Quick Reference Guide
Quick Reference Guide
Completion requirements
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Step 2
Quick Reference Guide
The team leader's pocket card
Opening script
Say this in the first minute
"Hello, I am the ED registrar and I will lead. Is it safe? Gloves and apron on. Can I have a handover? Sarah, airway and oxygen. Tom, monitoring, access and bloods with a gas. Ali, drugs and scribe. I will assess ABCDE."
ABCDE: what to say and do
| Look for | Typical actions | |
|---|---|---|
| A | Talking? Noises? Obstruction? | Airway manoeuvres, suction, adjuncts, call anaesthetist |
| B | Rate, SpO2, work of breathing, chest sounds | Oxygen, nebulisers, decompress tension, ventilate |
| C | HR, BP, CRT, ECG rhythm, bleeding | Access ×2, bloods and gas, fluids or blood, ECG |
| D | AVPU or GCS, pupils, glucose, seizures | Treat glucose, seizures, protect airway |
| E | Rash, bleeding, temperature, injuries | Expose, keep warm, look for the cause |
Closed-loop phrases
- "Tom, please … and tell me when it is done."
- "Can you repeat that back to me?"
- "Thank you. Ali, please record that at 10:42."
- "Summary for everyone: … Next we will … Any concerns?"
- "I am concerned about … Let us stop and check."
Adult cardiac arrest numbers (RCUK 2025)
| Item | Value |
|---|---|
| CPR ratio | 30:2; swap compressor every 2 minutes |
| Adrenaline | 1 mg IV/IO: non-shockable as soon as possible; shockable after 3rd shock; then every 3 to 5 minutes |
| Amiodarone | 300 mg IV after 3rd shock; 150 mg after 5th shock |
| After ROSC | SpO2 94 to 98%, normal PaCO2, SBP above 100 mmHg, 12-lead ECG, temperature control |
Paediatric numbers (RCUK 2025)
| Item | Value |
|---|---|
| CPR ratio | 15:2 (5 rescue breaths first) |
| Defibrillation | 4 J/kg |
| Adrenaline | 10 micrograms/kg IV/IO |
| Amiodarone | 5 mg/kg after 3rd and 5th shocks |
| Fluid bolus | 10 mL/kg, then reassess |
| Glucose | 2 mL/kg of 10% |
4 Hs and 4 Ts
| 4 Hs | 4 Ts |
|---|---|
| Hypoxia | Thrombosis (coronary or pulmonary) |
| Hypovolaemia | Tension pneumothorax |
| Hyper/hypokalaemia and metabolic | Tamponade (cardiac) |
| Hypo/hyperthermia | Toxins |
Handover tools
| Tool | Parts |
|---|---|
| SBAR | Situation, Background, Assessment, Recommendation |
| ATMIST | Age, Time, Mechanism, Injuries, Signs, Treatment |
Closing line
Diagnosis, what has been done, current state, plan and destination, accepting team.
Doses are summarised from the Resuscitation Council UK 2025 guidelines and drug chart. Always check against the full algorithm and your local policy.
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