Common Medical Emergencies: Step-by-Step Management Protocols Every MBBS Doctor Must Know

Acute Coronary Syndrome

MONA-B: Morphine, Oxygen, Nitrates, Aspirin, Beta-blocker. STEMI: Primary PCI within 90 min (door-to-balloon). NSTEMI: Risk stratify (TIMI, GRACE), early invasive strategy if high risk.

Stroke

FAST screening. CT brain: exclude hemorrhage. IV tPA within 4.5 hours if ischemic. BP target <180/105 before thrombolysis.

Diabetic Ketoacidosis

1L NS/hr, Insulin 0.1 U/kg/hr, K+ replacement. Monitor glucose, electrolytes, venous blood gas. Bicarbonate only if pH < 6.9.

Acute Asthma

O2, SABA (Salbutamol nebulizers q20min), Ipratropium, Systemic steroids (Hydrocortisone). Magnesium sulfate if severe. Intubation if impending respiratory failure.

Sepsis

Sepsis-3 criteria: SOFA increase >= 2 + suspected infection. Surviving Sepsis 1-hour bundle: lactate, blood cultures, broad-spectrum antibiotics, 30mL/kg crystalloid for hypotension, vasopressors if MAP <65.