SLO 1: Stable adults and complex presentations
The outcome
Assess adults who are physiologically stable, including patients with several interacting problems or mental health needs, and agree a safe plan.
What this means in practice
Use a case to explain your differential diagnosis, disposition and safety-netting.
Use these cases to practise assessment and decisions across selected adult presentations.
Start here
Choose a starting point to suit what you need to work on.
Chapter 3: History taking
Use a focused history to understand the problem, the patient’s concerns and the next decision.
Chest pain: choosing the right diagnostic pathway
Choose investigations by working through the competing causes of chest pain.
Headache: the history that changes the plan
Use the headache history to decide what needs urgent investigation.
Chronic pain: a useful emergency consultation
Practise a useful consultation when someone with chronic pain has new symptoms.
Focused history and initial plan paired practice
Rehearse a focused consultation, then use the observer’s feedback for a second attempt.
More learning for this SLO
Learn
Ep 299 – Which patients with chest pain need a troponin?
Consider which stable patients with chest pain need troponin testing.
Ep 255 – Likelihood Ratios: Critical Appraisal Nugget 12
Review how pre-test probability changes the interpretation of an investigation.
Ep 243 – The Subarachnoid Haemorrhage in Emergency Department (SHED) Study
Explore residual diagnostic uncertainty after CT in the headache case. This is an advanced appraisal discussion.
Ep 55 – Communicating (not Breaking) Bad News with Liz Crowe
Practise listening and responding to distress in the early-pregnancy consultation.
Discuss
Syncope: a normal appearance is not the diagnosis
Reconstruct a blackout, identify concerning cardiac features and discuss monitoring, referral and advice.
Back pain: recognising the dangerous exception
Discuss spinal and vascular causes of back pain, the limits of examination and advice for uncomplicated pain.
The breathless patient: act, assess, reassess
Discuss initial care for breathlessness, oxygen targets and the different options for a stable pneumothorax.
Analgesia in the Emergency Department
Discuss prompt pain relief, prescribing risks and how to check whether treatment has helped.
Show 13 more lessons
Diagnostic testing: decide before you request
Use a D-dimer case and a worked table to understand test accuracy, pre-test probability and the decision after a result.
Assessing acute coronary syndrome
Discuss urgent ECG findings, initial ACS care and the limits of high-sensitivity troponin pathways.
Pain and bleeding in early pregnancy
Discuss possible ectopic pregnancy, uncertain early scan findings and sensitive explanations with reliable follow-up.
The red leg: cellulitis, mimics and dangerous infection
Compare cellulitis, a non-infective red leg and possible necrotising infection, with attention to treatment and reassessment.
First assessment of suspected poisoning
Assess an uncertain exposure, find current poisons advice and plan observation alongside psychosocial care.
Recognising and responding to suspected sepsis
Compare high- and lower-risk presentations of possible sepsis, including treatment timing, fluids and reassessment.
Upper gastrointestinal bleeding: first assessment
Work through initial care for upper GI bleeding and the assessment needed before considering discharge.
Carbon monoxide: recognise the exposure, protect the household
Assess possible carbon monoxide exposure, interpret a later blood result and plan care that includes the safety of the home.
Tick bites and Lyme disease: a UK approach
Compare a recent tick bite, erythema migrans and symptoms that need specialist assessment.
Recognising acute aortic dissection
Discuss when to suspect aortic dissection and how to arrange imaging and specialist care without delay.
Interpreting chest X-rays
Review five chest X-rays and discuss how the findings change the next clinical decision.
Upper gastrointestinal bleeding: decisions under pressure
Discuss resuscitation, anticoagulant reversal and definitive haemostasis when GI-bleeding treatment decisions are complicated.
Your first day in Emergency Medicine
Find out how to get help, hand over unfinished work and make discharge decisions on your first ED shifts.
Practise
One learner performs. One checks the key steps and gives feedback. Then swap roles. These are practice tools, not official RCEM mark schemes.
Lower limb neurological examination
Practise the neurological examination component of an adult back-pain assessment.
Cardiovascular examination
Practise cardiovascular examination alongside the stable blackout cases.
Respiratory examination
Practise respiratory examination as one part of assessing a stable adult with breathlessness.
Teaching programmes
Starting in Emergency Medicine
5 relevant sessions in this programme.
Early-career Emergency Medicine
8 relevant sessions in this programme.
Higher Training and Advanced Discussion
2 relevant sessions in this programme.
Apply it in practice
Choose one thing to try on your next suitable shift, within your role and level of supervision. Discuss what happened and what you would change.
More mapped resources
Browse 22 more mapped St Emlyn’s resources
22 tagged resources
The Fifth Universal Definition of Myocardial Infarction: What Emergency Clinicians Need to Know
ASPIRED: Ambulatory ECG Monitoring After Unexplained Syncope
Communication Series – Listening.
Does Sodium bicarbonate improve outcomes for in-hospital cardiac arrest?
JC: Magnesium for Acute Headache: Maybe, but perhaps not for all..
JC: Salbutamol for Analgesia in Renal Colic – Worth a Puff or a Painful Disappointment?
Is nebulised ketamine an option in the Emergency Department?
Thunderstorm Asthma: St Emlyn's