ACEM Fellowship interactive diagrams
39 interactive teaching figures mapped to 29 ACEM Fellowship learning objectives. Each diagram opens inside the matching note in Primex.
Section me-cvs
Acute coronary syndromes and myocardial infarction — aetiology, prehospital pathways, complex ECG
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ACEMF-3.1-TS1-1.1 Renin-angiotensin-aldosterone systemRenin-angiotensin-aldosterone system — Aetiology and pathophysiology of: congestive cardiac failure, valvular disorders, disorders of the myocardium, disorders of the pericardium (including pericarditis, pericardial effusion and cardiac tamponade), cardiogeni…
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ACEMF-3.1-TS2-2.1 ECG — coronary territoriesECG — coronary territories — Aetiology and pathophysiology of acute coronary syndromes, including: right ventricular myocardial infarction, thrombolysis myocardial infarction, left ventricular failure and cardiogenic shock in the setting of myocardi…
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ACEMF-3.1-TS3-3.6 ECG rhythm recognition trainer + ECG — coronary territoriesECG rhythm recognition trainer + ECG — coronary territories — Interpret a complex ECG in the setting of acute coronary syndromes.
Arrhythmia and accessory pathways — pathophysiology, WPW, ANZCOR algorithms
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ACEMF-3.1-TS1-1.2 Adult bradycardia algorithm + ECG rhythm recognition trainer + Cardiac action potential + Adult tachycardia (with a pulse) algorithmAdult bradycardia algorithm + ECG rhythm recognition trainer + Cardiac action potential + Adult tachycardia (with a pulse) algorithm — Pathophysiology of arrhythmia, including: bradycardias (sinus bradycardia, heart block), tachycardias (narrow complex regular, narrow complex irregular, wide complex regular, wide complex irregular, torsade des pointes, …
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ACEMF-3.1-TS3-3.2 Adult tachycardia (with a pulse) algorithmAdult tachycardia (with a pulse) algorithm — ANZCOR guidelines for the management of arrhythmias.
Section me-neuro
Altered consciousness — GCS, approach to coma, metabolic vs structural
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ACEMF-3.4-TS1-1.4 Status epilepticus algorithmStatus epilepticus algorithm — Aetiology and pathophysiology of seizures and status epilepticus.
Guillain-Barré syndrome — recognition, FVC monitoring, immunoglobulin
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ACEMF-3.4-TS3-3.4 Dermatomes & myotomesDermatomes & myotomes — Aetiology and pathophysiology of spinal cord injury, including medical problems in the spinally injured patient.
Post-resuscitation care — targeted temperature management, neuroprognostication
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ACEMF-3.4-TS3-3.5 Cerebral autoregulation (CBF vs MAP / PaCO₂ / PaO₂) + Monro-Kellie intracranial volume + ICP curveCerebral autoregulation (CBF vs MAP / PaCO₂ / PaO₂) + Monro-Kellie intracranial volume + ICP curve — Aetiology and pathophysiology of neurosurgical presentations, including intracranial aneurysms, AV malformations, subarachnoid haemorrhage, cerebral tumours, shunt complications, elevated intracranial pressure, intervert…
Section me-tox
General toxicology assessment — toxidromes, risk assessment, antidotes and antivenom
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ACEMF-3.8-TS1-1.1 Toxidrome discriminator gridToxidrome discriminator grid — Aetiology and pathophysiology of poisoning, drug overdose and envenomation.
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ACEMF-3.8-TS1-1.17 Toxidrome discriminator gridToxidrome discriminator grid — Identify the underlying cause of the presentation, including distinguishing toxidromes for poisoning, drug overdose and envenomation.
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ACEMF-3.8-TS2-2.4 Toxidrome discriminator gridToxidrome discriminator grid — Identify the appropriate antidote or antivenom.
Industrial and CBRN toxicology — toxic metals and gases, exposure syndromes
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ACEMF-3.8-TS3-3.3 Dose-response curvesDose-response curves — Aetiology and pathophysiology of exposure syndromes of chemical, biological and radiological agents, with specific regard to dose-response relationships, factors affecting toxicity and latency.
Section me-endo
DKA in children — fluid protocol, cerebral oedema risk
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ACEMF-3.9-TS1-1.1 Hypothalamic-pituitary-adrenal axis + Glucose homeostasisHypothalamic-pituitary-adrenal axis + Glucose homeostasis — Aetiology and pathophysiology of the endocrine system, including: disorders of glucose metabolism, alcoholic ketoacidosis, adrenal disorders, thyroid disorders, pituitary disorders.
