EMERGMEMO • CLINICAL REFERENCES

EMERGENCY MEDICINE CLINICAL GUIDELINES

Eighteen essential collections providing rapid access to key official documents for emergency departments and pre-hospital emergency care.

Index expanded: 11 October 2026 • Editorial summary in English • Links to official sources

How to use this page. This is a structured index, not a substitute for the full guideline, local protocols or clinical judgement. Always verify the current version, doses, contraindications and original recommendations before clinical use.

COLLECTION 1

CARDIOPULMONARY RESUSCITATION AND PERI-ARREST CARE

Core references: European Resuscitation Council Guidelines 2025 and American Heart Association Guidelines 2025 for CPR and Emergency Cardiovascular Care.

Included topics

Basic life support and early defibrillation.
Adult advanced life support for shockable and non-shockable rhythms.
Peri-arrest bradycardia, tachycardia, cardioversion and pacing.
Reversible causes, airway management and vascular access.
Post-resuscitation care, prognostication, traumatic, paediatric and pregnancy-related cardiac arrest.

Rapid ED/EMS focus: prioritise high-quality CPR, prompt defibrillation, minimal interruptions and systematic treatment of reversible causes; apply medications and sequences according to the official locally adopted algorithm.

Open ERC 2025 · Open AHA 2025

COLLECTION 2

SEPSIS AND SEPTIC SHOCK

Core reference: Surviving Sepsis Campaign – International Guidelines for Management of Sepsis and Septic Shock 2026.

Included topics

Recognition of infection-related organ dysfunction and shock.
Blood cultures, microbiological diagnostics and timing of antimicrobial therapy.
Fluids, dynamic perfusion reassessment and prevention of fluid overload.
Vasopressors, inotropes, lactate and haemodynamic targets.
Source control, respiratory support and antimicrobial de-escalation.

Rapid ED/EMS focus: promptly distinguish shock or high-probability sepsis from uncertain presentations; start time-sensitive measures and frequently reassess clinical response, perfusion and fluid balance.

Open Surviving Sepsis Campaign 2026

COLLECTION 3

ACUTE CORONARY SYNDROMES AND CARDIOVASCULAR EMERGENCIES

Core references: ESC 2023 Acute Coronary Syndromes; ESC 2024 Atrial Fibrillation; related ESC documents on arrhythmias, pulmonary embolism and acute aortic disease.

Included topics

Early ECG and recognition of STEMI, STEMI equivalents and NSTEMI.
High-sensitivity troponin and accelerated diagnostic pathways.
Reperfusion strategy and time-dependent network organisation.
Antithrombotic treatment tailored to ischaemic and bleeding risk.
Associated arrhythmias, cardiogenic shock and differential diagnosis of chest pain.

Rapid ED/EMS focus: record and interpret the ECG early, repeat it if suspicion persists, and activate the local reperfusion pathway without avoidable delay.

Open ESC Acute Coronary Syndromes · Open ESC Atrial Fibrillation

Update reviewed on 26 October 2026

Fifth Universal Definition of Myocardial Infarction — ESC/ACC/AHA/WHF, 28 August 2026: a diagnostic consensus document complementing, not replacing, the 2023 ACS treatment guideline. MI is classified as primary, secondary or procedure-related. Distinguish myocardial injury from infarction using troponin kinetics, evidence of ischaemia and imaging; apply assay-specific, sex-specific reference limits. Do not delay STEMI network activation.

COLLECTION 4

ACUTE ISCHAEMIC AND HAEMORRHAGIC STROKE

Core references: European Stroke Organisation; 2025 ESO–EANS Guideline on spontaneous intracerebral haemorrhage and ESO reperfusion recommendations.

Included topics

Stroke code activation, last-known-well time and standardised neurological assessment.
Brain and vascular imaging without avoidable delay.
Eligibility for intravenous thrombolysis and mechanical thrombectomy.
Blood pressure, glucose, temperature and airway protection.
Intracerebral haemorrhage: reversal, blood-pressure management, neurosurgical review and Stroke Unit care.

