Give me a list of 100 most common emergency cases that come in er that require immediate and most precise medical attention and the first line of treatment and first aids that the doctor should know for these cases throughout all departments of medical sciences

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Given the library doesn't have a dedicated emergency medicine textbook, I'll now compile a comprehensive, authoritative answer from my medical knowledge, organized by department. This is a well-established clinical topic.

100 Most Common ER Emergency Cases: First-Line Treatment & First Aid

Organized by medical specialty. All treatments are first-line/immediate management.

🫀 CARDIOVASCULAR (1–12)

1. ST-Elevation Myocardial Infarction (STEMI)

First Aid: Aspirin 325 mg chewed immediately, supplemental O₂ if SpO₂ <90%
First-Line Tx: Activate cath lab for primary PCI within 90 min; if unavailable, fibrinolysis (tPA/streptokinase); anticoagulation (heparin), P2Y12 inhibitor (ticagrelor/clopidogrel), nitrates for pain, morphine PRN

2. Non-ST-Elevation ACS (NSTEMI/UA)

First Aid: Aspirin 325 mg, sublingual nitroglycerin, IV access, O₂
First-Line Tx: Dual antiplatelet (aspirin + ticagrelor), anticoagulation (LMWH/heparin), risk-stratify with TIMI/GRACE score, early invasive strategy for high-risk

3. Acute Decompensated Heart Failure (Pulmonary Edema)

First Aid: Sit upright, high-flow O₂, legs dependent
First-Line Tx: IV furosemide 40–80 mg, IV nitroglycerin (if SBP >90), NIV (CPAP/BiPAP), morphine carefully; intubate if failing

4. Hypertensive Emergency (BP >180/120 + end-organ damage)

First Aid: Calm patient, IV access, monitor
First-Line Tx: IV labetalol or nicardipine; reduce MAP by 25% in first hour only; nitroprusside for hypertensive encephalopathy; avoid rapid overcorrection

5. Cardiac Tamponade

First Aid: IV fluids to maintain preload, supplemental O₂
First-Line Tx: Emergent pericardiocentesis (subxiphoid approach); echo-guided preferred; surgical drainage if reaccumulates; avoid positive pressure ventilation

6. Aortic Dissection (Type A)

First Aid: IV access ×2, supplemental O₂, BP monitoring both arms, analgesia
First-Line Tx: Type A → emergent surgery; Type B → IV esmolol (HR <60) then nitroprusside; target SBP 100–120 mmHg; CT angiography to confirm

7. Ventricular Fibrillation / Pulseless VT (Cardiac Arrest)

First Aid: CPR immediately (30:2), call for defibrillator
First-Line Tx: Defibrillation 200 J (biphasic); epinephrine 1 mg IV q3–5 min; amiodarone 300 mg IV; continue ACLS protocol; identify and treat reversible H's and T's

8. Complete Heart Block (3rd Degree AV Block)

First Aid: Atropine 0.5 mg IV (up to 3 mg), transcutaneous pacing
First-Line Tx: Transvenous pacing; dopamine/epinephrine infusion as bridge; treat underlying cause (MI, drug toxicity)

9. Supraventricular Tachycardia (SVT)

First Aid: Valsalva maneuver, carotid sinus massage
First-Line Tx: Adenosine 6 mg rapid IV push (then 12 mg); if unstable → synchronized cardioversion 50–100 J; calcium channel blocker (diltiazem) or beta-blocker if recurrent

10. Atrial Fibrillation with Rapid Ventricular Response

First Aid: O₂, IV access, 12-lead ECG
First-Line Tx: Rate control: IV diltiazem or metoprolol; if unstable → cardioversion 120–200 J; anticoagulate if AF >48 h; treat precipitating cause

11. Massive Pulmonary Embolism

First Aid: O₂, IV access, position upright, avoid hypotension-inducing agents
First-Line Tx: If unstable (shock/arrest): systemic thrombolysis (alteplase 100 mg IV over 2 h); if stable: anticoagulate with heparin; catheter-directed therapy or surgical embolectomy as escalation

12. Acute Limb Ischemia

First Aid: Anticoagulate immediately (heparin), protect limb, analgesia
First-Line Tx: Emergent surgical embolectomy or catheter-directed thrombolysis; 6-hour window critical; Doppler assessment

🧠 NEUROLOGY (13–22)

13. Ischemic Stroke

First Aid: FAST recognition, IV access, non-contrast CT head immediately
First-Line Tx: tPA (alteplase 0.9 mg/kg, max 90 mg) within 4.5 hours if no contraindications; mechanical thrombectomy within 24 h for large vessel occlusion; aspirin 325 mg if tPA not given; strict BP management

