Respiratory Emergencies
Assess dyspnoea, cough, pleuritic symptoms and abnormal gas exchange in stable adults.
How to prepare for MRCEM SBA
Build clinical synthesis across stable adult care, resuscitation, injury, paediatrics, procedures and complex decisions while preserving the full RCEM clinical-syllabus breadth.
Core concepts
Concept 1
Asthma, COPD, pneumonia, pleural disease, pulmonary embolism, interstitial disease, respiratory infection, blood gases and oxygen strategy.
Exam cue: Identify diagnosis, investigation, immediate treatment, longer management, disposition or professional action in the lead-in.
Concept 2
Combine severity, physiology, imaging and response to initial treatment to choose investigation, treatment and disposition.
Exam cue: Use acuity, age, physiology, time course, comorbidity and response to treatment to rank plausible options.
Concept 3
Recognise impending ventilatory failure, silent chest, tension physiology and deterioration despite apparently acceptable oxygen saturation.
Exam cue: Choose the single fully correct action at this point in care and know when senior, specialty or critical-care escalation is required.
Concept 4
Use the current Year 1-3 RCEM capabilities and the full clinical syllabus at the understanding-and-applying level expected before higher specialist training.
Risk pitfalls and guardrails
Treating oxygen saturation as a complete assessment of ventilation, work of breathing and acid-base status.
Guardrail: Do not choose an option merely because it is true; select the one that fits the exact patient, urgency and time point.
Choosing a true statement that does not answer the exact time point or clinical task.
Guardrail: Do not choose an option merely because it is true; select the one that fits the exact patient, urgency and time point.
Inventing a paper-specific or subcategory weighting that RCEM has not published.
Guardrail: Do not choose an option merely because it is true; select the one that fits the exact patient, urgency and time point.
Memory anchors
Respiratory Emergencies: scope
Asthma, COPD, pneumonia, pleural disease, pulmonary embolism, interstitial disease, respiratory infection, blood gases and oxygen strategy.
Respiratory Emergencies: clinical synthesis
Combine severity, physiology, imaging and response to initial treatment to choose investigation, treatment and disposition.
Respiratory Emergencies: safety boundary
Recognise impending ventilatory failure, silent chest, tension physiology and deterioration despite apparently acceptable oxygen saturation.
Respiratory Emergencies: common trap
Treating oxygen saturation as a complete assessment of ventilation, work of breathing and acid-base status.
Respiratory Emergencies: MRCEM SBA sequence
Identify the clinical task and acuity, synthesise history, examination and investigations, choose the safest evidence-based decision, then check disposition and escalation.
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 23-year-old woman with asthma is exhausted and unable to complete sentences. Respiratory rate is 34/min, oxygen saturation 90% on air and peak flow is 28% of her best. On auscultation the chest is almost silent. Which description best fits this attack?
A 69-year-old man with COPD presents with an infective exacerbation. He is drowsy but breathing spontaneously; saturation is 82% on air. While an arterial blood gas is obtained, what oxygen saturation target should be used?
Answer all questions to submit.
Next step personalized recommendations
Continue learning
Move forward only after this module is stable.
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