Evidence-based clinical decision support
Acute Medical Take
UK Acute Medicine Clinical Guide
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An internationally inclusive clinical education navigator for healthcare professionals at every career stage—combining UK acute-medicine standards with practical, globally accessible learning.
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Follow the complete fourteen-stage guide covering preparation, acute practice, prescribing, communication, patient safety, referrals, procedures, wellbeing and career development.
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Clinical category
All clinical pathways
531 pathways — scroll down to choose
ProceduresAbdominal paracentesisPicture-guided stand-alone ascitic tap and drainage pathway→Critical careABG & VBG interpretationChoose the right sample, identify the acid–base disorder and connect physiology to immediate management→EndocrinologyAcromegaly and pituitary tumoursRecognise mass effect and hormone excess, then coordinate pituitary-centre diagnosis and treatment.→GastrointestinalAcute abdominal pain and the acute abdomenSeparate medical pain from time-critical surgical, vascular, gynaecological and metabolic disease.→GastrointestinalAcute alcohol-associated hepatitisRecognise severe inflammatory alcohol-related liver injury, exclude mimics and prevent avoidable organ failure.→Allergy & ImmunologyAcute angioedema and airway riskEnhanced allergy & immunology pathway→OphthalmologyAcute angle-closure glaucomaEnhanced ophthalmology pathway→CardiologyAcute aortic syndromesAortic dissection, intramural haematoma and penetrating aortic ulcer: rapid imaging, anti-impulse therapy and definitive repair→GastrointestinalAcute cholangitis and biliary sepsisTreat sepsis and secure urgent biliary drainage when obstruction is infected.→InfectionAcute cholangitis and cholecystitisEnhanced high-priority infection pathway→GastrointestinalAcute cholecystitisConfirm gallbladder inflammation, grade severity, control sepsis and achieve definitive source control during the index admission.→MusculoskeletalAcute compartment syndromeEnhanced musculoskeletal pathway→Older peopleAcute delirium in older adultsEnhanced older people pathway→Neurological emergenciesAcute demyelination—MS relapse, transverse myelitis, NMOSD and MOGADDistinguish inflammatory relapse from infection, compression and pseudo-relapse before immunotherapy.→GastrointestinalAcute diarrhoeaResuscitation, infection control and selective pathogen testing→Movement DisordersAcute dystoniaRecognise a drug-induced emergency and protect the airway→ENTAcute epistaxis and major nasal haemorrhageEnhanced ent pathway→RespiratoryAcute exacerbation of interstitial lung diseaseExclude infection, oedema, PE and pneumothorax before labelling acute ILD exacerbation.→Older peopleAcute frailty assessment and comprehensive geriatric assessmentEnhanced older people pathway→GastrointestinalAcute gastric-outlet obstructionDecompress safely, correct metabolic consequences and identify benign versus malignant obstruction.→GastrointestinalAcute gastrointestinal and liver disease in pregnancyStabilise the mother, use pregnancy-aware diagnostics and coordinate obstetric, gastroenterology and surgical care.→Renal & metabolicAcute glomerulonephritis and rapidly progressive GNRecognise the nephritic sediment and preserve kidney and lung function while diagnosis is secured.→Oncological emergenciesAcute haemolytic anaemia and autoimmune haemolysisConfirm haemolysis, define immune versus non-immune mechanisms and support oxygen delivery→Neurological emergenciesAcute headachePhenotype the headache, detect secondary causes and investigate safely→CardiologyAcute heart failurePulmonary oedema, congestion and cardiogenic shock→GastrointestinalAcute hepatitis and jaundiceDefine injury pattern and identify treatable viral, toxic, autoimmune and obstructive causes.→MusculoskeletalAcute hip pain and inability to weight-bearEnhanced musculoskeletal pathway→Electrolyte imbalancesAcute hypercalcaemiaRecognise severe hypercalcaemia and treat the cause→RespiratoryAcute hypercapnic respiratory failureCorrect reversible ventilatory failure, initiate NIV safely and recognise failure early.→RespiratoryAcute hypoxaemic respiratory failure and ARDSIdentify the cause and escalate oxygen support without delaying lung-protective ventilation.→MusculoskeletalAcute inflammatory polyarthritisEnhanced musculoskeletal pathway→Renal & metabolicAcute interstitial nephritis and tubulointerstitial diseaseRecognise medicine-, infection- and immune-mediated interstitial injury before fibrosis develops.→Renal & metabolicAcute kidney injuryConfirm and stage the injury, identify the renal compartment and treat reversible physiology before complications become established.→MusculoskeletalAcute limb neurovascular compromiseEnhanced musculoskeletal pathway→GastrointestinalAcute liver failureEarly recognition, antidote consideration and specialist referral→Oncological emergenciesAcute lymphoblastic leukaemia (ALL)Lineage and genetics-led acute leukaemia treatment with CNS-directed therapy→PsychiatryAcute maniaEnhanced psychiatry pathway→MusculoskeletalAcute monoarthritis and suspected septic jointEnhanced musculoskeletal pathway→RheumatologyAcute monoarthritis, gout and CPPDEnhanced rheumatology pathway→Oncological emergenciesAcute myeloid leukaemia (AML)Time-critical recognition, molecular classification and subtype-directed therapy→MusculoskeletalAcute neck pain and cervical spine emergencyEnhanced musculoskeletal pathway→RespiratoryAcute NIV and AIRVOSafe selection, setup, monitoring and weaning of acute NIV and nasal high-flow therapy→GastrointestinalAcute pancreatitisConfirm the diagnosis, assess severity and identify the cause→CardiologyAcute pericarditisRecognise pericardial inflammation, high-risk features and tamponade→Neurological emergenciesAcute peripheral vertigoTIMING · TRIGGERS · TARGETED EXAM→PsychiatryAcute psychosis and first-episode psychosisEnhanced psychiatry pathway→RespiratoryAcute severe asthmaSeverity assessment and escalation for life-threatening asthma→MusculoskeletalAcute shoulder pain and loss of functionEnhanced musculoskeletal pathway→MusculoskeletalAcute spinal injury, back pain and spinal red flagsEnhanced musculoskeletal pathway→EndocrinologyAcute symptomatic hypocalcaemiaTreat tetany, seizure, laryngospasm and QT-related arrhythmia while defining the cause.→Role of MDTAcute Take - MDTHow PT, OT, ILS, dietetics, pharmacy, social work and mental-health nursing connect around the patient→Oncological emergenciesAcute transfusion reactionsStop the component, resuscitate and distinguish haemolysis, sepsis, TRALI and TACO→Renal & metabolicAcute urinary retention and post-obstructive diuresisDecompress safely, identify the cause and replace only clinically significant post-obstructive losses.→ENTAcute vertigo and peripheral vestibular emergenciesEnhanced ent pathway→Neurological emergenciesAcute weakness and paralysis—localisation and differential diagnosisLocalise brain, cord, root, nerve, neuromuscular junction or muscle before deterioration becomes respiratory failure.→EndocrinologyAdrenal incidentaloma and suspected adrenal malignancyDecide whether an adrenal mass is hormonally active or radiologically malignant before intervention.→EndocrinologyAdrenal insufficiency and adrenal crisisRecognise adrenal crisis, localise failure across the HPA axis and provide safe lifelong replacement and crisis prevention.→Cardiac ArrestAdult cardiac arrestTwo-page specialist ALS guide: shockable and non-shockable arrest→CardiologyAdult congenital heart diseaseIdentify anatomy, repair history and residual physiology; involve an ACHD centre before routine assumptions or intervention.→RheumatologyAdult-onset Still disease and cytokine stormEnhanced rheumatology pathway→DatixAfter submitting a DatixSupport openness, review and system improvement→Palliative careAgitation, delirium and psychological distress at end of lifeEnhanced palliative care pathway→RespiratoryAir travel and fitness-to-fly assessmentPredict altitude-related hypoxaemia and device needs using disease-specific risk rather than resting saturation alone.→Oncological emergenciesAL amyloidosisEnhanced secondary specialist haematology pathway→GastrointestinalAlcohol withdrawalPrevent seizures, delirium tremens and Wernicke encephalopathy→GastrointestinalAlcohol-withdrawal seizureTerminate the seizure, prevent recurrence and exclude a second cause→RespiratoryAllergic bronchopulmonary aspergillosis and chronic pulmonary aspergillosisDistinguish allergic, chronic cavitary and invasive phenotypes because treatment and urgency differ.