Diabetic ketoacidosis in adults — fluids, insulin, potassium, euglycaemic DKA
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ACEMF-3.9-TS1-1.2 Glucose homeostasisGlucose homeostasis — ED diagnosis and stepwise management of adult diabetic ketoacidosis: precipitants (infection, non-compliance, SGLT2-associated euglycaemic DKA), diagnostic criteria (pH < 7.3, HCO3 < 15, ketones), fluid resuscitation str…
Hyperosmolar hyperglycaemic state — slower correction, VTE prophylaxis
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ACEMF-3.9-TS1-1.3 Glucose homeostasisGlucose homeostasis — ED recognition and management of hyperosmolar hyperglycaemic state (HHS), including distinction from DKA, calculated effective osmolality, slower fluid replacement, lower insulin requirements, prophylactic anticoagulatio…
Adrenal crisis — hydrocortisone first, fluids, sick-day rules
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ACEMF-3.9-TS2-2.3 Hypothalamic-pituitary-adrenal axisHypothalamic-pituitary-adrenal axis — Diagnosis and ED treatment of adrenal crisis, including primary vs secondary causes, presentation with shock and hyponatraemia, immediate hydrocortisone 100 mg IV stat then 50 mg q6h, fluid resuscitation with normal sali…
Severe adult hypoglycaemia — dextrose, glucagon, octreotide for sulfonylurea
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ACEMF-3.9-TS2-2.4 Glucose homeostasisGlucose homeostasis — ED management of severe hypoglycaemia in adults, including IV 10% dextrose dosing, IM glucagon when no access, sulfonylurea-related prolonged hypoglycaemia with octreotide, malicious insulin (factitious) work-up with C-p…
Pituitary apoplexy and hypopituitarism — steroid cover, urgent imaging
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Hypothalamic-pituitary-adrenal axis + Renin-angiotensin-aldosterone system — Diagnosis and ED management of acute hypopituitarism (including pituitary apoplexy), recognition of headache, visual field defect, ophthalmoplegia and adrenal insufficiency, urgent MRI/CT pituitary, immediate hydrocortis…
Section me-haem
Massive haemorrhage — damage control resuscitation, 1:1:1 ratio, TXA
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ACEMF-3.10-TS1-1.5 Coagulation cascadeCoagulation cascade — Aetiology and pathophysiology of the haematological system, including: anaemia, abnormal haemoglobins, disorders of haemostasis and coagulation, neutropenia, platelet disorders, haematological malignancy.
TTP and HUS — PLASMIC score, plasma exchange, avoid platelet transfusion
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ACEMF-3.10-TS1-1.3 Acute kidney injury stagingAcute kidney injury staging — Diagnosis and emergency management of thrombotic thrombocytopenic purpura (TTP) and haemolytic uraemic syndrome (HUS), including the pentad of MAHA, thrombocytopenia, neurology, renal failure and fever, PLASMIC score, AD…
Disseminated intravascular coagulation — ISTH scoring, blood product strategy
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ACEMF-3.10-TS2-2.2 Coagulation cascadeCoagulation cascade — ED diagnosis of disseminated intravascular coagulation, including ISTH overt-DIC score, common triggers (sepsis, trauma, obstetric, malignancy), interpretation of coagulation profile, treatment of the underlying cause, j…
Severe anaemia work-up — haemolysis screen, transfusion thresholds
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ACEMF-3.10-TS2-2.3 Iron homeostasisIron homeostasis — Structured ED work-up of severe anaemia, including history of bleeding, haemolysis screen (LDH, haptoglobin, bilirubin, blood film), iron studies, transfusion threshold (Hb 70 g/L vs higher in cardiac disease), and indic…
Section me-renal
Rhabdomyolysis — crush injury, AKI prevention, fluid targets, urine alkalization, monitoring
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ACEMF-3.12-TS1-1.1 Hyperkalaemia — ECG & treatment ladder + Acute kidney injury stagingHyperkalaemia — ECG & treatment ladder + Acute kidney injury staging — Aetiology and pathophysiology of renal presentations, including pyuria, infectious disorders, acute renal failure, chronic renal failure, hyperkalaemia in renal failure, complications of renal dialysis, haemolytic uremic…
Section me-infect
Sepsis — SOFA/qSOFA, Surviving Sepsis bundles, early antibiotics
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ACEMF-3.15-TS1-1.1 Severe sepsis escalation bundle + Antimicrobial PK/PD targetsSevere sepsis escalation bundle + Antimicrobial PK/PD targets — Aetiology and pathophysiology of infectious diseases, including: antibiotic use in the ED, systemic inflammatory response syndrome, sepsis and septic shock, multiple organ dysfunction, toxic shock syndrome, infections in…
Section me-immuno
Anaphylaxis — adrenaline dosing, refractory anaphylaxis, biphasic reactions
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ACEMF-3.16-TS1-1.1 Anaphylaxis & adrenaline algorithmAnaphylaxis & adrenaline algorithm — Aetiology and pathophysiology of immunological conditions, including anaphylaxis, angioedema, urticaria, systemic lupus erythematosus and autoimmune conditions, primary and secondary immunodeficiency states.
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ACEMF-3.16-TS2-2.1 Anaphylaxis & adrenaline algorithmAnaphylaxis & adrenaline algorithm — Principles of management of anaphylaxis and severe allergic reactions.
Section me-obs
Pre-eclampsia and eclampsia — magnesium sulfate, delivery decision
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ACEMF-3.17-TS3-3.2 Renin-angiotensin-aldosterone systemRenin-angiotensin-aldosterone system — Complications of pregnancy, including: hyperemesis gravidarum, miscarriage, septic abortion, ectopic pregnancy, HELLP syndrome, first trimester bleeding, antenatal haemorrhage (placental abruption, placenta praevia, vasa…
Section me-metab
DKA in adults — fluid resuscitation, fixed-rate insulin, SGLT2-precipitated DKA, transition
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ACEMF-3.18-TS1-1.3 ABG interpretation algorithm + Oxygen cascade — atmosphere to mitochondrionABG interpretation algorithm + Oxygen cascade — atmosphere to mitochondrion — Principles of arterial and venous blood gas analysis, including alveolar gas equation and A-a gradient.
Electrolyte emergencies and acid-base interpretation — hyperkalaemia, hyponatraemia, ABG analysis
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ACEMF-3.18-TS3-3.1 Hyperkalaemia — ECG & treatment ladderHyperkalaemia — ECG & treatment ladder — Interpret relevant investigations including electrocardiograph in electrolyte disturbance and arterial and venous blood gases for advanced analysis.
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