Shock, Sepsis and Anaphylaxis
Classify shock dynamically and treat perfusion failure while identifying and controlling the cause.
How to prepare for FRCEM SBA
Protect the full Emergency Medicine curriculum, prioritise the published item counts and practise the decisions expected of a clinician approaching independent practice.
Core concepts
Concept 1
Use history, physiology, response to intervention and bedside ultrasound to distinguish distributive, hypovolaemic, cardiogenic and obstructive processes.
Exam cue: Treat shock and anaphylaxis on recognition; obtain source control or relieve obstruction before irreversible organ injury develops.
Concept 2
Give cause-appropriate fluids, blood, adrenaline, vasoactive support, antimicrobials and source control with frequent reassessment.
Exam cue: Trend lactate, perfusion, organ function and focused imaging while cultures and definitive tests run in parallel with resuscitation.
Risk pitfalls and guardrails
Repeating undifferentiated fluid boluses despite non-response or evidence of cardiogenic or obstructive shock.
Guardrail: Do not select an option because it is technically true; select the one that best fits the patient's current physiology, evidence, urgency and decision point.
Choosing an answer that is generally true but does not fit the patient's physiology, urgency, evidence or current decision point.
Guardrail: Do not select an option because it is technically true; select the one that best fits the patient's current physiology, evidence, urgency and decision point.
Memory anchors
What frames decisions in shock, sepsis and anaphylaxis?
Use history, physiology, response to intervention and bedside ultrasound to distinguish distributive, hypovolaemic, cardiogenic and obstructive processes.
Which shock, sepsis and anaphylaxis findings change urgency?
Treat shock and anaphylaxis on recognition; obtain source control or relieve obstruction before irreversible organ injury develops.
How should investigation be planned in shock, sepsis and anaphylaxis?
Trend lactate, perfusion, organ function and focused imaging while cultures and definitive tests run in parallel with resuscitation.
What makes management complete in shock, sepsis and anaphylaxis?
Give cause-appropriate fluids, blood, adrenaline, vasoactive support, antimicrobials and source control with frequent reassessment.
What common error should be avoided in shock, sepsis and anaphylaxis?
Repeating undifferentiated fluid boluses despite non-response or evidence of cardiogenic or obstructive shock.
Checkpoint rule
Do the check-up only after you can summarize each concept in one sentence and identify one dangerous pitfall from memory.
Knowledge Check (after reading)
Short check-up to confirm understanding of this module.
Check-up Questions
A 64-year-old woman has septic shock from pyelonephritis. After appropriate crystalloid boluses, mean arterial pressure remains 54 mmHg and bedside ultrasound does not suggest further fluid responsiveness. Which vasopressor is first line?
A 73-year-old man with pneumonia has received 30 mL/kg crystalloid. He remains hypotensive, has crackles, a raised JVP and no increase in stroke volume during passive leg raise. What is the best next haemodynamic step?
Answer all questions to submit.
Next step personalized recommendations
Continue learning
Move forward only after this module is stable.
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