14. Hemorrhagic Stroke (Intracerebral Hemorrhage)

First Aid: Airway protection, IV access, avoid anticoagulants
First-Line Tx: Reverse anticoagulation (vitamin K, PCC, FFP); target SBP <140 mmHg (labetalol, nicardipine); neurosurgery consult; ICP management if needed

15. Subarachnoid Hemorrhage

First Aid: "Worst headache of life" — IV access, analgesics, strict bed rest
First-Line Tx: CT head → LP if CT negative; nimodipine 60 mg q4h (vasospasm prevention); BP control; emergent neurosurgery/interventional neuroradiology for aneurysm clipping/coiling

16. Status Epilepticus

First Aid: Protect airway, lateral decubitus, time the seizure, oxygen
First-Line Tx: Lorazepam 0.1 mg/kg IV (or midazolam 10 mg IM if no IV); if persists → fosphenytoin or valproate IV; refractory → phenobarbital or propofol infusion; check glucose

17. Meningitis (Bacterial)

First Aid: Isolate, IV access, do NOT delay treatment for LP
First-Line Tx: Ceftriaxone 2 g IV + vancomycin 15–20 mg/kg + dexamethasone 0.15 mg/kg IV (give before or with first antibiotic dose); LP only after CT to rule out mass; empiric acyclovir if encephalitis suspected

18. Hypertensive Encephalopathy

First Aid: IV access, O₂, quiet environment
First-Line Tx: IV labetalol or nicardipine; target 20–25% MAP reduction over 1 hour; avoid nitroprusside first-line; seizure prophylaxis if needed

19. Acute Spinal Cord Compression

First Aid: Spinal precautions, immobilization
First-Line Tx: High-dose dexamethasone IV; emergent MRI; neurosurgical decompression; treat underlying cause (epidural abscess → antibiotics + surgery)

20. Guillain-Barré Syndrome (Acute)

First Aid: Monitor respiratory function (FVC, NIF), IV access
First-Line Tx: IVIG 0.4 g/kg/day × 5 days OR plasmapheresis; intubate if FVC <20 mL/kg or NIF < −25 cmH₂O; DVT prophylaxis; pain management

21. Wernicke's Encephalopathy

First Aid: Do NOT give glucose before thiamine
First-Line Tx: Thiamine 500 mg IV TID × 3 days; then 250 mg/day; correct electrolytes; glucose after thiamine

22. Cerebral Herniation / Raised ICP

First Aid: Head of bed 30°, avoid hypotension/hypoxia, hyperventilate briefly
First-Line Tx: Mannitol 1 g/kg IV bolus OR hypertonic saline (3% NaCl); intubation with target PaCO₂ 35–40; dexamethasone if vasogenic edema; emergent neurosurgery

🫁 RESPIRATORY (23–32)

23. Acute Severe Asthma (Status Asthmaticus)

First Aid: Sit upright, O₂ to maintain SpO₂ >94%, nebulized salbutamol
First-Line Tx: Salbutamol 2.5 mg + ipratropium 0.5 mg nebulized q20 min × 3; IV methylprednisolone 125 mg; magnesium sulphate 2 g IV over 20 min; heliox; intubate if exhausted/silent chest

24. Acute Exacerbation of COPD

First Aid: Controlled O₂ (24–28%, target SpO₂ 88–92%), position upright
First-Line Tx: Salbutamol + ipratropium nebulized; systemic steroids (prednisolone 40 mg PO or IV methylprednisolone); antibiotics if purulent sputum (amoxicillin-clavulanate or azithromycin); NIV (BiPAP) if pH <7.35; avoid high-flow O₂

25. Tension Pneumothorax

First Aid: CLINICAL DIAGNOSIS — do not wait for CXR; decompress immediately
First-Line Tx: Needle decompression — 2nd ICS, MCL, 14–16G cannula; then chest tube 4th/5th ICS anterior axillary line; O₂; IV fluids if hypotensive

26. Spontaneous Pneumothorax

First Aid: O₂ (high-flow accelerates reabsorption), monitor
First-Line Tx: Small (<2 cm) + stable: observation; large or symptomatic: aspiration or chest tube; pleural drainage

27. Acute Respiratory Distress Syndrome (ARDS)

First Aid: O₂, IV access, position prone if severe
First-Line Tx: Lung-protective ventilation: TV 6 mL/kg IBW, plateau pressure <30 cmH₂O, PEEP titrated; treat underlying cause; prone positioning if PaO₂/FiO₂ <150; neuromuscular blockade if severe

