Clinical guides
What to do first, the doses, and when to call your senior, for 145 situations you will meet as a house officer.
Start with the core emergencies
Detailed, step-by-step guides with diagrams, written for your first day on call.
- Medical emergencyStrokeCheck the sugar, pin down the time last known well, get a CT head immediately, and decide with your senior who needs thrombolysis, thrombectomy, aspirin only, or supportive care.Open guide
- Medical emergencySepsisRecognise it early, give the Sepsis Six within one hour, then find and control the source. A normal temperature does not rule sepsis out.Open guide
- Medical emergencyDKA and HHSFluids first, check the potassium, then fixed-rate IV insulin by weight. Keep the insulin running and always find out why it happened.Open guide
- Cardiology on callAcute coronary syndrome (heart attack)ECG within 10 minutes. STEMI: primary PCI if it can happen within 120 minutes, otherwise thrombolysis within 30 minutes of arrival. NSTEMI: antiplatelets, anticoagulation and risk-guided angiography.Open guide
- Medical emergencyAnaphylaxisLie the patient flat, give IM adrenaline into the thigh straight away, repeat after 5 minutes if needed, and give fluids for low BP. Antihistamines and steroids come later, not first.Open guide
- Medical emergencyDengue feverKnow the day of illness, watch for warning signs as the fever settles, give fluids by protocol only when needed, and do not chase the platelet count.Open guide
- Gynae and obs emergencyPostpartum haemorrhage (PPH)Call for help, rub up the uterus, give oxytocin and tranexamic acid, replace blood, and work through the 4 Ts. Act early: measure the blood, do not guess it.Open guide
- Medical emergencyStatus epilepticusProtect the airway, check the sugar, give a benzodiazepine at 5 minutes and once more if needed, then a second-line drug by 20 minutes and anaesthesia by 40.Open guide
Browse by where you are
Emergency, on call at night, labour room, OPD or the procedure room.
Medical emergency
Chest pain, breathlessness, fits, poisoning and fever in the medical ER.
See all 26 guidesCardiology on call
ACS, arrhythmias, heart failure and BP emergencies in CCU and the cardiology ward.
- Acute coronary syndrome (heart attack)
- Atrial fibrillation
- Fast heart rhythms (SVT, VT and others)
- Bradycardia and heart block
Medicine on call
When the staff nurse calls you about a patient on the medical ward at night.
- The deteriorating patient and NEWS2
- Oxygen and the basic airway
- Low blood pressure on the ward
- Low oxygen saturations on the ward
Surgical emergency
The acute abdomen, head injury and urological emergencies in surgical ER.
- Acute abdominal pain
- Appendicitis
- Gallstone disease: colic, cholecystitis, cholangitis
- Acute pancreatitis
Surgery on call
Post-op problems and urological calls on the surgical ward.
See all 4 guidesOrthopaedics on call
Fractures, dislocations, joint and spine emergencies, and minor injuries.
- Fractures and dislocations: the essentials
- Open fractures
- Hip (neck of femur) fracture
- Compartment syndrome
Gynae and obs emergency
Bleeding in pregnancy, ectopic, pre-eclampsia and PPH in the labour room and gynae ER.
- Postpartum haemorrhage (PPH)
- Pre-eclampsia and eclampsia
- Vaginal bleeding in pregnancy
- Ectopic pregnancy
Paeds emergency
The febrile, breathless, dehydrated or limping child in paeds ER.
- Sepsis in children
- The febrile child
- Fever in a well-looking child
- Diarrhoea and dehydration in children
Medical OPD
Common medical problems in a busy OPD: typhoid, malaria, UTI, chest infection and more.
See all 14 guidesSurgical OPD
Abscesses, wounds, burns, bites and the minor procedures you will do yourself.
See all 6 guidesEye OPD
Red eye, eye injuries and the eye problems that must not be missed.
See all 3 guidesENT OPD
Earache, sore throat, nosebleeds, foreign bodies and dental pain.
See all 6 guidesWard procedures
Step-by-step guides to the procedures every house officer does: cannula, catheter, NG tube, ABG and more.
See all 11 guidesPrintable templates
History, examination, progress note and discharge templates for the ward.