→RespiratoryAlpha-1 antitrypsin deficiencyRecognise inherited emphysema and liver disease and connect families to specialist testing.→Renal & metabolicAnaemiaPhysiology-led stabilisation, morphological classification and definitive cause-finding→Oncological emergenciesAnaemia and haemolysis investigation algorithmSpecialist haematology investigation or procedure pathway→Cardiac ArrestAnaphylaxisVisual step-by-step treatment of anaphylaxis and refractory reactions→Oncological emergenciesAnticoagulant reversal quick-referenceSpecialist haematology investigation or procedure pathway→Oncological emergenciesAnticoagulant-associated bleeding and emergency reversalIdentify the agent and reverse critical bleeding while securing source control→InfectionAntimicrobial resistance and safe empirical prescribingEnhanced high-priority infection pathway→CardiologyAntiplatelet and anticoagulant managementMatch agent and duration to indication, timing, renal function and bleeding risk—with a written interruption/restart plan.→ToxicologyAntipsychotic poisoning and neuroleptic malignant syndromeEnhanced toxicology specialist pathway→InfectionAntiretroviral medicines (ARVs)Illustrated ART classes with preferred first-line and highlighted specialist second-line pathways→RespiratoryApproach to BreathlessnessA structured ABCDE approach to rapid stabilisation, diagnosis and treatment→EndocrinologyArginine vasopressin deficiency (cranial diabetes insipidus)Prevent omitted desmopressin, uncontrolled water loss and catastrophic hypernatraemia.→ProceduresArterial blood gas samplingPicture-guided stand-alone radial ABG pathway→RespiratoryArterial blood-gas interpretation in respiratory failureUse a reproducible acid–base and oxygenation sequence to guide ventilatory support and reassessment.→GastrointestinalAscites and spontaneous bacterial peritonitisSample deteriorating ascites promptly and treat infected fluid before organ failure.→RespiratoryAspiration pneumonia and aspiration pneumonitisSeparate chemical injury from bacterial infection and secure airway, swallow and source-control plans.→Oncological emergenciesAsplenia, hyposplenism and post-splenectomy careEnhanced secondary specialist haematology pathway→CardiologyAtrial fibrillationNew or fast AF, instability and stroke prevention→InfectionAtypical pneumoniaExposure-led assessment for Legionella, Mycoplasma, psittacosis and Q fever→DermatologyAutoimmune blistering disease—pemphigoid and pemphigusEnhanced dermatology pathway→Neurological emergenciesAutoimmune encephalitisRecognise subacute psychiatric, cognitive, seizure and movement syndromes while excluding infection in parallel.→GastrointestinalAutoimmune hepatitisConfirm immune-mediated hepatitis, grade severity and use response-guided immunosuppression safely.→Neurological emergenciesAutonomic disorders and dysautonomiaIdentify neurogenic orthostatic hypotension, POTS and multisystem autonomic failure while excluding common cardiovascular causes.→Neurological emergenciesBenign paroxysmal positional vertigo (BPPV)SECONDS · POSITION-TRIGGERED · NO HEARING LOSS→ToxicologyBenzodiazepine and sedative poisoningEnhanced toxicology specialist pathway→ToxicologyBeta-blocker overdoseAnticipate bradycardia, shock and metabolic complications→Allergy & ImmunologyBiologic therapy reactions and immunogenicityEnhanced allergy & immunology pathway→InfectionBite wounds, zoonoses and post-exposure preventionEnhanced infection specialist pathway→Oncological emergenciesBlood-component selection and prescribingSpecialist haematology investigation or procedure pathway→ProceduresBlood-culture collectionPicture-guided stand-alone blood-culture collection pathway→Oncological emergenciesBlood-film interpretationSpecialist haematology investigation or procedure pathway→Oncological emergenciesBone-marrow aspiration and trephine biopsySpecialist haematology investigation or procedure pathway→GastrointestinalBowel obstruction and ileusRecognise strangulation and perforation while decompressing and resuscitating.→Cardiac ArrestBradyarrhythmiasAtropine, pacing and tachy–brady syndrome in the peri-arrest patient→Palliative careBreathlessness in advanced illnessEnhanced palliative care pathway→RespiratoryBronchiectasis exacerbationUse previous microbiology, airway clearance and complication screening to treat precisely.→RespiratoryBronchiectasis—long-term managementReduce exacerbations through cause-finding, airway clearance and microbiology-led prevention.→RespiratoryBronchoscopy—indications, preparation and complicationsChoose flexible or rigid bronchoscopy for a defined diagnostic or therapeutic question with airway-risk planning.→InfectionCandidemia and invasive fungal infectionEnhanced high-priority infection pathway→ToxicologyCannabis toxicity & hyperemesisDistinguish intoxication, synthetic cannabinoids and hyperemesis→PsychiatryCapacity, consent and Mental Health Act interfaceEnhanced psychiatry pathway→ToxicologyCarbon monoxide and cyanide poisoningEnhanced toxicology specialist pathway→CardiologyCardiac Device TherapyPacemakers, ICD and CRT: identify indications, complications and urgent device problems→CardiologyCardiac disease in pregnancyUse pregnancy-specific risk, safe diagnostics and a Pregnancy Heart Team from pre-conception through postpartum.→CardiologyCardiac InvestigationsBiochemical, radiological and rhythm tests: indication and interpretation→CardiologyCardiac masses and intracardiac thrombusUse multimodality imaging to distinguish thrombus, tumour, vegetation and artefact before anticoagulation or surgery.→CardiologyCardiac rehabilitation after ACS, PCI and CABGBegin rehabilitation before discharge with exercise, education, psychological support and risk-factor treatment.→CardiologyCardiac traumaIdentify myocardial injury, tamponade, coronary/valve disruption and traumatic aortic injury within the major-trauma pathway.→CardiologyCardio-oncologyBaseline risk, biomarker/strain surveillance and rapid management of cancer-therapy cardiovascular toxicity.→CardiologyCardiogenic shockPhenotype congestion and perfusion, identify the mechanical/ischaemic cause and activate a shock pathway early.→CardiologyCardiomyopathyPhenotype, family assessment, sudden-death risk and disease-specific care→Renal & metabolicCardiorenal syndrome and diuretic resistanceDecongest without losing sight of perfusion, reversible AKI and advanced heart-failure physiology.→CardiologyCardiovascular disease in chronic kidney diseaseBalance congestion, perfusion, potassium and contrast while preserving proven cardiovascular therapy.→Palliative careCare in the last days of life and anticipatory prescribingEnhanced palliative care pathway→PsychiatryCatatonia and malignant catatoniaEnhanced psychiatry pathway→GastrointestinalCaustic ingestion and corrosive oesophageal injuryProtect the airway, define injury safely and prevent perforation without inducing further exposure.→DermatologyCellulitis mimics and inflammatory red legEnhanced dermatology pathway→InfectionCellulitis, erysipelas and necrotising soft-tissue infectionEnhanced high-priority infection pathway→InfectionCentral-line and device-associated infectionEnhanced high-priority infection pathway→Neurological emergenciesCerebral venous sinus thrombosisIdentify venous thrombosis in headache, seizure or focal neurology—especially during pregnancy, puerperium or prothrombotic illness.→OphthalmologyChemical eye injuryEnhanced ophthalmology pathway→CardiologyChest pain & suspected ACSTime-critical ECG, risk assessment and reperfusion pathway→RespiratoryChest X-ray and thoracic CT interpretationInterpret thoracic imaging systematically, communicate critical findings and link patterns to the next diagnostic action.→ProceduresChest-drain insertionPicture-guided stand-alone pleural-drain pathway→RespiratoryChest-drain insertion, management and complicationsInsert for a clear indication with ultrasound and maintain a closed, observable system until safe removal.→RespiratoryChronic coughUse cough phenotype, red flags and treatable traits rather than repeated empirical antibiotics.→GastrointestinalChronic diarrhoeaInvestigate inflammatory, malabsorptive, secretory and functional causes→CardiologyChronic heart failure / congestive cardiac failureSpecialist pathway for chronic congestion, phenotype-led treatment and long-term prognosis→Renal & metabolicChronic kidney disease and acute-on-chronic kidney injurySeparate chronic impairment from a new reversible insult and protect remaining kidney function.