28. Massive Hemothorax

First Aid: IV access ×2, fluid resuscitation, type and crossmatch
First-Line Tx: Large-bore chest tube (28–32 Fr); cell salvage autotransfusion; if >1.5 L on drainage or >200 mL/h → emergent thoracotomy; blood products

29. Epiglottitis

First Aid: Keep patient calm and sitting upright; do NOT examine throat in children; call anesthesia and ENT immediately
First-Line Tx: Secure airway (intubation by most experienced provider, in OR); ceftriaxone 2 g IV; dexamethasone 0.6 mg/kg; no tongue depressor in children

30. Foreign Body Airway Obstruction

First Aid: Conscious adult: back blows × 5 + abdominal thrusts (Heimlich) × 5; unconscious: CPR + look in mouth before ventilating
First-Line Tx: Direct laryngoscopy + Magill forceps; cricothyrotomy if cannot intubate or oxygenate; bronchoscopic removal for lower airway

31. Pneumonia with Sepsis

First Aid: O₂, IV access, blood cultures before antibiotics
First-Line Tx: Antibiotics within 1 hour: ceftriaxone + azithromycin (CAP); piperacillin-tazobactam + vancomycin (HAP/VAP); IV fluids 30 mL/kg; vasopressors if fluid-refractory; consider ICU

32. Acute Upper Airway Angioedema

First Aid: High-flow O₂, call anesthesia for airway immediately, IV access
First-Line Tx: Epinephrine 0.3–0.5 mg IM (anterolateral thigh); IV diphenhydramine + ranitidine; methylprednisolone 125 mg IV; early intubation before edema progresses; C1 esterase inhibitor for hereditary angioedema

🔥 TRAUMA & SURGICAL (33–44)

33. Polytrauma / Major Trauma

First Aid: Primary survey: ABCDE; C-spine immobilization; hemorrhage control
First-Line Tx: Damage control resuscitation: 1:1:1 pRBC:FFP:platelets; permissive hypotension (SBP 80–90) until hemorrhage control; TXA within 3 hours (1 g IV); FAST exam; emergent OR if unstable

34. Hemorrhagic Shock

First Aid: Direct pressure on bleeding, elevate extremities, two large-bore IVs
First-Line Tx: Blood products (pRBC, FFP) over crystalloid; TXA 1 g IV; vasopressors if needed; definitive hemorrhage control (surgery/IR); massive transfusion protocol activation

35. Tension Pneumothorax (Trauma)

See #25 above

36. Flail Chest

First Aid: O₂, analgesia, monitor
First-Line Tx: Adequate analgesia (epidural/intercostal nerve blocks); lung-protective ventilation; treat underlying pneumothorax/hemothorax; surgical stabilization for refractory respiratory failure

37. Traumatic Brain Injury (Severe)

First Aid: Airway protection, C-spine immobilization, avoid hypotension and hypoxia
First-Line Tx: Intubation (RSI); target SBP >90, SpO₂ >95%, PaCO₂ 35–40; mannitol/hypertonic saline for ICP; neurosurgery for epidural/subdural hematoma; ICP monitoring

38. Spinal Cord Injury (Acute Cervical)

First Aid: Rigid collar, log-roll precautions, IV access
First-Line Tx: Maintain MAP 85–90 (vasopressors); avoid hypoxia; emergent MRI; methylprednisolone (controversial, some centers); spinal decompression if indicated; ICU admission

39. Abdominal Compartment Syndrome

First Aid: Decompress NG tube, urinary catheter, positioning
First-Line Tx: Bladder pressure monitoring; if >20 mmHg + organ dysfunction → emergent decompressive laparotomy; remove tight dressings/eschar; neuromuscular blockade trial

40. Ruptured Abdominal Aortic Aneurysm

First Aid: Two large-bore IVs, permissive hypotension, call vascular surgery STAT
First-Line Tx: Emergent EVAR or open repair; massive transfusion protocol; minimize pre-op intervention time; do NOT over-resuscitate

41. Acute Surgical Abdomen (Perforation)

First Aid: IV access, NPO, analgesia (does NOT mask examination), NG tube
First-Line Tx: IV antibiotics (piperacillin-tazobactam); IV fluids; emergent surgery (laparotomy/laparoscopy); upright CXR for free air; CT abdomen if stable

42. Testicular Torsion

First Aid: Analgesia, urgent urology consult, do NOT delay for ultrasound
First-Line Tx: Manual detorsion ("open book" technique) as bridge; emergent surgical exploration and orchiopexy within 6 hours; bilateral orchiopexy

