ACRRM Emergency Medicine Study Guide

The aim of this guide is provide an approach and resources to those intending to work as Rural Generalists and in particular registrars preparing for assessment in the Emergency Medicine Advanced Skill through the Australian College of Rural and Remote Medicine (ACRRM).

Note it is not the official work of ACRRM, but rather a collection of self-made and FOAMed Resources from across the web.

Official Resources

Please always check ACRRM.org.au to ensure you have the latest information regarding the curriculum and assessment requirements.

STAMPS Community Profile - Emergency + GEM from Aaron Sparshott

Recommended Reading as per ACRRM

• Cameron, P et al: Textbook of Adult Emergency Medicine, Edinburgh – Churchill Livingstone.
• Cameron, P et al: Textbook of Paediatric Emergency Medicine, Edinburgh – Churchill Livingstone.
• Rosen: Emergency Medicine
• Tintinalli, J et al: Emergency Medicine, a comprehensive study guide, New York -McGraw-Hill.
• ACRRM online learning: www.acrrm.org.au
• Bersten A, Soni N, Oh T: Oh’s Intensive Care Manual, Edinburgh - ButterworthHeinemann.
• McRae R, Esser M: Practical fracture treatment, Edinburgh - Churchill Livingstone.
• Murray L et al: Toxicology Handbook, Sydney - Elsevier
• Shann, F: Drug doses, Parkville Vic - Collective.
• Australian Medicines Handbook: Drug Choice Companion Emergency Care, Adelaide
• Australian Medicines Handbook Pty Ltd.

STAMPs Proforma

This is an approach I use to prepare for the formal assessment after receiving the stem. You may also find it useful for preparing responses, however feel free to adapt it as you see fit.

ACRRM STAMPs proforma from Aaron Sparshott

STAMPS Study Guide

The following topics which will be covered progressively in this guide. The study guide is largely structured to address aspects of the ACRRM STAMPS Proforma above. Topics which are available for reading will have: Topic - current as of date.

Airway

Severe Asthma
Tension Pneumothorax
Pneumothorax
Anaphylaxis and Allergies (including ASCIA guidelines)
Acute Pulmonary Oedema
Pneumonia

Cardiology

Acute Coronary Syndrome

• STEMI/NTSTEMI - current as of June 2018
• Thrombolytics for AMI - current as of June 2018
• Contraindications to Thrombolysis - current as of June 2018
• Sgarbossa Criteria (AMI w/ LBBB)
• Chest Pain Descriptors Associated With AMI
• Chest Pain Risk Stratification
• TIMI Score / Risk

An Approach to Syncope

• San Francisco Syncope Rule (“CHESS” mnemonic)
• ECG in Syncope

Pulmonary Embolism

Aortic Dissection (thoracic)

An Approach to Arrhythmias
Infective Endocarditis

Critical Care.

Sepsis

• SIRS, Sepsis & Septic Shock
• Management of Septic Shock
• Antibiotics in Sepsis

Inotropes

Endocrinology/Metabolics

DKA Management
Diabetic HHS
Hypoglycaemia
Hyperthyroidism + Thyroid Storm
Hypothyroidism + Myxoedema Coma
Adrenal Insufficiency
Phaeochromocytoma
Hyponatraemia
Hypokalaemia / Hyperkalaemia
Hypercalcaemia

Gastroenterology

Upper GIT Bleeding

• Causes of Upper GIT bleeding
• Clinical features mandating urgent endoscopy

Gastroentertitis

General Surgery

Abdominal Aortic Anuersym
Appendicitis

• Alvarado Score (Appendicitis)

Pancreatitis

• Ranson Criteria (Pancreatitis)

Intestinal Obstruction

Haematology

Transfusion Reactions
Anaemias
Thrombocytopenia
DIC
ITP & TTP

Indigenous/ATSI

Acute Rheumatic Fever

Infectious Diseases

HIV/AIDS
Fever in a Returned Traveler

Neurology/Neurosurgery

Stroke - current as of June 2018
Seizure - current as of July 2018

Head Trauma - current as of June 2018

Subarachnoid Haemorrhage
Meningitis
Cerebral abscess
Brainstem: Rule of 4’s

Ophthalmology

Common Eye Complaints
The Red Eye
Angle Closure Glaucoma
Ruptured Globe / Penetrating Eye Injury
Aniscoria

Orthopaedics

Elbow Xray
Elbow Dislocation
Shoulder Dislocations
Shoulder Relocation Techniques
Distal Radial Fractures (Colles, Smith & Barton)
Forearm Fractures
Scaphoid Fracture
Scapholunate Dissociation
Lunate & Perilunate Dislocations
Ottawa Knee Rules
Ottawa Ankle Rules
Lower Leg Compartments
Lower Leg Fractures

Paediatrics

Approach the Seriously Ill Child provides a structured approach to Paediatric Assessment.
For more guidelines and the management of other conditions go to Royal Children Hospital Clinical Guidelines and do APLS.

Psychiatric / Mental Health

Acute Psychosis/Agitated Patients
Suicide Risk Assessment
Depression
Anxiety

Renal + Electrolytes.

Causes of acute renal failure
RIFLE criteria
Indications for haemodialysis
Sodium & Free-water correction
Causes of rhabdomyolysis
Hypotensive dialysis patient

Toxicology

Approach to Toxicology
Snake Bite / Envenomation
Osmolar Gap
Anticholinergic Syndrome
Cholinergic Crisis
Neuroleptic Malignant Syndrome
Serotonin Syndrome
Dialysable Drugs

Trauma

Ultimate Guide to Trauma - current as of June 2016
Cervical Spine X-rays
NEXUS Low-risk Criteria
Canadian C-spine Rules
Penetrating Neck Trauma (Hard & Soft Signs)

Procedures

Rapid Sequence Intubation
Lumbar puncture
Chest Drain insertion
Central Venous Line insertion
Procedural Sedation
Biers Block