→GastrointestinalChronic liver diseaseAssess decompensated cirrhosis and treat the precipitating cause→Oncological emergenciesChronic lymphocytic leukaemia (CLL)Distinguish observation from treatment and manage infection, cytopenia and transformation→Oncological emergenciesChronic myeloid leukaemia (CML)Confirm BCR::ABL1, define phase and select a monitored tyrosine-kinase inhibitor→GastrointestinalChronic pancreatitis and pancreatic exocrine insufficiencyControl pain and malnutrition while detecting diabetes, obstruction and malignancy.→Renal & metabolicCKD anaemia, IV iron and erythropoiesis-stimulating agentsConfirm iron availability and exclude alternative anaemia before ESA or IV iron therapy.→Renal & metabolicCKD mineral and bone disorderInterpret calcium, phosphate, PTH and bone risk together—not as isolated numbers.→InfectionClostridioides difficile infection and toxic megacolonEnhanced high-priority infection pathway→GastrointestinalClostridioides difficile infection—initial, recurrent and fulminantGrade severity, stop avoidable drivers and recognise ileus, toxic megacolon and surgical failure early.→InfectionCMV, HSV and VZV infectionEnhanced infection specialist pathway→Oncological emergenciesCoagulation-screen and mixing-study interpretationSpecialist haematology investigation or procedure pathway→ToxicologyCocaine toxicityRecognise sympathomimetic toxicity and cardiovascular complications→GastrointestinalCoeliac disease and malabsorptionConfirm diagnosis before restriction and replace deficiencies while defining the cause.→GastrointestinalColitisRecognise acute severe colitis, infection and complications→Neurological emergenciesComa and acute encephalopathyStabilise first, reverse immediately treatable causes and use localisation plus tempo to direct testing.→RespiratoryCommunity- and hospital-acquired pneumoniaGrade severity, start prompt source-appropriate treatment and actively search for complications.→CardiologyConduction disordersRecognise sinus-node disease, AV block and bundle-branch disease; stabilise bradycardia and select monitoring or pacing→Renal & metabolicConservative kidney management and advance-care planningProvide active symptom-focused renal care when dialysis is not chosen or no longer beneficial.→DNACPRConsidering DNACPRMake an individual CPR decision—not a blanket ceiling of care→GastrointestinalConstipation and faecal impactionExclude obstruction and secondary disease before safe disimpaction.→Renal & metabolicContrast-associated acute kidney injuryBalance renal risk against the harm of delaying a clinically necessary contrast study.→RespiratoryCOPD exacerbationControlled oxygen, bronchodilation and ventilatory support→EscalationCritical-care referralMake a focused, timely referral with a clear treatment ceiling→Critical careCritical-care referral, transfer and handoverEnhanced critical care pathway→Critical careCritical-care sedation, analgesia and deliriumEnhanced critical care pathway→GastrointestinalCrohn disease and ulcerative colitisSeparate acute severe colitis from Crohn complications and coordinate rescue therapy.→InfectionCryptococcosis and cryptococcal meningitisEnhanced infection specialist pathway→MusculoskeletalCrystal arthritis and inflammatory flareEnhanced musculoskeletal pathway→EndocrinologyCushing syndrome and acute cortisol excessRecognise severe hypercortisolism, control complications and expedite pituitary/adrenal MDT care.→RespiratoryCystic fibrosis in adultsProtect airway clearance, nutrition and established specialist regimens during every admission.→RehabilitationDeconditioning & frailtyPrevent avoidable loss of strength and independence→Older peopleDeconditioning, immobility and pressure-injury preventionEnhanced older people pathway→ENTDeep-neck space infection and peritonsillar abscessEnhanced ent pathway→CardiologyDeep-vein thrombosis (DVT)Probability-led diagnosis, safe interim anticoagulation and definitive VTE care→Older peopleDeliriumRecognise acute cognitive change and treat precipitants→Neurological emergenciesDementia and rapidly progressive cognitive declineSeparate delirium from chronic neurodegeneration and urgently investigate subacute, reversible or inflammatory decline.→Older peopleDementia with acute behavioural or functional deteriorationEnhanced older people pathway→EscalationDeteriorating patientRecognise deterioration and call for help early→Critical careDeteriorating patient, NEWS2 and rapid responseEnhanced critical care pathway→EndocrinologyDiabetes during fasting, surgery and enteral feedingMatch insulin to carbohydrate delivery and avoid interruption-related hypoglycaemia or ketosis.→Renal & metabolicDiabetic kidney diseaseReduce cardiorenal risk while recognising when atypical features indicate another renal diagnosis.→Renal & metabolicDialysis access and modality complicationsA visual cross-modality pathway for failing clearance, access and dialysis-related instability.→Critical careDifficult airway and emergency tracheal intubationEnhanced critical care pathway→ToxicologyDigoxin and cardiac-glycoside poisoningEnhanced toxicology specialist pathway→DNACPRDiscussing & documenting DNACPRCommunicate sensitively and document a clear, reviewable decision→Oncological emergenciesDisseminated intravascular coagulationDynamic consumptive coagulopathy—treat the driver and support clinically significant bleeding→GastrointestinalDiverticulitis and complicationsIdentify abscess, perforation, fistula and obstruction.→Neurological emergenciesDix–Hallpike and Epley manoeuvreDIAGNOSE THE CANAL · THEN REPOSITION→EndocrinologyDKA & HHSStructured fluids, insulin and electrolyte monitoring→DNACPRDNACPR during deteriorationContinue all clinically appropriate treatment short of CPR→DermatologyDRESS syndrome and severe drug hypersensitivityEnhanced dermatology pathway→ToxicologyDrug-induced hyperthermia and severe agitationEnhanced toxicology specialist pathway→CardiologyDyslipidaemia and secondary cardiovascular preventionTreat global risk, intensify lipid lowering early and close the post-event prevention gap.→GastrointestinalDysphagia and oesophageal food-bolus obstructionProtect the airway and recognise complete obstruction, perforation and malignancy.→Older peopleDysphagia, aspiration and nutrition in frailtyEnhanced older people pathway→Nutritional supportDysphagia, aspiration risk and texture-modified nutritionEnhanced nutritional support pathway→RehabilitationEarly rehabilitation assessmentStart rehabilitation alongside acute treatment→PsychiatryEating-disorder medical emergenciesEnhanced psychiatry pathway→CardiologyECG interpretationA repeatable approach to rate, rhythm, conduction, QRS and ST–T change→DermatologyEczema herpeticum and disseminated viral skin infectionEnhanced dermatology pathway→Renal & metabolicEmergency kidney replacement therapy indicationsEscalate on life-threatening physiology and treatment failure—not an isolated urea or creatinine value.→RespiratoryEmergency oxygen prescribing and oxygen toxicityPrescribe oxygen to a target range and prevent both hypoxaemia and oxygen-induced harm.→EscalationEmergency transfer & handoverStabilise, communicate and transfer with appropriate escort→InfectionEmerging diseasesRapid recognition and containment of new, re-emerging and high-consequence infections→EndocrinologyEndocrine complications of cancer immunotherapyRecognise hypophysitis, adrenal failure, thyroiditis and insulin-deficient diabetes before collapse.→EndocrinologyEndocrine disease in pregnancyUse pregnancy-specific ranges and coordinate maternal medicine, obstetrics and endocrinology early.→ENTENT foreign body, facial trauma and post-tonsillectomy bleedEnhanced ent pathway→Nutritional supportEnteral & parenteral nutritionChoose the safest route and define monitoring→GastrointestinalEnteral and parenteral nutritional supportChoose the safest route, prevent refeeding syndrome and monitor delivery.→Nutritional supportEnteral tube feeding—selection, placement and complicationsEnhanced nutritional support pathway→Oncological emergenciesEosinophilia and hypereosinophilic syndromesEnhanced secondary specialist haematology pathway→RespiratoryEosinophilic lung disease and pulmonary vasculitisLink eosinophilia and pulmonary infiltrates to drugs, infection, EGPA, hypereosinophilic disease or eosinophilic pneumonia.→Neurological emergenciesEpilepsy and long-term antiseizure-medicine managementClassify seizure type and syndrome, optimise treatment and reduce avoidable harm from interactions, pregnancy and sudden death.