43. Crush Syndrome / Rhabdomyolysis

First Aid: IV access, aggressive IV fluids before extrication if possible
First-Line Tx: IV NS/LR at 1–1.5 L/h targeting urine output 200–300 mL/h; urinary alkalinization (sodium bicarbonate) for myoglobinuria; monitor K⁺, Ca²⁺, renal function; dialysis if AKI

44. Compartment Syndrome (Extremity)

First Aid: Remove all constrictive dressings/casts; elevate limb to heart level
First-Line Tx: Pressure >30 mmHg or Δ pressure <30 mmHg → emergent fasciotomy; analgesia; monitor post-op for reperfusion injury

🩺 GASTROINTESTINAL (45–51)

45. Upper GI Bleed (Variceal)

First Aid: IV access ×2, NPO, type and screen, O₂
First-Line Tx: Octreotide 50 mcg IV bolus then 50 mcg/h; ceftriaxone 1 g IV (SBP prophylaxis); IV PPI; emergent endoscopy within 12 h; band ligation; Sengstaken-Blakemore tube if uncontrolled; TIPS

46. Upper GI Bleed (Non-Variceal)

First Aid: IV access ×2, NPO, resuscitate
First-Line Tx: IV PPI (pantoprazole 80 mg bolus then 8 mg/h); endoscopy within 24 h (12 h if high risk); epinephrine injection + thermal/clip at endoscopy; H. pylori testing

47. Acute Liver Failure

First Aid: IV access, glucose monitoring, avoid hepatotoxic drugs
First-Line Tx: N-acetylcysteine (all causes, especially paracetamol); IV dextrose for hypoglycemia; lactulose for encephalopathy; manage coagulopathy (FFP for bleeding only, not prophylactically); urgent liver transplant assessment

48. Acute Pancreatitis (Severe)

First Aid: NPO, IV access, fluid resuscitation, analgesia
First-Line Tx: Aggressive IV crystalloid (250–500 mL/h LR preferred); pain control (IV morphine/hydromorphone); antibiotics only if infected necrosis confirmed; ERCP if gallstone pancreatitis with cholangitis; ICU if severe

49. Mesenteric Ischemia (Acute)

First Aid: IV access, analgesia, NPO; suspect in any elderly patient with pain out of proportion to exam
First-Line Tx: IV heparin; CT angiography; emergent surgery/catheter-directed thrombolysis; bowel resection if necrosis; broad-spectrum antibiotics

50. Bowel Obstruction (Complete)

First Aid: NPO, NG decompression, IV access, electrolytes
First-Line Tx: IV fluids, electrolyte correction; NG tube decompression; serial abdominal exams; CT abdomen; emergent surgery if strangulation/perforation; water-soluble enema for colonic obstruction

51. Acute Cholangitis (Ascending)

First Aid: IV access, IV fluids, blood cultures × 2, analgesia
First-Line Tx: IV antibiotics (piperacillin-tazobactam or meropenem for severe); IV fluids; urgent ERCP within 24–48 h; percutaneous drainage if ERCP fails

🧪 METABOLIC / ENDOCRINE (52–58)

52. Diabetic Ketoacidosis (DKA)

First Aid: IV access, glucose check, IV fluids
First-Line Tx: IV NS 1 L/h × 2 h, then 0.45% NS; insulin 0.1 u/kg/h IV infusion; potassium replacement when K⁺ >3.5; switch to dextrose-containing fluids when glucose <250; monitor K⁺, bicarbonate hourly; identify precipitant

53. Hyperosmolar Hyperglycemic State (HHS)

First Aid: IV access, IV fluids aggressively, glucose check
First-Line Tx: IV 0.9% NaCl (1 L/h initially); low-dose insulin only after fluid resuscitation; correct Na⁺ slowly; heparin anticoagulation (high thrombosis risk); identify precipitant

54. Severe Hypoglycemia

First Aid: If conscious: oral glucose (juice/dextrose tablets); unconscious: do NOT give PO
First-Line Tx: D50W 25–50 mL IV bolus; or glucagon 1 mg IM/SC if no IV access; recheck glucose in 15 min; identify cause; oral carbohydrates once alert

55. Thyroid Storm (Thyrotoxic Crisis)

First Aid: IV access, cooling measures, IV fluids, O₂
First-Line Tx: PTU 200 mg q4h (blocks synthesis + peripheral conversion) then Lugol's iodine 5 drops q6h (1 hour after PTU); propranolol 1 mg IV q5 min or 40–80 mg PO q6h; dexamethasone 2 mg IV q6h; treat precipitant; cooling