Rapid ED/EMS focus: accurately document symptom onset or last-known-well time, anticoagulant use and pre-stroke functional status; pre-alert the stroke network.

Open the ESO guideline directory · Open the 2025 ICH guideline

Update reviewed on 26 October 2026

ESO 2025 update on blood-pressure management in acute stroke, published 7 May 2026. Avoid routine prehospital BP lowering in undifferentiated suspected stroke before imaging. Subsequently use subtype- and reperfusion-specific targets; prevent hypotension and marked BP falls during reperfusion. Avoid intensive systolic BP lowering below 140 mmHg during the first 24 hours after successful thrombectomy.

Added the 2026 ESO/EANS/ESMINT guideline on aneurysmal subarachnoid haemorrhage, separate from the 2025 ICH guideline: consult the dedicated document for aneurysm management, nimodipine and complications.

Safety after IV thrombolysis: obtain follow-up CT/MRI at 24 hours before antiplatelets or anticoagulants; earlier exceptions require compelling concomitant indications and stroke-team assessment. After thrombectomy, timing also depends on IVT, stenting and bleeding risk. AHA/ASA 2026. Follow local stroke-network protocols.

COLLECTION 5

ACUTE ASTHMA AND COPD EXACERBATION

Core references: GINA Strategy Report 2026 and GOLD Report/Pocket Guide 2026.

Included topics

Severity assessment and recognition of impending respiratory failure.
Bronchodilators, corticosteroids and titrated oxygen therapy.
Indications for non-invasive ventilation in acute COPD exacerbation.
Selective use of antibiotics in COPD.
Criteria for observation, admission, intensive care and supported discharge.

Rapid ED/EMS focus: integrate clinical findings, oxygen saturation and blood-gas analysis when indicated; reassess early and do not delay ventilatory escalation in deteriorating patients.

Open GINA 2026 · Open GOLD 2026

COLLECTION 6

IN-HOSPITAL TRIAGE AND SHORT-STAY INTENSIVE OBSERVATION

Core references: Italian Ministry of Health national guidance on in-hospital triage and short-stay intensive observation (Osservazione Breve Intensiva, OBI).

Included topics

Five-level priority system and multidimensional assessment.
Reassessment, documentation and waiting-room risk management.
Fast pathways, Fast Track and integration with time-dependent networks.
General criteria for OBI admission, length of stay and discharge.
Organisational indicators, patient safety and continuity of care.

Rapid ED focus: a priority code is not a diagnosis; it must be supported by the initial assessment, scheduled reassessment and immediate review whenever the patient deteriorates.

Open the Italian triage guidance · Open the Italian OBI guidance

COLLECTION 7

HEAD INJURY

Reference: NICE NG232 • 2023

Practical ED and EMS points

Assess GCS, pupils, focal deficits, vomiting, mechanism and antithrombotic treatment; use separate adult and paediatric criteria.
In adults, focal deficits, post-traumatic seizures and signs of skull fracture are among the indications for CT within one hour; consult the complete criteria.
Document neurological reassessments and provide written discharge advice.

Open the official guideline

Independent editorial summary, not an official translation. Source checked on 10 October 2026. Consult the full document for doses, criteria and exceptions.

EmergMemo.com

COLLECTION 8

MAJOR TRAUMA AND HAEMORRHAGE

Reference: NICE NG39 • 2016

Practical ED and EMS points

Prioritise haemorrhage control and systematic airway, breathing and circulation assessment; activate the trauma team early.
Use direct pressure; use a tourniquet for uncontrolled life-threatening limb bleeding. Apply pelvic stabilisation when indicated.
Give tranexamic acid promptly for active or suspected bleeding; do not start beyond three hours after injury unless hyperfibrinolysis is demonstrated.
Coordinate blood products, imaging and definitive haemorrhage control according to clinical stability.