→Oncological emergenciesErythrocytosis and secondary polycythaemiaEnhanced secondary specialist haematology pathway→DermatologyErythrodermaEnhanced dermatology pathway→EndocrinologyEuglycaemic DKA and SGLT2-inhibitor emergenciesCheck ketones and acidosis even when glucose is normal or only modestly raised.→Oncological emergenciesEvans syndromeEnhanced secondary specialist haematology pathway→InfectionExtrapulmonary tuberculosisTissue-led diagnosis and site-specific specialist management→Older peopleFalls in older peopleAssess injury, acute illness, frailty and modifiable fall risks→Older peopleFalls, gait instability and multifactorial assessmentEnhanced older people pathway→InfectionFever in the returning travellerExposure- and incubation-led assessment, urgent malaria exclusion and imported-infection escalation→InfectionFever with rash and high-consequence infectionEnhanced infection specialist pathway→Neurological emergenciesFirst seizure, seizure clusters and non-convulsive status epilepticusStop ongoing seizure activity, identify reversible causes and recognise persistent electrographic status.→Renal & metabolicFluid-status assessment and specialist IV-fluid prescribingPrescribe fluids as a drug: resuscitation, routine maintenance, replacement, redistribution and reassessment.→RespiratoryForeign-body aspiration and central-airway obstructionRelieve complete obstruction and secure rigid-bronchoscopy or tumour-debulking expertise.→MusculoskeletalFragility fracture and acute osteoporosis careEnhanced musculoskeletal pathway→Older peopleFragility fracture, osteoporosis and bone protectionEnhanced older people pathway→Neurological emergenciesFunctional neurological disorder—acute presentationMake a positive, respectful diagnosis only after identifying features of FND and addressing dangerous mimics.→Oncological emergenciesG6PD deficiency and hereditary red-cell disordersEnhanced secondary specialist haematology pathway→ToxicologyGabapentin overdoseAssess sedation, respiratory compromise and co-ingestion→GastrointestinalGastritis, oesophagitis and gastro-oesophageal reflux diseaseTreat mucosal injury while identifying bleeding, stricture, Barrett change and malignancy.→GastrointestinalGastrointestinal and hepatobiliary malignancy presentationsRecognise alarm symptoms and acute cancer complications while securing diagnosis and staging.→GastrointestinalGastrointestinal polyps and hereditary cancer syndromesMatch polyp burden, histology and family history to surveillance, genetics and cancer prevention.→GastrointestinalGastroparesis and gastrointestinal motility disordersConfirm delayed transit after excluding obstruction and restore hydration, nutrition and symptom control.→RheumatologyGiant-cell arteritis and polymyalgia rheumaticaEnhanced rheumatology pathway→OphthalmologyGiant-cell arteritis with visual symptomsEnhanced ophthalmology pathway→Neurological emergenciesGuillain–Barré syndrome and chronic inflammatory demyelinating polyneuropathyRecognise acute inflammatory neuropathy, monitor respiratory/autonomic failure and distinguish chronic or relapsing disease.→Oncological emergenciesHaematological disorders during pregnancyEnhanced secondary specialist haematology pathway→Renal & metabolicHaematuria and proteinuriaSeparate glomerular bleeding from urological disease and quantify albuminuria before referral.→GastrointestinalHaemochromatosis and Wilson diseaseRecognise treatable iron or copper overload before irreversible hepatic and extrahepatic injury.→Renal & metabolicHaemodialysis emergenciesRecognise access, haemodynamic, electrolyte and infection complications before rapid deterioration.→Oncological emergenciesHaemophagocytic lymphohistiocytosis—haematology routeEnhanced secondary specialist haematology pathway→Oncological emergenciesHaemophilia, von Willebrand disease and acquired factor inhibitorsTreat critical-site bleeding before imaging or confirmatory factor results→MusculoskeletalHand infection, bite and flexor tenosynovitisEnhanced musculoskeletal pathway→CardiologyHeart Failure RehabilitationPersonalised exercise, education and multidisciplinary recovery for stable heart failure→Oncological emergenciesHeparin-induced thrombocytopeniaRecognise immune thrombosis, calculate probability and replace all heparin→GastrointestinalHepatic encephalopathyProtect the airway, identify precipitants and avoid diagnostic anchoring.→GastrointestinalHepatitis A infectionConfirm acute faecal–oral hepatitis, identify acute liver failure and protect close contacts.→GastrointestinalHepatitis B infectionDistinguish acute, chronic, immune-active and resolved HBV, prevent transmission and treat fibrosis/viral-risk rather than ALT alone.→GastrointestinalHepatitis C infectionConfirm active viraemia, stage liver disease and cure infection with a short pangenotypic direct-acting antiviral regimen.→GastrointestinalHepatitis D infectionTest every HBsAg-positive person appropriately because HDV accelerates cirrhosis and depends on HBV for propagation.→GastrointestinalHepatitis E infectionRecognise waterborne travel-associated and zoonotic foodborne HEV, with special risk in pregnancy and immunosuppression.→GastrointestinalHepatorenal syndrome and acute kidney injury in cirrhosisIdentify reversible AKI and initiate specialist therapy when HRS-AKI is diagnosed.→Allergy & ImmunologyHereditary and acquired bradykinin-mediated angioedemaEnhanced allergy & immunology pathway→Nutritional supportHigh-output stoma and short-bowel intestinal failureEnhanced nutritional support pathway→Neurological emergenciesHINTS examinationONLY FOR ACUTE VESTIBULAR SYNDROME→InfectionHIVRecognise new HIV, advanced immunosuppression and opportunistic illness→CardiologyHoliday heart syndromeAcute alcohol-associated AF or another tachyarrhythmia: stabilise, identify coexisting toxicity/withdrawal and manage rhythm and stroke risk exactly as seriously as other AF.→Electrolyte imbalancesHyperkalaemiaProtect the myocardium and lower potassium safely→Movement DisordersHyperkinetic movement emergencyAssess severe tremor, chorea, myoclonus or dyskinesia→Electrolyte imbalancesHypernatraemiaAssess volume status, define the water deficit and correct at a monitored rate→CardiologyHypertensive emergenciesLower blood pressure by the correct amount for the injured organ—not to a normal number immediately.→Renal & metabolicHypochromic microcytic anaemiaConfirm iron restriction, exclude haemoglobinopathy and find the source of blood loss→EndocrinologyHypoglycaemiaRestore glucose promptly and prevent recurrence→Electrolyte imbalancesHypokalaemiaAssess severity, cardiac risk and the underlying cause→Electrolyte imbalancesHypomagnesaemiaCorrect cardiac and neuromuscular instability with linked electrolyte deficits→Electrolyte imbalancesHyponatraemiaAssess symptoms, tonicity, volume status and chronicity→Electrolyte imbalancesHypophosphataemiaRecognise severe phosphate depletion, refeeding risk and organ dysfunction→Allergy & ImmunologyImmunodeficiency with acute infectionEnhanced allergy & immunology pathway→Allergy & ImmunologyImmunoglobulin infusion reactionsEnhanced allergy & immunology pathway→CardiologyIndications for echocardiographyChoose urgent or routine echocardiography for a defined clinical question→InfectionInfections during pregnancy and postpartumEnhanced infection specialist pathway→CardiologyInfective endocarditisModified Duke/ESC criteria, microbiological diagnosis, valve/device imaging and early Endocarditis Team decisions.→RheumatologyInflammatory arthritis flare and immunosuppressant complicationsEnhanced rheumatology pathway→RheumatologyInflammatory myositis and rhabdomyolysis differentialEnhanced rheumatology pathway→InfectionInfluenza, COVID-19 and severe respiratory viral infectionEnhanced high-priority infection pathway→CardiologyInherited cardiac conditions and channelopathiesRecognise phenotype, prevent sudden death and protect relatives through an inherited-cardiac-conditions service.→EndocrinologyInpatient diabetes and insulin managementKeep basal insulin safe, individualise targets and prevent hypo-, hyperglycaemia and medication harm.→EndocrinologyInsulin pumps and continuous glucose monitoring in hospitalPreserve safe self-management when appropriate and know when technology must be stopped.→RespiratoryInterstitial lung diseaseClassify fibrotic and inflammatory ILD through multidisciplinary clinical, radiological and pathological reasoning.→InfectionIntra-abdominal infection and peritonitisEnhanced high-priority infection pathway→Neurological emergenciesIntracerebral haemorrhage and anticoagulant-associated brain bleedingStabilise physiology, reverse anticoagulation rapidly and reach stroke/neurosurgical care without avoidable delay.