamine (4–5 mg/kg IM) provides rapid dissociation within 2–4 minutes;...
Open Clinical Protocol
Cardiovascular Emergencies

Acute Coronary Syndromes & STEMI Equivalents

Emergency management of ischemic chest pain: ECG diagnosis of subtle STEMI equivalents, right ventricular infarction precautions, antiplatelet/anticoagulation dosing, and cath lab activation pathways.

Key Pearl: Time is myocardium. Do NOT wait for troponin results to activate the cardiac catheterization laboratory for STEMI or STEMI equival...
Open Clinical Protocol
Neurological Emergencies

Acute Ischemic & Hemorrhagic Stroke

Hyperacute management of stroke: non-contrast head CT, CTA head and neck, tenecteplase dosing, groin puncture within 24 hours for large vessel occlusion (LVO), and tight blood pressure titration in spontaneous intracerebral hemorrhage.

Key Pearl: In acute ischemic stroke, establish exact time last known normal (LKN). Non-contrast CT rules out hemorrhage; CTA identifies Large...
Open Clinical Protocol
Pulmonary Emergencies

Acute Pulmonary Embolism & Right Heart Strain

Risk stratification and acute management of pulmonary embolism: Wells and PERC algorithms, CT pulmonary angiography, bedside echocardiography for McConnell's sign, and systemic alteplase dosing for hemodynamic collapse.

Key Pearl: Pulmonary embolism triage is driven by hemodynamics, not clot burden. Massive PE = sustained hypotension (SBP < 90 mmHg for > 15 m...
Open Clinical Protocol
Pulmonary Emergencies

Acute Severe Asthma & COPD Exacerbation

Emergency management of life-threatening obstructive lung disease: continuous beta-agonist nebulization, systemic corticosteroids, intravenous magnesium, terbutaline, and mechanical ventilation traps.

Key Pearl: The 'silent chest' in a severe asthmatic is an ominous sign of impending respiratory arrest due to air trapping, not improvement. ...
Open Clinical Protocol
Resuscitation & Critical Care

Airway & Rapid Sequence Intubation (RSI)

The definitive emergency department airway guide: pre-oxygenation strategies, hemodynamically neutral induction, paralytic selection, video laryngoscopy technique, and the can't-intubate-can't-oxygenate (CICO) surgical airway pathway.

Key Pearl: RSI in the emergency department is fundamentally a resuscitation procedure. Peri-intubation cardiac arrest is prevented by pre-emp...
Open Clinical Protocol
Neurological Emergencies

Altered Mental Status & Coma

Systematic emergency approach to the confused, stuporous, or comatose patient: rapid reversible fixes, metabolic vs toxic vs structural workup, and managing acute brain herniation.

Key Pearl: Altered Mental Status (AMS) is a presentation, not a diagnosis. The initial approach is to immediately secure the airway and rule ...
Open Clinical Protocol
Metabolic & Endocrine Emergencies

Diabetic Ketoacidosis (DKA) & Hyperosmolar Hyperglycemic State (HHS)

Evidence-based metabolic resuscitation: aggressive isotonic rehydration, preventing fatal hypokalemia, continuous vs bolus regular insulin titration, and pediatric cerebral edema protocols.

Key Pearl: In DKA, the glucose is a symptom; the ketoacidosis is the disease. NEVER start insulin until the serum potassium is verified to be...
Open Clinical Protocol
HEENT & Airway

ENT Emergencies, Epistaxis & Deep Neck Infections

Critical ear, nose, and throat management: anterior vs posterior epistaxis balloon tamponade, peritonsillar abscess needle aspiration, Ludwig's angina airway salvage, retropharyngeal space widening, and button battery emergencies.

Key Pearl: Epistaxis refractory to direct pressure and anterior packing is posterior epistaxis (sphenopalatine artery), requiring dual-balloo...
Open Clinical Protocol
Environmental & Toxicology

Environmental, Wilderness & Hyper/Hypothermic Emergencies

Critical wilderness and environmental medicine: hypothermia Swiss staging and ECMO rewarming ('not dead until warm and dead'), heat stroke ice-water immersion, frostbite thrombolysis, HAPE/HACE descent protocols, and rattlesnake CroFab antivenom.