56. Adrenal Crisis (Addisonian Crisis)

First Aid: IV access, IV fluids aggressively, glucose check
First-Line Tx: Hydrocortisone 100 mg IV bolus then 50–100 mg q6h; IV 0.9% NaCl with dextrose; treat precipitating illness; fludrocortisone once oral intake possible

57. Severe Hyponatremia (Na⁺ <120 mEq/L with symptoms)

First Aid: IV access, assess for cerebral edema
First-Line Tx: If symptomatic (seizure/coma): 100 mL 3% NaCl IV over 10 min (×3 if needed); target Na⁺ rise 4–6 mEq/L in first hour, then ≤8–10 mEq/L/24h (avoid osmotic demyelination); water restriction; treat cause

58. Hyperkalemia (K⁺ >6.5 or with ECG changes)

First Aid: IV access, ECG immediately, calcium gluconate if ECG changes
First-Line Tx: Calcium gluconate 10 mL 10% IV (membrane stabilization); insulin 10 U IV + dextrose 50%; salbutamol 10–20 mg nebulized; sodium bicarbonate; furosemide; sodium polystyrene or patiromer; dialysis for refractory

🦠 INFECTIOUS DISEASE / SEPSIS (59–64)

59. Septic Shock

First Aid: IV access ×2, blood cultures × 2, O₂, lactate
First-Line Tx: Antibiotics within 1 hour (broad spectrum: piperacillin-tazobactam + vancomycin); 30 mL/kg IV crystalloid; norepinephrine if MAP <65 after fluids; stress-dose steroids (hydrocortisone 200 mg/day) if refractory; source control

60. Necrotizing Fasciitis

First Aid: IV access, analgesia, mark skin borders
First-Line Tx: Emergent surgical debridement (within 6–12 h — key to survival); IV antibiotics: piperacillin-tazobactam + clindamycin + vancomycin; IV fluids; ICU; hyperbaric O₂ adjunct; serial debridement

61. Ludwig's Angina

First Aid: Airway is priority — call anesthesia and ENT immediately
First-Line Tx: Secure airway (awake fiberoptic if possible); IV ampicillin-sulbactam or clindamycin + ceftriaxone; surgical drainage; avoid blind intubation

62. Toxic Shock Syndrome

First Aid: IV access, fluids, remove foreign body/tampon/dressing
First-Line Tx: IV fluids aggressively; anti-staphylococcal antibiotics (cloxacillin/vancomycin + clindamycin); IVIG 2 g/kg (toxin neutralization); vasopressors; source control

63. Malaria (Severe/Cerebral)

First Aid: IV access, glucose check, O₂
First-Line Tx: IV artesunate 2.4 mg/kg (preferred); if unavailable: IV quinine; dextrose for hypoglycemia; ICU care; exchange transfusion (rare); treat complications (seizures, AKI)

64. Rabies Post-Exposure (Prophylaxis)

First Aid: Wash wound thoroughly with soap and water for 15 min; iodine/70% ethanol
First-Line Tx: HRIG 20 IU/kg (infiltrate wound + remainder IM); rabies vaccine (HDCV) days 0, 3, 7, 14; do NOT suture wound initially; report to public health

💊 TOXICOLOGY / POISONING (65–73)

65. Paracetamol (Acetaminophen) Overdose

First Aid: IV access, time of ingestion, paracetamol level at 4 hours
First-Line Tx: N-acetylcysteine (NAC): 150 mg/kg IV over 1h → 50 mg/kg over 4h → 100 mg/kg over 16h; activated charcoal if <2 hours; use Rumack-Matthew nomogram; liver function monitoring

66. Opioid Overdose

First Aid: Airway positioning, rescue breathing if apneic
First-Line Tx: Naloxone 0.4–2 mg IV/IM/IN; repeat q2–3 min (up to 10 mg); infusion 2/3 of reversal dose/hour for long-acting opioids; monitor for re-narcotization

67. Benzodiazepine Overdose

First Aid: Airway management, positioning, O₂
First-Line Tx: Supportive care; flumazenil 0.2 mg IV (cautious use — may precipitate seizures in dependent patients); airway protection; do NOT use flumazenil in mixed ingestions

68. Tricyclic Antidepressant (TCA) Overdose

First Aid: IV access, 12-lead ECG (QRS widening is key warning)
First-Line Tx: Sodium bicarbonate 1–2 mEq/kg IV bolus if QRS >100 ms or arrhythmia/hypotension; target pH 7.45–7.55; intubation if seizures; avoid physostigmine; lipid emulsion therapy adjunct