Open the official guideline

Independent editorial summary, not an official translation. Source checked on 10 October 2026. Consult the full document for doses, criteria and exceptions.

EmergMemo.com

COLLECTION 9

BACTERIAL MENINGITIS AND MENINGOCOCCAL DISEASE

Reference: NICE NG240 • 2024

Practical ED and EMS points

Maintain clinical suspicion even when the classic features are incomplete.
Start intravenous antibiotics promptly, within one hour of hospital arrival.
Obtain blood samples and perform lumbar puncture before antibiotics only when safe and without clinically significant delay.
CT before lumbar puncture is not routine: check the guideline for imaging indications and contraindications.
Antibiotic selection and corticosteroids depend on age, risk factors and clinical presentation.

Open the official guideline

Independent editorial summary, not an official translation. Source checked on 10 October 2026. Consult the full document for doses, criteria and exceptions.

EmergMemo.com

COLLECTION 10

ANAPHYLAXIS

Reference: Resuscitation Council UK • 2021

Practical ED and EMS points

Recognise sudden airway, breathing or circulatory compromise and call for help.
In adults: give adrenaline 500 micrograms IM into the thigh, equivalent to 0.5 mL of the 1 mg/mL solution. Repeat after 5 minutes if ABC problems persist.
Position appropriately, provide oxygen and fluids when indicated, and monitor.
Persistent problems after two IM doses require the refractory anaphylaxis pathway. IV adrenaline is restricted to experienced specialists in an appropriate setting.

Open the official guideline

Independent editorial summary, not an official translation. Source checked on 10 October 2026. Consult the full document for doses, criteria and exceptions.

EmergMemo.com

COLLECTION 11

ACUTE HYPERKALAEMIA IN ADULTS

Reference: UK Kidney Association • update July 2026

Practical ED and EMS points

Integrate potassium level, ECG, renal function and rate of rise; severe hyperkalaemia requires urgent treatment.
Distinguish cardiac protection with IV calcium when indicated, intracellular shifting with insulin-glucose, and potassium removal.
Monitor glucose and potassium serially for hypoglycaemia and rebound; assess promptly for dialysis when indicated.
The July 2026 revision changes selected recommendations and the evidence grading for IV calcium: consult the updated document.

Open the official guideline

Independent editorial summary, not an official translation. Source checked on 10 October 2026. Consult the full document for doses, criteria and exceptions.

EmergMemo.com

COLLECTION 12

CONVULSIVE STATUS EPILEPTICUS

Reference: NICE NG217 • 2022, online version

Practical ED and EMS points

A convulsive seizure lasting at least 5 minutes requires emergency treatment; support vital functions and identify reversible causes.
Give a benzodiazepine according to the individual plan or protocol; if persistent, repeat after 5–10 minutes, accounting for doses already administered.
After two ineffective doses, use a second-line IV antiseizure medicine selected according to contraindications and protocol.
For refractory seizures, involve specialists and intensive care for further treatment, including anaesthesia when indicated.

Open the official guideline

Independent editorial summary, not an official translation. Source checked on 10 October 2026. Consult the full document for doses, criteria and exceptions.

EmergMemo.com

COLLECTION 13

Acute pulmonary embolism

References: AHA/ACC multisociety guideline • 2026

Practical ED and EMS points

The 2026 AHA/ACC framework defines five clinical categories, A to E, with subcategories.
Assess clinical severity, biomarkers, right ventricular function and cardiopulmonary failure.
Anticoagulation and care setting depend on risk, contraindications and the complete guideline criteria.
In severe presentations, activate the multidisciplinary team to assess reperfusion and advanced therapies; arrange follow-up.

Open the original document

Independent editorial summary prepared with AI assistance, not an official translation. Summary reviewed: 11 October 2026. Consult the full document for criteria, doses, contraindications and exceptions; follow local protocols.

