Emergency Medicine Pathways

39 pathways

Work through 39 interactive emergency medicine decision pathways — branching, guideline-grounded workflows that take you from presentation to assessment, risk stratification and management. Each pathway cites its source (NICE, ESC, AHA and specialty guidance), embeds the relevant calculators, and makes escalation and safety-netting explicit. For decision support only — apply clinical judgement and local protocols.

Acute Chest Pain

Systematic evaluation of acute chest pain to identify STEMI, NSTEMI, PE, aortic dissection, and other life-threatening causes.

NICE CG95; ESC 2023 ACS Guidelines
Anaphylaxis Management

Recognition and immediate treatment of anaphylaxis in adults and children, following Resuscitation Council UK / NICE guidelines.

Resuscitation Council UK 2021; NICE CG134
Sepsis Screening and Sepsis Six

Identification of sepsis and immediate delivery of the Sepsis Six bundle within 1 hour of recognition.

UK Sepsis Trust; NICE NG51; Surviving Sepsis Campaign 2021
Acute Stroke / TIA Assessment

Rapid assessment, diagnosis, and management of suspected acute ischaemic stroke and TIA using FAST, ROSIER, and NIHSS tools.

NICE NG128; RCP Stroke Guidelines 2023
Acute Asthma in Adults

Assessment and management of acute asthma exacerbations, severity classification, and escalation criteria.

BTS/SIGN British Guideline on Asthma 2019; NICE NG80
Diabetic Ketoacidosis (DKA)

Diagnosis and management of DKA in adults following JBDS guidelines with fluid resuscitation, fixed-rate insulin infusion, and monitoring.

JBDS 2013 / Joint British Diabetes Societies; NICE NG17
Status Epilepticus (Adults)

Time-critical management of convulsive status epilepticus using the established benzodiazepine, phenytoin/levetiracetam, and anaesthetic escalation pathway.

NICE CG137; ESEM guidelines; RCP Neurology Guidelines
Upper GI Bleeding

Risk stratification and management of upper gastrointestinal haemorrhage using the Glasgow-Blatchford score and Rockall score.

BSG Guidelines 2019; NICE NG141
Pulmonary Embolism Assessment

Risk stratification, diagnosis, and management of pulmonary embolism using Wells score, PERC rule, and PESI score.

NICE NG158; ESC 2019 PE Guidelines
Major Trauma — Primary Survey (ATLS)

Systematic ATLS primary survey approach to major trauma: ABCDE with simultaneous haemorrhage control, C-spine precautions, and activation of major haemorrhage protocol.

ATLS 10th Edition; JRCALC; NICE NG39
Hyperkalaemia Management

Risk stratification and urgent treatment of hyperkalaemia with cardiac stabilisation, potassium shifting, and elimination strategies.

UK Kidney Association Guidelines 2020; NICE CKD Guidelines
Major Haemorrhage / Massive Transfusion

Major Haemorrhage / Massive Transfusion clinical pathway.

BCSH; RCOA; RCEM; RCS — BCSH Guidelines
Adult Cardiac Arrest (ALS)

Resuscitation Council UK ALS algorithm for in-hospital cardiac arrest in adults — shockable vs non-shockable rhythm, drugs, reversible causes, post-ROSC care.

RCUK 2021 Adult ALS
Peri-Arrest Tachyarrhythmia (Adult)

RCUK adult tachycardia algorithm — stable vs unstable, narrow vs broad complex, regular vs irregular.

RCUK 2021 Adult Tachycardia Algorithm
Peri-Arrest Bradyarrhythmia (Adult)

RCUK adult bradycardia algorithm — drug therapy, transcutaneous pacing, transvenous pacing.

RCUK 2021 Adult Bradycardia Algorithm
Acute Exacerbation of COPD (AECOPD)

NICE NG115 / GOLD 2024 management of AECOPD — controlled oxygen, bronchodilators, corticosteroids, antibiotics, NIV.

NICE NG115; GOLD 2024
Spontaneous Pneumothorax (Adult)

BTS 2023 guideline — symptom-based vs size-based approach to primary and secondary spontaneous pneumothorax in adults.

BTS Pleural Disease 2023
Suspected Bacterial Meningitis (Adult)

NICE NG240 — early antibiotics, dexamethasone, lumbar puncture indications, contact prophylaxis.