69. Organophosphate Poisoning

First Aid: Remove contaminated clothing, decontaminate with water; avoid self-exposure
First-Line Tx: Atropine 2–4 mg IV q5–10 min until secretions dry (may need massive doses); pralidoxime (2-PAM) 1–2 g IV over 15–30 min then infusion; intubation; benzodiazepines for seizures

70. Carbon Monoxide Poisoning

First Aid: Remove from source immediately, 100% O₂ via NRB mask
First-Line Tx: 100% O₂ (reduces CO half-life from 5h to 1h); hyperbaric O₂ if loss of consciousness, cardiac involvement, or COHb >25%; treat seizures; cardiac monitoring

71. Cyanide Poisoning

First Aid: Remove from exposure, 100% O₂
First-Line Tx: Hydroxocobalamin 5 g IV over 15 min (preferred); or sodium nitrite + sodium thiosulfate (if no hydroxocobalamin); 100% O₂; decontaminate skin

72. Digoxin Toxicity

First Aid: IV access, ECG, check K⁺ (hypokalemia worsens toxicity)
First-Line Tx: Digoxin-specific antibody fragments (Fab — Digibind): dose based on ingestion amount or serum level; correct K⁺, Mg²⁺; atropine for bradycardia; avoid calcium (may worsen)

73. Beta-Blocker / Calcium Channel Blocker Overdose

First Aid: IV access, ECG, glucose check
First-Line Tx: Calcium gluconate/chloride IV; glucagon 3–5 mg IV bolus (beta-blocker); high-dose insulin + dextrose (1 u/kg/h); IV lipid emulsion 20%; norepinephrine; pacing for refractory bradycardia; ECMO for refractory shock

🩸 HEMATOLOGY / ONCOLOGY (74–78)

74. Massive Hemorrhage / Coagulopathy

First Aid: Direct pressure, tourniquet for extremities, IV access
First-Line Tx: Massive transfusion protocol (1:1:1); TXA 1 g IV within 3 h; FFP, cryoprecipitate, platelets; correct hypothermia and acidosis; surgical source control

75. Hyperleukocytosis / Leukostasis

First Aid: Avoid red cell transfusion (raises viscosity), hydration
First-Line Tx: Emergent leukapheresis; hydroxyurea 50–100 mg/kg/day; allopurinol + hydration for TLS; avoid pRBC transfusion; urgent hematology consult

76. Tumor Lysis Syndrome (TLS)

First Aid: IV fluids aggressively, monitor electrolytes
First-Line Tx: IV fluids 200 mL/h; allopurinol or rasburicase (rasburicase preferred for severe); treat hyperkalemia, hyperphosphatemia, hypocalcemia; dialysis if refractory; avoid nephrotoxins

77. Febrile Neutropenia

First Aid: Blood cultures × 2 (peripheral + central), IV access, O₂
First-Line Tx: Antibiotics within 1 hour: cefepime or piperacillin-tazobactam IV (add vancomycin if line infection/hemodynamic instability); G-CSF in selected cases; avoid NSAIDs; temperature >38.3°C + ANC <500

78. Sickle Cell Vaso-Occlusive Crisis / Acute Chest Syndrome

First Aid: O₂, IV access, analgesia, IV fluids
First-Line Tx: IV morphine (PCA); IV fluids; incentive spirometry; O₂ if SpO₂ <95%; exchange transfusion for acute chest syndrome; hydroxyurea long-term; blood transfusion if severe anemia

🫘 RENAL / UROLOGICAL (79–83)

79. Acute Kidney Injury (Oliguric/Anuric)

First Aid: Catheterize to rule out obstruction, IV access, stop nephrotoxic drugs
First-Line Tx: IV fluid challenge (500 mL NS over 30 min) if pre-renal; furosemide challenge; dialysis indications: AEIOU (Acidosis, Electrolytes, Ingestion, Overload, Uremia); treat underlying cause

80. Urological Sepsis / Pyelonephritis

First Aid: IV access, urine cultures, blood cultures
First-Line Tx: IV ceftriaxone or ciprofloxacin; IV fluids; IV paracetamol + buscopan for pain; drain obstruction (JJ stent/nephrostomy) if obstructive uropathy; ICU if septic shock

81. Renal Colic with Obstruction and Infection

First Aid: IV access, analgesia (IV ketorolac or morphine), antiemetics
First-Line Tx: IV antibiotics if infected (surgical emergency); IV fluids; urgent urology consult; percutaneous nephrostomy or JJ stent; CT KUB for diagnosis; medical expulsive therapy if no infection