Key Pearl: In severe hypothermic cardiac arrest (core temp < 30°C), withhold multiple shocks and epinephrine until core temperature reaches >...
Open Clinical Protocol
OB/GYN Emergencies

Obstetric & Gynecologic Emergencies

High-stakes maternal-fetal emergency management: ultrasound confirmation of intrauterine pregnancy, beta-hCG discriminatory zones, magnesium sulfate protocols, oxytocin titration, and the 4-minute resuscitative hysterotomy.

Key Pearl: Any female of reproductive age presenting with abdominal pain, syncope, or vaginal bleeding has an ectopic pregnancy until proven ...
Open Clinical Protocol
Ophthalmology & HEENT

Ophthalmologic Emergencies & Acute Visual Loss

Rapid ED visual threat triage: acute angle-closure glaucoma medical decompression, central retinal artery vs vein occlusion, open globe management with Fox eye shield, Morgan lens chemical decontamination, and contact lens bacterial keratitis.

Key Pearl: Immediate visual acuity is the vital sign of the eye; however, in chemical ocular burns, instant copious irrigation with normal sa...
Open Clinical Protocol
Orthopedics & Trauma

Orthopedic Emergencies, Fractures & Splinting

Critical emergency orthopedics: acute compartment syndrome diagnostic thresholds (delta P <= 30 mmHg), Gustilo open fracture staging, knee/hip dislocation neurovascular jeopardy, Kocher septic arthritis criteria, and bedside splint application.

Key Pearl: Acute compartment syndrome is a surgical emergency diagnosed clinically by pain out of proportion to exam and pain with passive st...
Open Clinical Protocol
Pediatric Emergencies

Pediatric Emergencies: Fever & Resuscitation

Emergency pediatric care: risk stratification of neonatal fever, LP indications, weight-based PALS drug calculator, non-invasive fluid titration, and nebulized epinephrine for respiratory distress.

Key Pearl: Children are not small adults: bradycardia is the primary cardiac response to hypoxia and shock. The febrile infant under 28 days ...
Open Clinical Protocol
Resuscitation & Critical Care

Cardiac Arrest & Resuscitation (ACLS)

Comprehensive emergency resuscitation guide covering high-quality chest compressions, shockable vs non-shockable pathways, double sequential defibrillation, ECMO/E-CPR, and targeted temperature management.

Key Pearl: Survival in cardiac arrest hinges on immediate high-quality chest compressions (100–120/min, 5–6 cm depth, complete recoil, CCF > ...
Open Clinical Protocol
Infectious Disease & Sepsis

Sepsis & Septic Shock

Emergency management of sepsis: SOFA and qSOFA scores, early source control, blood cultures before broad-spectrum empiric antibiotics within 1 hour, balanced crystalloids, and vasopressor initiation.

Key Pearl: Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Administer broad-spectrum antibi...
Open Clinical Protocol
Resuscitation & Critical Care

Shock & Undifferentiated Hypotension

Emergency evaluation and aggressive resuscitation of the hypotensive patient: differentiating hypovolemic, cardiogenic, obstructive, and distributive shock with the bedside RUSH exam and targeted inotropes.

Key Pearl: Shock is cellular hypoxia and impaired tissue perfusion, NOT a blood pressure number. Tachycardia, altered mentation, mottled extr...
Open Clinical Protocol
Trauma & Resuscitation

Tension Pneumothorax & Thoracic Trauma

Emergency thoracic trauma algorithms: landmarking and executing needle decompression, finger thoracostomy in ventilated patients, chest tube placement, and emergency department resuscitative thoracotomy criteria.

Key Pearl: Tension pneumothorax is a clinical diagnosis; obtaining a chest radiograph in an unstable patient is malpractice. Decompress immed...
Open Clinical Protocol
Toxicology & Poisoning

Toxicology: Toxidromes & Critical Antidotes

Rapid emergency toxicology: recognizing physical exam signatures of acute poisonings, ordering co-ingestion screens, calculating the osmolar gap, and administering life-saving antidotes.

Key Pearl: In unknown overdose cases, physical examination reveals the toxidrome (vitals, pupils, skin moisture, bowel sounds, reflex tone). ...
Open Clinical Protocol
Trauma & Resuscitation

Trauma Primary Survey & Hemorrhagic Shock

Systematic trauma resuscitation: ATLS primary and secondary survey, identifying life threats in seconds, balanced blood component resuscitation, tranexamic acid, and pelvic binding.

Key Pearl: Hemorrhagic shock is the leading cause of preventable trauma death. Stop the bleed. Replace blood with blood: activate Massive Tra...
Open Clinical Protocol