NICE NG240 (2024); NICE NG143 (paeds)
Suspected Subarachnoid Haemorrhage

Thunderclap headache assessment — Ottawa SAH rule, CT within 6h, LP after 12h if CT negative, neurosurgical referral.

NICE NG228; RCEM 2023; AHA/ASA 2023
Adult Head Injury

NICE NG232 — CT head selection, observation, discharge advice for adult head injury.

NICE NG232 (2023)
Burns — TBSA Estimation & Fluid Resuscitation

Adult burns — Wallace rule of nines, Lund-Browder, Parkland formula, escharotomy, referral criteria.

British Burn Association; EMSB; RCEM 2024
Adult Hypoglycaemia (Treated Diabetes)

JBDS-IP — recognition and management of hypoglycaemia in adults with diabetes; conscious vs unconscious treatment, post-event review.

JBDS-IP (2023): Hospital Management of Hypoglycaemia
Adrenal Crisis

Society for Endocrinology — recognition and immediate management of adrenal crisis; emergency hydrocortisone, fluids, glucose, sick-day rules.

Society for Endocrinology Emergency Guidance (2024)
Acute Heart Failure / Pulmonary Oedema

NICE NG106 — diagnosis with NT-proBNP, echo, oxygen, IV diuretic, vasodilators, NIV; ESC profile-based therapy.

NICE NG106; ESC 2021 HF Guideline
Syncope / Transient Loss of Consciousness

NICE CG109 — assessment of TLoC, red flags, San Francisco / Canadian Syncope rule, admission criteria.

NICE CG109; ESC 2018 Syncope
Acute Behavioural Disturbance / Rapid Tranquillisation

RCEM/RCPsych/NICE NG10 — de-escalation, oral options, IM rapid tranquillisation, monitoring, post-event review.

RCEM 2022; RCPsych 2022; NICE NG10
Lower Gastrointestinal Bleed

BSG 2019 / NICE NG141 — risk-stratify with Oakland score, stable vs unstable, imaging strategy, transfusion thresholds.

BSG 2019; NICE NG141
Accidental Hypothermia

Swiss staging, passive vs active rewarming, ALS modifications, ECMO referral for stage III/IV with cardiac instability.

ERC 2021; Wilderness Medical Society
Heat Stroke (Exertional & Classical)

Core temp >40°C with CNS dysfunction — rapid cooling within 30 min critical, supportive care, complications.

ACSM 2015; Wilderness Medical Society 2019
Acute Red Eye / Vision Loss Screen

Differentiate sight-threatening vs benign — angle-closure glaucoma, GCA, retinal detachment, central retinal artery occlusion, scleritis.

RCOphth 2020; NICE CKS
Renal Colic — ED Workflow

NICE NG118 — analgesia, low-dose CT-KUB, expectant management vs urgent intervention for obstruction/sepsis.

NICE NG118 (2019); BAUS 2018
Foreign Body Airway Obstruction (Choking)

RCUK adult choking algorithm — encourage cough, back blows, abdominal thrusts, advanced airway in unconscious.

RCUK 2021 Adult Choking
Rhabdomyolysis

CK ≥5× ULN with myalgia / dark urine / AKI — aggressive fluid resuscitation, electrolyte management, identify cause.

Renal Association 2018; UpToDate 2024
Pre-Eclampsia / Eclampsia in ED

NICE NG133 — recognition of severe pre-eclampsia, blood pressure control, magnesium sulfate for eclampsia, urgent obstetric input.

NICE NG133; RCOG Green-top 10A
Suspected Ectopic Pregnancy

NICE NG126 — assessment of early pregnancy bleeding, βhCG + USS, surgical/medical/expectant management, anti-D.

NICE NG126; RCOG Green-top 21
Self-Harm Presentation

NICE NG225 — non-judgemental assessment, treat physical injury, mental state and risk assessment, psychosocial referral.

NICE NG225 (2022)
Acute Scrotum

Differentiate testicular torsion (urgent) from epididymo-orchitis, torsion of appendix testis, hernia, hydrocele.

BAUS 2018; EAU 2024
Adult Upper Airway Obstruction (Stridor)

Adult stridor — anaphylaxis, angioedema, epiglottitis, foreign body, deep neck space infection, croup.

DAS 2015 unanticipated difficult airway; RCEM
Drowning / Submersion Injury

ERC 2021 — primary respiratory pathology, in-water rescue breaths, modified ALS, no role for routine c-spine immobilisation.

ERC 2021 Drowning