→InfectionInvasive aspergillosis and mucormycosisEnhanced infection specialist pathway→Critical careInvasive mechanical ventilationEnhanced critical care pathway→Oncological emergenciesIron overload, haemochromatosis and chelationEnhanced secondary specialist haematology pathway→ToxicologyIron poisoningEnhanced toxicology specialist pathway→GastrointestinalIrritable bowel syndrome and functional gastrointestinal disordersMake a positive diagnosis after proportionate exclusion of alarm disease and treat the dominant symptom.→Oncological emergenciesKaposi sarcomaHHV-8 tumour: biopsy, visceral staging and HIV-oncology treatment→Renal & metabolicKidney biopsy indications, preparation and complicationsUse biopsy when histology will change management and minimise bleeding risk.→Renal & metabolicKidney-transplant emergencies and immunosuppression problemsProtect graft function while managing rejection, infection, interactions and immunosuppressant toxicity.→MusculoskeletalKnee injury and acutely locked kneeEnhanced musculoskeletal pathway→Neurological emergenciesLabyrinthitisCONTINUOUS VERTIGO + NEW HEARING LOSS→CardiologyLeft bundle branch blockRecognise true LBBB, separate chronic conduction disease from acute coronary occlusion and assess structural disease, syncope and CRT eligibility.→ToxicologyLithium poisoningEnhanced toxicology specialist pathway→GastrointestinalLiver investigations and non-invasive liver screen (NILS)Interpret liver injury, synthetic function, aetiology and fibrosis together rather than treating an isolated ALT as a diagnosis.→GastrointestinalLiver masses, hepatocellular carcinoma and surveillanceCharacterise focal liver lesions in the correct background and connect high-risk patients to timely MDT treatment.→GastrointestinalLiver-biopsy indications, preparation and complicationsObtain decisive histology only when it changes care, using the safest route and complete post-procedure surveillance.→GastrointestinalLiver-transplant emergencies and immunosuppression complicationsProtect the graft and patient by treating sepsis and organ dysfunction while obtaining immediate transplant-centre advice.→RespiratoryLong-term oxygen therapy and home NIVPrescribe domiciliary support only after stable physiological assessment, education and follow-up.→GastrointestinalLower gastrointestinal bleedingResuscitation, risk stratification and definitive haemostasis.→ProceduresLumbar puncturePicture-guided stand-alone LP pathway: safety, landmarking, opening pressure, CSF tubes and aftercare→RespiratoryLung cancer, pulmonary nodules and diagnostic pathwaysMove from radiographic abnormality to timely histology, staging and treatment without unsafe biopsy.→RespiratoryLung-cancer emergenciesRecognise airway obstruction, SVCO, malignant effusion and haemoptysis while preserving diagnostic options.→RespiratoryLung-transplant emergenciesProtect graft function while rapidly separating infection, rejection, airway and vascular complications.→Oncological emergenciesLymphomaSecure an adequate tissue diagnosis, stage accurately and treat urgent compression syndromes→Oncological emergenciesMacrocytic anaemia—B12, folate and marrow causesEnhanced secondary specialist haematology pathway→MusculoskeletalMajor fracture and joint dislocationEnhanced musculoskeletal pathway→Oncological emergenciesMajor haemorrhage and massive transfusionCoordinated resuscitation, haemorrhage control and targeted component therapy→EndocrinologyMale hypogonadism and testosterone safetyConfirm true androgen deficiency, identify pituitary/testicular danger and prescribe testosterone safely.→Nutritional supportMalnutrition screeningIdentify nutritional risk early in the admission→Nutritional supportMalnutrition screening and refeeding-risk pathwayEnhanced nutritional support pathway→RespiratoryMassive haemoptysisProtect the non-bleeding lung, reverse correctable haemostasis and secure embolisation or surgery.→Oncological emergenciesMassive-transfusion monitoring chartSpecialist haematology investigation or procedure pathway→Allergy & ImmunologyMast-cell activation and recurrent idiopathic anaphylaxisEnhanced allergy & immunology pathway→Neurological emergenciesMénière disease20 MIN–12 H · FLUCTUATING HEARING · TINNITUS/FULLNESS→Neurological emergenciesMeningitis & encephalitisTreat suspected CNS infection promptly while securing diagnostics→GastrointestinalMesenteric ischaemia and ischaemic colitisTreat threatened bowel as a vascular-surgical emergency.→GastrointestinalMetabolic dysfunction-associated steatotic liver diseaseStage fibrosis and reduce cardiovascular, metabolic and liver risk rather than following ALT alone.→Nutritional supportMicronutrient deficiency and specialised supplementationEnhanced nutritional support pathway→GastrointestinalMicroscopic colitis and bile-acid diarrhoeaInvestigate chronic watery diarrhoea beyond a normal-looking colon and treat the defined mechanism.→Oncological emergenciesMonoclonal gammopathy and MGUSEnhanced secondary specialist haematology pathway→Renal & metabolicMonoclonal gammopathy and myeloma-related kidney diseaseDetect light-chain injury quickly and link renal rescue to urgent clone-directed treatment.→Neurological emergenciesMotor neurone diseaseRecognise progressive upper/lower motor-neurone disease early and coordinate respiratory, nutritional, communication and palliative care.→EndocrinologyMultiple endocrine neoplasia and inherited endocrine syndromesTreat the presenting hormone crisis and connect patients and relatives to coordinated lifelong surveillance.→Oncological emergenciesMultiple myelomaRecognise myeloma-defining events and protect kidney, bone and spinal cord→Neurological emergenciesMultiple sclerosis and chronic demyelinating diseaseDiagnose accurately, separate relapse from progression or pseudo-relapse and monitor disease-modifying treatment safely.→MusculoskeletalMuscle weakness and inflammatory myopathyEnhanced musculoskeletal pathway→MusculoskeletalMusculoskeletal infection and necrotising soft-tissue infectionEnhanced musculoskeletal pathway→Neurological emergenciesMyasthenia gravis—specialist and longitudinal careConfirm fatigable weakness, avoid treatment-related deterioration and prevent myasthenic crisis.→Oncological emergenciesMyelodysplastic syndromes (MDS)Clonal cytopenias: establish subtype and risk, then individualise supportive and disease-modifying care→Oncological emergenciesMyeloproliferative neoplasmsPV, ET and myelofibrosis: reduce thrombosis, control counts and detect progression→CardiologyMyocarditisPresentation-led diagnosis of inflammatory myocardial disease with arrhythmia, heart-failure and fulminant-shock escalation.→Neurological emergenciesMyopathy, inflammatory myositis and muscular dystrophySeparate inflammatory, toxic, endocrine, metabolic and inherited muscle disease and detect cardiac or respiratory involvement.→CardiologyMyopericarditisPericarditic presentation with myocardial injury or dysfunction→Palliative careNausea, vomiting, bowel obstruction and secretionsEnhanced palliative care pathway→Renal & metabolicNephrotic syndromeConfirm nephrotic-range protein loss, protect against thrombosis and infection, and identify the glomerular cause.→Renal & metabolicNephrotoxic medicines, renal dosing and sick-day safetyPrevent avoidable AKI while preserving medicines with proven cardiac and renal benefit.→Neurological emergenciesNeuro-oncology, leptomeningeal and paraneoplastic diseaseRecognise tumour-related neurological syndromes and coordinate imaging, tissue, oncological and supportive treatment.→Neurological emergenciesNeuro-ophthalmological emergenciesProtect sight and detect aneurysm, raised pressure, arteritis, optic neuritis and orbital disease.→Neurological emergenciesNeurogenetic and mitochondrial disordersRecognise inherited neurological disease, manage metabolic decompensation and use phenotype-led genomic testing responsibly.→PsychiatryNeuroleptic malignant syndrome and serotonin toxicityEnhanced psychiatry pathway→Neurological emergenciesNeurological disease in pregnancy and the puerperiumBalance maternal neurological urgency, fetal safety and pregnancy-specific differentials through multidisciplinary care.→Neurological emergenciesNeuromuscular respiratory failureRecognise myasthenic crisis, Guillain–Barré syndrome and bulbar failure→Neurological emergenciesNeurorehabilitation, spasticity and neuropalliative careStart goal-led rehabilitation early while treating tone, pain, cognition, communication and end-of-life needs.