Build recall around decisions, not isolated facts

ACEM Fellowship assesses whether you can practise as an independent emergency physician at consultant level. In a time-limited clinical scenario or viva, knowing a dose is useful only if you can also identify the immediate threat, explain why the treatment is appropriate and state what you will do next.

That changes how flashcards should be written. A card such as “What is the dose of adrenaline?” has too little context. A more useful prompt makes you retrieve the decision and the dose together: “What is first-line drug treatment for adult anaphylaxis, and how is it given?” Keep each answer to one principal fact, then practise adding the surrounding reasoning aloud.

The deck below covers common resuscitation decisions across several presentations. It is not a prediction of exam content. Use your own notes and current local guidance to check details, especially where a hospital protocol or patient-specific factor changes management. The doses here are adult examples; paediatric care requires age- or weight-appropriate guidance.

Work through this deck

Read one question, commit to an answer before revealing the back, then grade your recall honestly. Use Again if you could not retrieve the key fact, Hard if you needed substantial effort, Good if the answer came accurately, and Easy if it was immediate and clear. A near miss on a dose or a safety condition is not a correct recall.

A MySummaries deck on resuscitation puts the question first and the answer behind it, so the candidate can retrieve each fact before grading it:

Cards — ACEM Fellowship — Resuscitation first actions18 due

Adult anaphylaxis: what is the first-line drug, dose and route?

Give adrenaline 500 micrograms IM (0.5 mL of 1 mg/mL solution) into the anterolateral thigh; repeat after 5 minutes if needed.

All 18 cards
Adult anaphylaxis: what is the first-line drug, dose and route?Give adrenaline 500 micrograms IM (0.5 mL of 1 mg/mL solution) into the anterolateral thigh; repeat after 5 minutes if needed.
How should a patient with suspected anaphylaxis be positioned?Keep the patient lying flat; if breathing is difficult, allow a position of comfort with legs extended. Do not let them stand or walk.
In severe adult asthma, what nebulised salbutamol dose is commonly used initially?Salbutamol 5 mg by nebuliser.
In severe adult asthma, what nebulised ipratropium dose is commonly added?Ipratropium 500 micrograms by nebuliser.
What oral corticosteroid dose is commonly used early for an adult acute asthma exacerbation?Prednisolone 50 mg orally, if the patient can take oral medication.
For an adult with ongoing convulsive status epilepticus and IV access, what initial lorazepam dose is commonly used?Lorazepam 4 mg IV; a further dose may be given after 5 minutes if convulsions continue, following local protocol.
What immediately reversible metabolic cause should be checked in a patient with seizure or altered consciousness?Check blood glucose and treat hypoglycaemia promptly.
For stable, regular, narrow-complex SVT persisting after vagal manoeuvres, what is the usual initial adenosine dose?Adenosine 6 mg as a rapid IV bolus followed immediately by a flush.
If regular narrow-complex SVT persists after 6 mg adenosine, what dose is commonly given next?Adenosine 12 mg as a rapid IV bolus followed immediately by a flush, if appropriate.
What antiplatelet loading dose is commonly given early in suspected acute coronary syndrome if there is no contraindication?Aspirin 300 mg orally, chewed or dispersed for absorption.
What oxygen saturation target is commonly used in an acute COPD exacerbation when the patient is at risk of hypercapnic respiratory failure?Target SpO₂ 88–92%, with reassessment and blood gas testing as clinically indicated.
What is the immediate principle in suspected tension pneumothorax with haemodynamic compromise?Decompress immediately on clinical grounds; do not delay treatment to obtain imaging.
When reversing opioid-related respiratory depression with naloxone, what is the treatment endpoint?Titrate naloxone to restore adequate ventilation, rather than aiming necessarily for complete wakefulness.
What bedside test should be checked early in suspected stroke because it can mimic a neurological deficit?Check blood glucose and correct hypoglycaemia.
In suspected sepsis, what is the rule for taking blood cultures before antibiotics?Take cultures first when feasible, but do not let culture collection cause a clinically important delay to antibiotics.
For an adult with significant traumatic haemorrhage, what is the commonly used tranexamic acid regimen when indicated within 3 hours of injury?Give 1 g IV over 10 minutes, followed by 1 g IV over 8 hours, in line with the applicable trauma protocol.
If an adult with hypoglycaemia is conscious and can swallow safely, what is an initial oral treatment?Give 15–20 g of fast-acting oral glucose, then recheck glucose and provide further treatment as needed.
What is the core sequence when an acutely unwell patient first arrives?Use an ABCDE assessment, treating immediately threatening problems as they are identified, then reassess.

That is a MySummaries deck, filled with ACEM Fellowship material. Yours is written from your own notes. Start free

Turn each fact into an oral answer

After grading a card, practise saying one extra sentence that applies it to a case. For example: “I would give IM adrenaline now, call for resuscitation support and reassess ABCDE, repeating adrenaline after five minutes if symptoms persist.” That sentence tests whether the fact sits in a safe sequence rather than floating alone.

For a treatment card, retrieve four things where relevant: the indication, the action, the dose or target, and the reassessment or escalation step. Avoid adding a long explanation to every card; the point is fast, accurate retrieval. Put important exceptions or local-protocol details in your own notes and check them against current Australian guidance.

If you miss a card, identify the type of miss. Was the dose absent, the route wrong, the indication too broad, or the next step missing? Make the repair specific. “Review asthma” is not a useful action; “retrieve the adult nebulised ipratropium dose” is. If you keep missing the same fact, rewrite its prompt so it asks for the decision you failed to make.

The core this deck was cut from

A compact core is useful for a rapid check before practice, but it does not replace retrieving the individual answers. Read each line and ask whether you could explain when it applies and what you would reassess afterwards.

Must not miss coreACEM Fellowship — Resuscitation first actions
Adult anaphylaxis: adrenaline 500 micrograms IM (0.5 mL of 1 mg/mL); repeat after 5 minutes if needed.
Severe adult asthma: nebulised salbutamol 5 mg and ipratropium 500 micrograms; give prednisolone 50 mg orally if able.
Stable regular narrow-complex SVT after vagal manoeuvres: adenosine 6 mg rapid IV, then 12 mg if it persists and treatment remains appropriate.
Significant traumatic haemorrhage: when indicated within 3 hours, tranexamic acid 1 g IV over 10 minutes, then 1 g over 8 hours.

Repair repeated misses

A repeated miss should become a short, answerable prompt rather than another general revision task. In a viva, a missed dose can also signal that the candidate has not linked the treatment to its indication or reassessment. After reviewing the fact, say the full action in one concise sentence and include what you will monitor.

A card waiting after two lost marks might look like this:

Remediation tray

You lost this mark twice: in adult anaphylaxis, what is the adrenaline dose, concentration, route and repeat interval?

Add cardDismiss

Use the tray prompt to retrieve the complete answer, not just “give adrenaline”. If you cannot provide the dose and route reliably, return to your source notes, confirm the detail and then test yourself again. Do not use a flashcard as authority over a current guideline or a patient-specific contraindication.

How MySummaries helps

MySummaries builds revision boards from your own PDFs, slides and photographed notes, then turns board material into flashcards with spaced repetition. For ACEM Fellowship preparation, use it to keep resuscitation facts connected to your own study material and revisit cards you have not yet retrieved reliably.