82. Ruptured Ectopic Pregnancy

First Aid: IV access ×2, IV fluids, type and crossmatch, call OB/GYN immediately
First-Line Tx: Emergent surgical intervention (salpingectomy); blood transfusion; do NOT delay for imaging if hemodynamically unstable; if stable: transvaginal USS confirmation then MTX if criteria met

83. Urinary Retention (Acute)

First Aid: Urinary catheterization immediately; monitor post-void residual
First-Line Tx: Foley catheter (14–16 Fr); if impossible → suprapubic catheter; treat underlying BPH (alpha-blockers); check for medications causing retention; monitor for post-obstructive diuresis

👶 OBSTETRIC / GYNECOLOGICAL (84–88)

84. Eclampsia

First Aid: Position left lateral decubitus, O₂, IV access, call OB
First-Line Tx: Magnesium sulphate 4 g IV over 5–10 min then 1–2 g/h infusion (seizure prophylaxis/termination); IV labetalol or hydralazine for BP >160/110; deliver fetus regardless of gestational age (after stabilization); calcium gluconate for Mg toxicity

85. Placental Abruption / APH

First Aid: IV access ×2, type and screen, IV fluids, fetal monitoring
First-Line Tx: IV fluids; blood transfusion; urgent delivery (vaginal if fetus deceased; C-section if fetal distress); DIC management (FFP, platelets, cryoprecipitate); massive transfusion protocol

86. Postpartum Hemorrhage (PPH)

First Aid: Bimanual uterine massage, estimate blood loss, IV access ×2
First-Line Tx: Oxytocin 10 IU IM/IV; ergometrine 0.5 mg IM (if no hypertension); carboprost 0.25 mg IM q15 min; misoprostol 800 mcg PR; uterine balloon tamponade; TXA 1 g IV; surgical (B-Lynch suture, hysterectomy)

87. Ovarian Torsion

First Aid: IV access, analgesia, urgent gynaecology consult
First-Line Tx: Emergent laparoscopic detorsion (within 6 hours); cystectomy if cyst; oophorectomy if necrotic; Doppler USS but clinical diagnosis drives decision

88. Hyperemesis Gravidarum with Severe Dehydration

First Aid: IV access, IV fluids, antiemetics, nothing PO initially
First-Line Tx: IV Hartmann's/NS; IV thiamine 100 mg before dextrose; IV ondansetron or promethazine; correct electrolytes; TPN if oral nutrition impossible; screen for alternative diagnoses

👁️ OPHTHALMOLOGY / ENT (89–93)

89. Chemical Eye Injury (Alkali/Acid)

First Aid: Immediate copious irrigation with water/saline for ≥30 minutes; remove contact lenses; pH check — continue until pH 7.0–7.4
First-Line Tx: Topical anesthetic for compliance with irrigation; emergent ophthalmology; topical steroids + antibiotics; alkali burns are worse (deeper penetration)

90. Acute Angle-Closure Glaucoma

First Aid: IV access, analgesia, antiemetics; urgent ophthalmology
First-Line Tx: IV acetazolamide 500 mg + PO 250 mg q6h; IV mannitol 1–2 g/kg; topical timolol, pilocarpine 2%, and prednisolone; urgent laser peripheral iridotomy

91. Central Retinal Artery Occlusion (CRAO)

First Aid: Ocular massage (15 s on, 15 s off × 15 min); reduce IOP urgently
First-Line Tx: Ocular massage; IV acetazolamide; anterior chamber paracentesis; sublingual isosorbide dinitrate; rebreathing into bag; thrombolytics if within 4.5 h (selected centres); treat systemic risk factors urgently

92. Epistaxis (Posterior / Severe)

First Aid: Lean forward, pinch anterior nares × 10–20 min, ice
First-Line Tx: Anterior: silver nitrate cautery or anterior nasal packing (Merocel/BIPP); posterior: Foley balloon or Rapid Rhino posterior pack; ENT consult; check BP and coagulopathy; reversal of anticoagulants if needed

93. Sudden Hearing Loss (SSNHL)

First Aid: Urgent ENT referral (within 24–48 h is time-critical)
First-Line Tx: Oral prednisolone 1 mg/kg/day × 14 days (or intratympanic dexamethasone); MRI IAM to exclude acoustic neuroma; hyperbaric O₂ (adjunct in some centres); treat within 2 weeks for best outcome

🧒 PEDIATRIC EMERGENCIES (94–97)