→Oncological emergenciesNeutropenia, agranulocytosis and febrile neutropeniaImmediate sepsis care while identifying drug, infection and marrow causes→GastrointestinalNeutropenic enterocolitisRecognise bowel-wall infection and inflammation during profound neutropenia without precipitating perforation.→ToxicologyNifedipine & calcium-channel blocker overdoseRecognise vasodilatory or cardiogenic shock early→InfectionNon-tuberculous mycobacterial infectionEnhanced infection specialist pathway→Oncological emergenciesNormocytic anaemia and anaemia of chronic diseaseEnhanced secondary specialist haematology pathway→CardiologyNSTEMITroponin-positive NSTE-ACS: stabilise, risk-stratify and plan invasive management→Renal & metabolicNutrition in advanced CKD and dialysisPrevent malnutrition while individualising protein, salt, potassium, phosphate and fluid advice.→EndocrinologyObesity & central adiposityDefine general and central obesity, assess complications and select personalised specialist treatment→RespiratoryObstructive sleep apnoea and obesity-hypoventilation syndromeDistinguish upper-airway obstruction from daytime ventilatory failure and reduce cardiometabolic risk.→Renal & metabolicObstructive uropathy and hydronephrosisRelieve an infected or bilateral obstruction before irreversible renal injury.→RespiratoryOccupational and environmental lung diseaseIdentify causal exposure early enough to prevent irreversible disease and protect others.→InfectionOccupational and sexual exposure prophylaxisEnhanced infection specialist pathway→OphthalmologyOcular trauma and open-globe injuryEnhanced ophthalmology pathway→GastrointestinalOesophageal rupture and perforationTreat mediastinal contamination as a time-critical upper-GI surgical emergency.→Oncological emergenciesOncological emergenciesTime-critical cancer complications, treatment toxicity, specialist medicines and escalation→Renal & metabolicOnconephrology and cancer-treatment nephrotoxicityRecognise AKI, electrolyte and vascular syndromes caused by cancer and systemic anticancer therapy.→ToxicologyOpioid and fentanyl toxicityEnhanced toxicology specialist pathway→Respiratory ArrestOpioid-induced respiratory depressionSupport ventilation and reverse opioid toxicity safely→OphthalmologyOptic neuritis and acute optic neuropathyEnhanced ophthalmology pathway→OphthalmologyOrbital cellulitis and cavernous sinus complicationsEnhanced ophthalmology pathway→ToxicologyOrganophosphate and cholinergic poisoningEnhanced toxicology specialist pathway→EndocrinologyOsteomalacia and metabolic bone diseaseFind the cause of defective mineralisation and replace vitamin D, calcium or phosphate safely.→EndocrinologyOsteoporosis and fragility-fracture preventionTreat the fracture as a sentinel event and match anti-osteoporosis therapy to imminent risk.→Oncological emergenciesOther haematological malignanciesA navigator for rarer lymphoid, plasma-cell and marrow neoplasms→InfectionOutpatient parenteral antimicrobial therapy (OPAT)Enhanced infection specialist pathway→Renal & metabolicPaediatric and adolescent kidney emergenciesUse age-, size- and safeguarding-aware assessment with early paediatric nephrology involvement.→OphthalmologyPainful red eye—uveitis, keratitis and scleritisEnhanced ophthalmology pathway→Palliative carePalliative pain crisis and opioid safetyEnhanced palliative care pathway→GastrointestinalPancreatic necrosis, pseudocyst and pancreatitis complicationsRecognise infected necrosis and vascular, ductal and collection-related complications using a step-up strategy.→Oncological emergenciesPancytopenia, aplastic anaemia and marrow failureSeparate production failure, infiltration, destruction and sequestration→PsychiatryPanic, severe anxiety and functional symptomsEnhanced psychiatry pathway→ToxicologyParacetamol overdoseTime-critical risk assessment and antidote pathway→Nutritional supportParenteral nutrition and intestinal failureEnhanced nutritional support pathway→Neurological emergenciesParkinson disease and atypical parkinsonismPreserve time-critical dopaminergic therapy, recognise atypical features and manage motor and non-motor complications.→Movement DisordersParkinsonism in hospitalGive time-critical medicines and avoid sudden withdrawal→Older peopleParkinsonism, Lewy body dementia and medicine timingEnhanced older people pathway→Oncological emergenciesParoxysmal nocturnal haemoglobinuriaEnhanced secondary specialist haematology pathway→MusculoskeletalPathological fracture and suspected bone or soft-tissue malignancyEnhanced musculoskeletal pathway→EndocrinologyPCOS and reproductive endocrinologyDiagnose by phenotype, exclude mimics and address metabolic, fertility and endometrial risk.→RespiratoryPeak-flow variability and bronchial challenge testingDemonstrate variable airflow obstruction safely when routine spirometry is non-diagnostic.→GastrointestinalPEG, feeding-tube and stoma complicationsRecognise displacement, buried bumper, peritonitis, blockage, aspiration and stoma ischaemia.→GastrointestinalPeptic ulcer diseaseH. pylori, medicines, endoscopic diagnosis and complication control→Oncological emergenciesPeri-procedural anticoagulation and bridgingEnhanced secondary specialist haematology pathway→CardiologyPericardial effusion and cardiac tamponadeRecognise pressure physiology, use focused echocardiography and drain unstable or high-risk effusions safely.→PsychiatryPerinatal and postpartum psychiatric emergencyEnhanced psychiatry pathway→CardiologyPeripheral arterial and systemic atherosclerotic diseaseRecognise acute limb ischaemia, diagnose chronic PAD and treat the whole vascular risk—not the leg alone.→Neurological emergenciesPeripheral neuropathy and radiculopathyDefine distribution and mechanism, identify reversible systemic causes and recognise urgent inflammatory, malignant or compressive disease.→Renal & metabolicPeritoneal dialysis emergencies and peritonitisTreat cloudy effluent and abdominal pain as PD peritonitis until excluded.→GastrointestinalPersistent nausea and vomitingCorrect dehydration and identify obstruction, neurological, metabolic, toxic and pregnancy causes.→EndocrinologyPhaeochromocytoma and paraganglioma crisisControl catecholamine crisis safely—alpha blockade and volume restoration precede beta blockade.→EndocrinologyPituitary apoplexyRecognise sudden haemorrhage/infarction, protect vision and treat cortisol deficiency immediately.→RespiratoryPleural disease and pleural proceduresSelect and perform pleural investigation and intervention with ultrasound, haemostasis and specimen safety.→RespiratoryPleural effusion, complicated parapneumonic effusion and empyemaUse ultrasound-led sampling and drain infected pleural fluid before sepsis and loculation progress.→RespiratoryPleural-fluid interpretationCombine appearance, immediate pH, Light’s criteria, microbiology and cytology to direct drainage and diagnosis.→InfectionPneumocystis jirovecii pneumonia (PCP/PJP)Opportunistic pneumonia with disproportionate hypoxaemia→InfectionPneumoniaSeverity scoring, timely antimicrobials and complications→RespiratoryPneumothorax and tension pneumothoraxRecognise tension physiology clinically, decompress immediately and select definitive pleural care.→Renal & metabolicPolycystic kidney disease and inherited nephropathiesManage acute complications while connecting patients and relatives to genetic renal care.→Older peoplePolypharmacy, deprescribing and adverse drug reactionsEnhanced older people pathway→GastrointestinalPortal hypertension, variceal surveillance and secondary preventionPrevent first and recurrent decompensation using risk-based non-invasive assessment and endoscopic therapy.→GastrointestinalPortal-vein thrombosis and Budd-Chiari syndromeDefine thrombus anatomy and chronicity, identify bowel/liver threat and coordinate anticoagulation or intervention.→Critical carePost-cardiac-arrest care and neuroprognosticationEnhanced critical care pathway→GastrointestinalPost-endoscopy and ERCP complicationsRecognise perforation, pancreatitis, bleeding, cholangitis and sedation complications.→CardiologyPost-PCI and post-CABG complicationsTreat recurrent ischaemia as stent/graft failure until proved otherwise and recognise bleeding, tamponade and access complications.→Neurological emergenciesPosterior circulation stroke (POCS)TIME IS BRAIN · NIHSS MAY UNDERESTIMATE→Neurological emergenciesPosterior-circulation stroke and acute vestibular syndromeRecognise disabling posterior stroke despite a low NIHSS or an initially normal CT.