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UK Emergency Pathways and Doses for PLAB 1

Thirty-two flashcards on UK emergency doses, time windows and algorithms drawn from NICE and Resuscitation Council UK guidance, for PLAB 1 revision.

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Adult anaphylaxis: first-line drug, dose and route
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1
Adult anaphylaxis: first-line drug, dose and route
Adrenaline 500 micrograms IM (0.5 mL of 1 in 1000) into the anterolateral thigh. Repeat after 5 minutes if there is no improvement.
2
Anaphylaxis adrenaline dose, child aged 6 to 12 years
300 micrograms IM (0.3 mL of 1 in 1000).
3
Anaphylaxis adrenaline dose, child aged 6 months to 6 years
150 micrograms IM (0.15 mL of 1 in 1000).
4
Adult BLS: compression depth, rate and ratio
5 to 6 cm, 100 to 120 per minute, 30 compressions : 2 breaths.
5
Shockable rhythm: drugs and timing in adult ALS
After the 3rd shock: adrenaline 1 mg and amiodarone 300 mg IV. Further amiodarone 150 mg after the 5th shock. Adrenaline then every 3 to 5 minutes.
6
Non-shockable rhythm (PEA or asystole): adrenaline timing
1 mg IV as soon as access is gained, then every 3 to 5 minutes. No shocks.
7
Paediatric BLS opening sequence
Open the airway, give 5 rescue breaths, then 15 compressions : 2 breaths.
8
Sepsis: antibiotic timing by NEWS2 (NICE NG51, 2024)
NEWS2 7 or more: IV antibiotics within 1 hour. NEWS2 5 or 6: within 3 hours if infection likely and no other cause, after senior review.
9
Sepsis: initial fluid for hypotension or raised lactate in adults
500 mL crystalloid over less than 15 minutes, then reassess.
10
Oxygen saturation targets (BTS)
Most acutely ill adults: 94 to 98 percent. At risk of hypercapnic respiratory failure (e.g. COPD): 88 to 92 percent.
11
CURB-65: components and severity
Confusion, Urea over 7 mmol/L, Respiratory rate 30 or more, Blood pressure (systolic under 90 or diastolic 60 or less), age 65 or over. 0 to 1 low, 2 intermediate, 3 or more severe.
12
Life-threatening asthma: features
Peak flow under 33 percent, SpO2 under 92 percent, silent chest, cyanosis, poor respiratory effort, arrhythmia, exhaustion, hypotension or confusion.
13
Head injury (NICE NG232): CT within 1 hour in adults
GCS under 13 on initial assessment, GCS under 15 at 2 hours, suspected open or depressed skull fracture, signs of basal skull fracture, post-traumatic seizure, focal deficit, more than one episode of vomiting.
14
Head injury on an anticoagulant with no other risk factor
Consider CT within 8 hours of injury. Aspirin monotherapy alone is not an indication.
15
STEMI: reperfusion choice
Primary PCI if it can be delivered within 120 minutes of when fibrinolysis could have been given; otherwise fibrinolysis.
16
Acute ischaemic stroke: time windows
IV thrombolysis within 4.5 hours of onset after haemorrhage is excluded. Thrombectomy up to 24 hours from last known well when occlusion is confirmed and tissue is salvageable.
17
Status epilepticus: first-line drug
Lorazepam 4 mg IV, repeated once after 10 minutes if seizures continue.
18
DKA: insulin regimen (JBDS)
Fixed-rate IV insulin 0.1 units per kg per hour, continue long-acting insulin, add glucose when it falls.
19
Hyperkalaemia with ECG changes: treatment order
IV calcium gluconate to protect the myocardium first, then insulin with glucose to shift potassium.
20
Symptomatic bradycardia with adverse features
Atropine 500 micrograms IV, repeated up to 3 mg, then consider pacing or an adrenaline infusion.
21
Regular narrow-complex tachycardia, stable
Vagal manoeuvres (modified Valsalva), then adenosine 6 mg rapid IV bolus with a flush, then 12 mg if needed.
22
Tachycardia with shock, syncope, ischaemia or heart failure
Synchronised DC cardioversion under sedation or anaesthesia.
23
Major trauma bleeding: antifibrinolytic
Tranexamic acid within 3 hours of injury (CRASH-2).
24
Burn first aid
Cool running water for 20 minutes. Do not use ice, butter or burst blisters.
25
Suspected variceal bleed: pre-endoscopy treatment
Terlipressin and prophylactic antibiotics alongside resuscitation, then urgent endoscopy and band ligation.
26
Opioid toxidrome and antidote
Coma, respiratory rate under 10, pinpoint pupils: naloxone, with monitoring because its effect is shorter than many opioids.
27
Staggered paracetamol overdose
Start acetylcysteine without waiting for a level, because the treatment line cannot be used.
28
Carbon monoxide poisoning: key points
Pulse oximetry reads falsely normal. Give 100 percent oxygen by non-rebreather mask.
29
Tension pneumothorax: management
Clinical diagnosis. Immediate needle decompression, then chest drain.
30
Glasgow Coma Scale scoring
Eyes 1 to 4, Verbal 1 to 5, Motor 1 to 6. Total 3 to 15. 8 or less: airway at risk.
31
Hypoglycaemia in an unconscious adult
IV glucose, or glucagon 1 mg IM if there is no IV access. Never give oral glucose to an unresponsive patient.
32
Major incident: first declaration format
METHANE: Major incident, Exact location, Type, Hazards, Access, Number of casualties, Emergency services.

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