94. Febrile Seizure / Pediatric Status Epilepticus

First Aid: Lateral position, time seizure, O₂, do not restrain
First-Line Tx: Buccal midazolam 0.5 mg/kg or rectal diazepam 0.5 mg/kg; if no response: IV lorazepam 0.1 mg/kg; second-line: levetiracetam or phenobarbital IV; glucose check; LP after stabilization for first episode

95. Croup (Severe)

First Aid: Keep calm, upright position, humidified O₂; avoid distressing child
First-Line Tx: Nebulized epinephrine (1:1000, 0.5 mL/kg, max 5 mL); dexamethasone 0.6 mg/kg PO/IM/IV; heliox; intubate if severe obstruction; admit if epinephrine required

96. Pediatric Meningococcemia

First Aid: IV access, immediate blood cultures, non-blanching rash = emergency
First-Line Tx: IV ceftriaxone 100 mg/kg (max 2 g) within minutes of recognition; IV dexamethasone; IV fluids; vasopressors; PICU; prophylaxis for contacts (rifampicin or ciprofloxacin)

97. Intussusception (Pediatric)

First Aid: IV access, IV fluids, analgesia, NPO
First-Line Tx: Pneumatic/hydrostatic enema reduction (diagnostic and therapeutic, 80–90% success); surgery if peritonitis, perforation, or failed enema; IV antibiotics; post-reduction observation 24h

🧘 PSYCHIATRIC / ENVIRONMENTAL (98–100)

98. Anaphylaxis

First Aid: Lay flat + legs elevated (unless breathing difficulty), call for help
First-Line Tx: Epinephrine 0.3–0.5 mg IM (1:1000) anterolateral thigh — IMMEDIATELY; repeat q5–15 min; O₂; IV access; IV diphenhydramine 50 mg; methylprednisolone 125 mg; IV fluids 1–2 L; salbutamol for bronchospasm; observe 4–6 hours minimum

99. Heat Stroke (Classic/Exertional)

First Aid: Remove from hot environment, remove clothing, ice packs to axillae/groin/neck
First-Line Tx: Cold water immersion (most effective) or ice packs; IV cooled saline; target temp <39°C within 30 min; intubation if obtunded; treat seizures (benzodiazepines); monitor for rhabdomyolysis, DIC, hepatic failure

100. Near-Drowning / Submersion Injury

First Aid: Remove from water, spine precautions, CPR if pulseless, lateral decubitus if breathing
First-Line Tx: O₂ (100% initially); assess for aspiration pneumonia; NIV/CPAP for pulmonary edema; warm if hypothermic (40°C heated humidified O₂, warm IV fluids); continue resuscitation for hypothermic arrest until T >35°C; ICU monitoring for delayed ARDS

Quick Reference Summary Table

#	Condition	Most Critical Immediate Action
1	STEMI	Aspirin + activate cath lab
5	Cardiac Tamponade	Pericardiocentesis
7	Cardiac Arrest (VF)	Defibrillate immediately
13	Ischemic Stroke	tPA within 4.5 h / thrombectomy
16	Status Epilepticus	IV/IM benzodiazepine
17	Bacterial Meningitis	Antibiotics + dexamethasone STAT
23	Status Asthmaticus	Salbutamol + IV steroids + Mg
25	Tension Pneumothorax	Immediate needle decompression
29	Epiglottitis	Airway — do not examine throat
33	Polytrauma	ABCDE + damage control resus
40	Ruptured AAA	Emergent vascular surgery
52	DKA	IV fluids + insulin + K replacement
55	Thyroid Storm	PTU + beta-blocker + iodine
59	Septic Shock	Antibiotics + fluids within 1 h
60	Necrotizing Fasciitis	Emergent surgical debridement
65	Paracetamol OD	N-acetylcysteine (NAC)
66	Opioid OD	Naloxone IM/IV
69	Organophosphate	Atropine + pralidoxime
70	CO Poisoning	100% O₂ / hyperbaric O₂
82	Ruptured Ectopic	Emergent surgery
84	Eclampsia	Magnesium + deliver fetus
86	PPH	Oxytocin + TXA + uterine massage
89	Chemical Eye Burn	Irrigate immediately × 30 min
98	Anaphylaxis	Epinephrine IM immediately

Key Universal Principles Across All ER Cases:

Airway is always the first priority
Time is tissue — stroke, STEMI, sepsis, and torsion all have hard time windows
Two large-bore IVs before anything else in hemodynamic emergencies
Do not delay antibiotics waiting for cultures in sepsis/meningitis
Permissive hypotension in uncontrolled hemorrhage until surgical control
Reverse the reversible — H's and T's in cardiac arrest, toxidrome antidotes
Call for help early — airway emergencies, trauma, obstetric crises

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