→CardiologyPre-operative cardiac risk assessmentEstimate surgical and patient risk, test only when results change management and avoid unnecessary delay.→Renal & metabolicPregnancy with CKD, dialysis or renal transplantationUse serum creatinine—not eGFR—and coordinate maternal renal, obstetric and neonatal care.→RespiratoryPreoperative respiratory assessmentEstimate pulmonary risk, optimise reversible disease and plan postoperative respiratory support.→EndocrinologyPrimary aldosteronism and endocrine hypertensionDetect mineralocorticoid excess, correct potassium and distinguish unilateral from bilateral disease.→GastrointestinalPrimary biliary cholangitis and primary sclerosing cholangitisTreat cholestatic disease while preventing decompensation, dominant-stricture sepsis and cancer.→EndocrinologyPrimary hyperparathyroidismConfirm PTH-dependent hypercalcaemia, assess organ injury and route definitive parathyroid care.→MusculoskeletalProsthetic-joint complicationsEnhanced musculoskeletal pathway→InfectionProsthetic-joint, vascular-graft and cardiac-device infectionEnhanced infection specialist pathway→CardiologyProsthetic-valve emergenciesDifferentiate thrombosis, pannus, degeneration, endocarditis, dehiscence and paravalvular leak with multimodality imaging.→RespiratoryPulmonary arteriovenous malformationsPrevent paradoxical emboli and haemorrhage through CT definition and embolisation-centre care.→RespiratoryPulmonary embolismClinical probability, imaging and haemodynamic risk→CardiologyPulmonary hypertension and acute right-heart failureProtect RV perfusion, avoid abrupt preload/afterload shifts and contact a pulmonary vascular centre early.→RespiratoryPulmonary hypertension and acute right-heart failureProtect RV perfusion, identify the trigger and never abruptly stop pulmonary vasodilators.→RespiratoryPulmonary rehabilitationConvert post-exacerbation recovery into sustained exercise, education and self-management.→InfectionPulmonary tuberculosisAirborne isolation, molecular diagnosis, resistance testing and treatment→Renal & metabolicPulmonary–renal syndrome and renal vasculitisTreat pulmonary haemorrhage with nephritic AKI as an organ-threatening emergency.→Renal & metabolicPyelonephritis, complicated UTI and renal abscessRecognise sepsis and obstruction, obtain cultures and secure source control.→InfectionPyelonephritis, complicated UTI and urosepsisEnhanced high-priority infection pathway→Neurological emergenciesRaised intracranial pressure, cerebral oedema and impending herniationProtect cerebral perfusion and obtain definitive neurosurgical treatment while temporising herniation.→Palliative careRapid palliative assessment and goals of careEnhanced palliative care pathway→Renal & metabolicRare genetic disordersRecognition and stabilisation of inherited metabolic, multisystem and pharmacogenetic emergencies→Oncological emergenciesRed-cell exchange transfusionSpecialist haematology investigation or procedure pathway→Critical careReduced consciousnessProtect the airway and rapidly search for reversible causes→Nutritional supportRefeeding syndrome riskStart nutrition cautiously with electrolyte and vitamin support→RehabilitationRehabilitation & dischargeMatch rehabilitation intensity and destination to need→Renal & metabolicRenal calculi and infected obstructed kidneyRelieve pain, identify sepsis and decompress an infected obstruction urgently.→Renal & metabolicRenal manifestations of systemic diseaseUse kidney findings to identify lupus, systemic sclerosis, sarcoidosis, amyloidosis and multisystem inflammation.→Critical careRenal replacement therapy in critical illnessEnhanced critical care pathway→Renal & metabolicRenal vascular emergenciesRecognise renal infarction, artery dissection, renal-vein thrombosis and cholesterol embolisation early.→Renal & metabolicResistant hypertension and renovascular diseaseConfirm true resistance, identify secondary causes and protect brain, heart, aorta and kidneys.→Respiratory ArrestRespiratory arrestOpen the airway and ventilate before cardiac arrest occurs→RespiratoryRespiratory disease in pregnancyStabilise maternal oxygenation first while using pregnancy-adapted imaging and medication decisions.→RespiratoryRespiratory failure from neuromuscular or chest-wall diseaseDetect falling vital capacity and hypoventilation before respiratory arrest.→MusculoskeletalRhabdomyolysis and crush injuryEnhanced musculoskeletal pathway→Renal & metabolicRhabdomyolysis and pigment-associated AKIControl the cause, prevent complications and avoid unproven routine alkalinisation.→CardiologyRight bundle branch blockIdentify complete or incomplete RBBB, search for acute right-heart strain and recognise associated fascicular disease that changes pacing risk.→Older peopleSafeguarding, self-neglect and discharge riskEnhanced older people pathway→ToxicologySalicylate poisoningEnhanced toxicology specialist pathway→RespiratorySarcoidosisConfirm organ involvement and treat only when symptoms, function or organ risk justify therapy.→RheumatologyScleroderma renal crisisEnhanced rheumatology pathway→Neurological emergenciesSeizureTerminate prolonged seizure and identify the cause→PsychiatrySelf-harm and suicide-risk assessmentEnhanced psychiatry pathway→InfectionSeptic arthritis and osteomyelitisEnhanced high-priority infection pathway→ToxicologySerotonin toxicity and serotonergic overdoseEnhanced toxicology specialist pathway→PsychiatrySevere agitation and behavioural disturbanceEnhanced psychiatry pathway→PsychiatrySevere depression with psychotic or stuporous featuresEnhanced psychiatry pathway→Allergy & ImmunologySevere drug hypersensitivity and immediate allergyEnhanced allergy & immunology pathway→EndocrinologySevere hypercalcaemia and parathyroid crisisRehydrate safely, control calcium and identify malignancy, hyperparathyroidism or medicine causes.→Critical careSevere metabolic acidosisTreat the cause and escalate profound physiological disturbance→Renal & metabolicSevere metabolic acidosis and renal tubular acidosisDefine the mechanism, treat the cause and recognise when acidaemia requires organ support.→DermatologySevere psoriasis and generalised pustular psoriasisEnhanced dermatology pathway→InfectionSexually transmitted infectionsSyndrome-led testing, lesion recognition, current UK treatment and partner prevention→Critical careShockIdentify the shock phenotype while resuscitating→Critical careShock differentiation and vasoactive supportEnhanced critical care pathway→GastrointestinalShort bowel syndrome, intestinal failure and high-output stomaReplace sodium-rich losses, protect kidneys and obtain intestinal-failure expertise.→EndocrinologySIADH and endocrine hyponatraemiaConfirm hypotonic hyponatraemia, exclude cortisol/thyroid deficiency and treat symptoms safely.→Oncological emergenciesSickle-cell emergenciesPain crisis, acute chest syndrome, stroke and severe anaemic complications→RespiratorySix-minute walk and cardiopulmonary exercise testingQuantify functional limitation, desaturation and cardiopulmonary mechanism with protocol-led safety.→Neurological emergenciesSleep neurologyDistinguish epilepsy, parasomnia, narcolepsy, restless legs and sleep-disordered breathing using targeted history and testing.→RespiratorySleep studiesSelect the least complex study that can reliably answer OSA, hypoventilation or parasomnia questions.→RespiratorySmoking cessation and tobacco dependenceTreat nicotine dependence during admission and connect every quit attempt to effective pharmacotherapy and support.→Neurological emergenciesSpinal cord & cauda equina compressionIdentify time-critical compression and arrange emergency imaging→RespiratorySpirometry and complete pulmonary-function testingMeasure ventilatory defect, gas transfer and lung volumes with quality control and clinical interpretation.→CardiologyStable AnginaDiagnose chronic coronary syndrome, control symptoms and reduce cardiovascular risk→Oncological emergenciesStem-cell collection and transplantation overviewSpecialist haematology investigation or procedure pathway→CardiologySTEMIImmediate reperfusion pathway for ST-elevation myocardial infarction→EndocrinologySteroid sick-day rules and perioperative coverPrevent adrenal crisis in established or glucocorticoid-induced adrenal insufficiency.