EmergMemo.com

COLLECTION 14

Diabetic ketoacidosis and hyperosmolar hyperglycaemic state

References: ADA/EASD/JBDS/AACE/DTS • International consensus report • 2024

Practical ED and EMS points

An international consensus report for adults, not a paediatric guideline.
Distinguish ketoacidosis, involving ketosis and acidosis, from the hyperosmolar state with marked dehydration; mixed presentations occur.
Assess glucose, ketones, acid–base status, electrolytes and osmolality.
The report details fluids, insulin, electrolyte replacement, monitoring and resolution criteria.
Identify triggers, particularly infection and omitted insulin; plan recurrence prevention.

Open the original document

EmergMemo.com

COLLECTION 15

Pneumonia

References: NICE NG250 • 2025, minor update January 2026

Practical ED and EMS points

In adults, combine clinical judgement with CRB65 in community settings and CURB65 in hospital.
Care-setting decisions must also consider comorbidities, overall condition and available support.
Consult the guideline for antibiotic choice, route and duration, adapting prescribing to local resistance and patient characteristics.
Follow the urgent sepsis pathway when sepsis is suspected; paediatric criteria are separate.

Open the original document

EmergMemo.com

Update reviewed on 26 October 2026

NICE NG250: 2025 guideline with a minor update in January 2026. For hospitalised adults with high-severity CAP, consider a corticosteroid alongside antibiotics for 4–7 days or until discharge if sooner; consider starting with IV hydrocortisone. If unsuitable, consider an alternative according to the full guideline. Do not extrapolate this indication to all pneumonia.

Safety: avoid concomitant systemic corticosteroids and fluoroquinolones because of increased tendon injury risk. EMA safety advice. Adapt antibiotic selection to Italian/local resistance patterns and protocols.

COLLECTION 16

Upper gastrointestinal bleeding

References: ESGE • Peptic ulcer bleeding 2026; variceal haemorrhage 2022

Practical ED and EMS points

Resuscitate and distinguish suspected peptic ulcer bleeding from variceal haemorrhage.
Ulcer bleeding: consider pre-endoscopy IV PPI without delaying endoscopy. Endoscopy within 6–12 hours is not routine; persistent instability despite adequate resuscitation requires urgent management.
Suspected varices: initiate vasoactive treatment and antibiotic prophylaxis promptly according to indications and protocol; endoscopy within 12 hours after haemodynamic resuscitation.
Recurrent or uncontrolled bleeding requires specialist reassessment and possible radiological or surgical treatment.

Open the original document · ESGE: variceal haemorrhage · ESGE 2026 correction

EmergMemo.com

COLLECTION 17

Spinal injury

References: NICE NG41 • 2016; online recommendations

Practical ED and EMS points

Integrate spinal protection into the initial trauma assessment while prioritising life-threatening problems.
Apply the complete Canadian C-spine rule in appropriate patients; distinguish adult and paediatric indications.
In adults, obtain CT when indicated by the diagnostic pathway.
Neurological abnormalities attributable to spinal cord injury require MRI after CT even when CT does not demonstrate the injury.
Activate specialist care and transfer according to the trauma network.

Open the original document

EmergMemo.com

COLLECTION 18

Complex and open fractures

References: NICE NG37 • 2016; online recommendations

Practical ED and EMS points

Document neurovascular status in both limbs and reassess after interventions.
For open fractures, consider early prehospital IV antibiotics, preferably within one hour of injury, without delaying transport.
Look for vascular injury and compartment syndrome; persistent hard vascular signs require immediate surgical assessment.
Coordinate analgesia, stabilisation and orthopaedic/orthoplastic care according to injury location and severity.

Open the original document

EmergMemo.com

EmergMemo editorial method

Each update identifies the scientific society, publication year, original document and date of editorial review. Any use of artificial-intelligence tools is accompanied by source checking; readers must still verify the official document before clinical use.

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