→DermatologyStevens–Johnson syndrome and toxic epidermal necrolysisEnhanced dermatology pathway→Neurological emergenciesStroke & TIAImmediate imaging and reperfusion assessment→Neurological emergenciesStroke clinical examinationsNIHSS, Hoover’s sign, HINTS and positional manoeuvres→InfectionStrongyloidiasis and hyperinfectionEnhanced infection specialist pathway→PsychiatrySubstance intoxication and withdrawalEnhanced psychiatry pathway→OphthalmologySudden painless visual lossEnhanced ophthalmology pathway→ENTSudden sensorineural hearing lossEnhanced ent pathway→GastrointestinalSupportive and palliative care in advanced gastrointestinal and liver diseaseIntegrate symptom relief, advance care planning and reversible-treatment decisions throughout advanced disease.→InfectionSuspected sepsisNEWS2 risk stratification, illustrated Sepsis Six, source control and repeated reassessment→Neurological emergenciesSuspected subarachnoid haemorrhageInvestigate thunderclap headache urgently→Cardiac ArrestSVTModified Valsalva, adenosine and escalation for regular narrow-complex SVT→CardiologySyncopeIdentify cardiac, neurological and haemorrhagic causes→Older peopleSyncope and collapse in older adultsEnhanced older people pathway→Palliative careSyringe driver prescribing and troubleshootingEnhanced palliative care pathway→RheumatologySystemic lupus erythematosus emergenciesEnhanced rheumatology pathway→RheumatologySystemic vasculitis and pulmonary–renal syndromeEnhanced rheumatology pathway→Cardiac ArrestTachyarrhythmiasStep-by-step stable and unstable peri-arrest tachyarrhythmia management→CardiologyTakotsubo syndromeTreat initially as acute coronary syndrome, confirm transient non-territorial ventricular dysfunction and actively screen for LVOTO, shock, arrhythmia and thrombus.→CardiologyTelemetrySelect, interpret and act on continuous rhythm monitoring→MusculoskeletalTendon rupture and acute soft-tissue injuryEnhanced musculoskeletal pathway→Oncological emergenciesThalassaemia and transfusion-dependent anaemiasEnhanced secondary specialist haematology pathway→InfectionThe immunocompromised patientImmune-defect-led assessment of infection, malignancy, treatment toxicity and urgent specialist escalation→Oncological emergenciesTherapeutic plasma exchangeSpecialist haematology investigation or procedure pathway→Oncological emergenciesTherapeutic venesectionSpecialist haematology investigation or procedure pathway→RespiratoryThoracic ultrasoundUse bedside ultrasound to answer focused pleural and lung questions and make procedures safer.→Oncological emergenciesThrombocytopenia and immune thrombocytopenia (ITP)Confirm true thrombocytopenia, exclude consumption and treat bleeding severity→Oncological emergenciesThrombocytopenia investigation algorithmSpecialist haematology investigation or procedure pathway→Oncological emergenciesThrombocytosis—reactive versus clonalEnhanced secondary specialist haematology pathway→Oncological emergenciesThrombophilia and antiphospholipid syndromeEnhanced secondary specialist haematology pathway→Oncological emergenciesThrombophilia testing—indications and timingSpecialist haematology investigation or procedure pathway→Renal & metabolicThrombotic microangiopathy, TTP and HUSRecognise microangiopathic haemolysis and thrombocytopenia before irreversible neurological or renal injury.→Oncological emergenciesThrombotic thrombocytopenic purpura and thrombotic microangiopathyRecognise microangiopathic haemolysis and start the TTP pathway before confirmation→EndocrinologyThyroid emergencyRecognise thyroid storm and myxoedema coma→ToxicologyToxic alcohol poisoning—methanol and ethylene glycolEnhanced toxicology specialist pathway→InfectionToxoplasmosis and opportunistic CNS infectionEnhanced infection specialist pathway→RespiratoryTracheostomy and laryngectomy emergenciesOxygenate through the correct airway and follow structured obstruction/displacement algorithms.→Oncological emergenciesTransfusion-reaction investigation and reportingSpecialist haematology investigation or procedure pathway→Neurological emergenciesTransient ischaemic attack (TIA)FOCAL TRANSIENT DEFICIT · SPECIALIST WITHIN 24 H→Neurological emergenciesTraumatic brain injury and post-concussion deteriorationDetect intracranial injury, prevent secondary brain damage and give explicit discharge safety-netting.→InfectionTravel medicineRegion- and itinerary-led prevention, epidemiology, pre-travel preparation and post-travel assessment→Neurological emergenciesTremor, chorea, dystonia, myoclonus and ataxiaPhenotype the movement, identify medicines and systemic causes, and recognise rapidly progressive or genetic syndromes.→ToxicologyTricyclic antidepressant poisoningEnhanced toxicology specialist pathway→InfectionTropical diseasesRegion-, exposure- and syndrome-led diagnosis with specialist treatment and medicines→RespiratoryTuberculosis and non-tuberculous mycobacterial diseaseIsolate infectious TB promptly and distinguish NTM colonisation from progressive disease.→InfectionTypical pneumoniaLobar bacterial pneumonia: severity-led treatment and complication control→CardiologyUnstable AnginaNSTE-ACS without myocardial necrosis: confirm diagnosis, stratify risk and plan early invasive care→GastrointestinalUpper GI bleedingRecognise, resuscitate, risk-stratify and secure definitive haemostasis→Respiratory ArrestUpper-airway obstructionRelieve obstruction and summon expert airway help→ENTUpper-airway obstruction, stridor and supraglottitisEnhanced ent pathway→Older peopleUrinary retention, incontinence and constipationEnhanced older people pathway→CardiologyValvular heart diseaseDefine valve anatomy, haemodynamic severity and the right timing for surgical or transcatheter intervention→DermatologyVasculitic, purpuric and non-blanching rashEnhanced dermatology pathway→MusculoskeletalVasculitis and connective-tissue disease emergencyEnhanced musculoskeletal pathway→ProceduresVenepuncturePicture-guided stand-alone venous blood-sampling pathway→Oncological emergenciesVenous thrombosis at unusual sitesEnhanced secondary specialist haematology pathway→Neurological emergenciesVestibular neuritisCONTINUOUS DAYS · NO COCHLEAR SYMPTOMS→Nutritional supportVitamin deficienciesSyndrome-led recognition, cause-finding, safe replacement and response monitoring→DatixWhen to submit a DatixRecord safety events, near misses and hazards for learning→DatixWriting a useful DatixProvide a neutral chronology that supports learning→
About the founder
Dr Blessing Ngonidzashe Dziwa
MBChB · MRCP (Glasg) · MRCPE · MRCP (London) · MBAFounder and Clinical Author, Acute Medical Take · IMPACT Instructor
I am an NHS Registrar in General and Acute Medicine with over 24 years of clinical experience. My work includes assessing and managing acute medical admissions, supporting and supervising junior doctors, and contributing to stroke thrombolysis and cardiac-arrest responses.
My work life: My international clinical career has included work in Zimbabwe, Lesotho, Eswatini, South Africa, The Gambia and Cameroon. This has given me broad experience in managing a diverse range of conditions—from infectious and tropical diseases, including HIV, to acute and general medicine—across varied communities and healthcare systems.
I am ALS certified and an IMPACT Instructor and Faculty Member with the Royal College of Physicians and Surgeons of Glasgow. As a paid-up member of the three UK Royal Colleges of Physicians, I hold MRCP (Glasg), MRCPE and MRCP (London).
Why I created Acute Medical Take
My goal is to make accurate, practical and evidence-based acute-medicine learning accessible to healthcare professionals everywhere. Built on UK clinical standards and linked specialist guidance, the platform supports students, newly qualified clinicians, international medical graduates, experienced practitioners and multidisciplinary teams across different health systems—helping them learn rapidly, decide safely and escalate appropriately.
“The future of medical education is not so much about who can regurgitate differentials from memory, but rather who can readily locate accurate information in a world where information is not in short supply.”— Dr Blessing Dziwa
Content is linked to recognised guidance and specialist resources. It remains an educational aid: clinicians must confirm publication dates, drug information, national recommendations and current local policies before applying it to patient care.
Clinical safety notice — local guidance must be checked
Source links checked 25 July 2026This app is a navigation aid for qualified healthcare professionals. It does not replace assessment, senior review, current local policy, specialist advice or emergency escalation. Verify drug doses, contraindications, monitoring requirements and publication dates in the source and local guideline.
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