> [!key points] Quick Links > - [[Day of exam cheat sheet]] > - [[ACEM syllabus]] > - [[Blood gas]] > - [[Easily missed fractures and dislocations]] > - [[High Yield Tables]] > - [[Airway]] > - [[Paeds#calculations, weight, ETT, obs|paeds calculations and normal obs]] > - [[Ortho#paeds ortho|paeds ortho]] > - [[Neonates]] > - [[Cardiac arrest]] > - [[Procedures]] These are my notes for the **ACEM fellowship written exam** sitting Nov 2024. They were actively updated while I studied, and thankfully I have now passed it. Browse topics in the column on the left (or the hamburger menu if you are on mobile) or search in the same place. > [!info]- About > There is nothing else on this page you need to read to use the resource; the info below is to explain behaviour of the website that may be confusing, and to provide some resource attributions and recommendations. > > These are NOTES from “core” textbooks, past papers/DEMT practice papers, and other sources I trust. I didn't write a textbook! In addition to the standard resources, particular credit is given to colleagues of mine who shared helpful study resources that I have used in my notes. > #### Caveats > Internal links to other pages on the website (styled like [[Welcome|this]]) will always work. However, there are many greyed-out external links (styled like <a href="http://oscepass.org" style="color: var(--text-normal);cursor: not-allowed; opacity: 0.5; text-decoration: none; font-family: var(--font-text);">this</a>) in these notes to sources in my personal DEVONthink database, cubox links (a Read It Later app), or Bookends pdf library ==that will not work if you click them because those sources are in my personal collection==. I will take this warning down if I publish a version of these notes without this limitation. Links that look like [this](http://oscepass.org) will still work. > > > Of specific note with respect to the above issue is that the "related questions" section at the bottom of many notes is past questions related to the current note. None of these links will work for you because the contents are in my DEVONthink vault, but you can access the question database at the [ED VIVAs website](https://www.edvivas.com/part2s/). > > The reason I have stored a lot of these resources in my personal collection is simple: I don't trust that resources will always be available at a particular web address, so if something is useful to me, I tend to download it and store it in my personal database. I can access nearly 100% of my study resources offline (eg on an airplane), which has a certain apocalypse prepper appeal. Setting up an offline ecosystem was actually quite simple and I'm happy to help you do the same for your own study if you are keen. I highly recommend buying a copy of Devonthink to assist with this if that is your aim, but to be honest simply making a great anki deck is probably a better use of your time. > > > ==Update!== > > I have hacked some code so that many links to these files will work if the corresponding file is <15mb. Because I have no business sharing many of these files, they are behind a password-protected website. I'll only share the password for limited contexts of "fair use" of the resources (eg many of the files are from publicly-available databases of past DEMT paper). > *** > There may be sections with a green box that looks like this: > ![[Pasted image 20240220185454.png]] > This is because a programatic feature called "dataview" that I use in the computer version of my notes (using an application called Obsidian) is not available yet for the online version of these notes; I may fix this at some point, but right now it is not a priority for me. > *** > Sometimes you will see a yellow box with a tag in it which you can click on to see other notes with that tag. You would be understandably inclined to assume that the tag eg \#ortho would lead you to all ortho subjects, but usually it is actually just the topics that aren’t already in the folder for that subject. Go to the hamburger menu and scroll to the folder if you want to browse the subject. The search bar is by far the easiest way to find what you are looking for. > > Another box you will see on most pages is a grey “*last updated*” date at the top. Take this with a grain of salt. Updates can be anything from content additions to layout changes to absolutely nothing but I accidentally edited the note while reviewing it. The last update date does NOT mean the contents in their entirety have been reviewed or are reliably contemporaneous. > *** > ==Please contact me if there is any information you would like taken down==; these are notes from a variety of sources for my personal study, and not intended as my own published work. As a result, there may be un-intended instances where proper attribution of the source was not provided. I have provided a list of sources used below. I have linked to resources that I own and gone out of my way to make sure they are not actually shared via this website by password-protecting it so only I can access it. > [!Key points]- Sources involved in notes > **“Core” texts** (in approximate order of influence) > - Cameron's emergency medicine 5th ed - nice scaffolding for first read through of the “core” material (but there are a lot of practice questions that are not covered in this book!) > - Murray tox 3rd ed (later 4th ed of Toxicology Handbook) - mandatory reading > - Cameron's textbook of paediatric emergency medicine 3rd and 4th ed - in my opinion explains concepts better than the RCH guidelines, but not as quick to parse > - Dunn's emergency medicine manual - Australian, I preferred it on my second pass of the info (can even filter it for only high yield content if you want) > - Rosen's 10th ed -lower yield than tintinalli’s, but I just liked reading it better. Latest version cites a lot of contemporaneous research > - Tintinalli's emergency medicine - this and Rosen’s give the best explanations and reasoning. > > **Others** > - [ANZCOR Guidelines](https://www.anzcor.org/home/adult-advanced-life-support/guideline-11-10-resuscitation-in-special-circumstances/) > - Own the Arterial Blood gas - luke lawton, aussie FACEM exam ABG book worth doing > - ~~Emergency Medicine MCQs - De Alwis 2012, variable usefulness but at least it’s Australian~~ honestly skip this; do EMCQ and recall MCQs > - Goldfrank's toxicological emergencies - nice explanations of how the treatments work > - Trauma by Ernest E Moore > - radiopaedia especially [trauma radiology course](https://radiopaedia.org/courses/trauma-radiology-course-online) > - EMCQ mcqs > - David Schwartz Emergency Radiology Case studies > - Marino ICU textbook - one of the best medical books ever written. New 5th edition just released, but older version is still perfect for the core concepts (eg chapter on hyperkalemia is mandatory reading) > - Schein's "Common sense emergency abdominal surgery" -- got me through intern year when I was afraid of abdominal exams. ignore the line when he says "Some ER physicians do not see much and do not understand the meaning of the little they do see; all they care about is where to dump the patient." > - Oh's Critical care - core text but not as readable as Marino’s. Probably need to have/read for your ICU rotation though. > - Ma and Mateer's emergency ultrasound > - [Melbourne Ultrasound](https://www.melbourneus.com) - Thanks Amaali! > - Robert hedges clinical procedures in ED > - Amal mattu's ECG book as well as [ECG weekly](https://ecgweekly.com) > - [Royal Children's Hospital clinical guidelines](https://www.rch.org.au/clinicalguide/) and [paediatric fracture guidelines](https://www.rch.org.au/clinicalguide/fractures/) > - [Royal Victorian Eye and Ear hospital clinical guidelines](https://eyeandear.org.au/health-professionals/clinical-practice-guidelines/) > - APLS textbook > - Mark Crislip's [Infectious diseases compendium](http://pusware.com/testpus/) - sadly he stopped updating, but this guideline was written in the voice of a knowledgeable consultant giving 30 years of knowledge during a ward round. > - “Big Gun. Strong. Powerful. There are adjectives that are often used to describe antibiotics. There are few things in medicine that are 100%. But if a physician uses the above adjectives to describe an antibiotic they do not know a burro from a burrow. It is 100% sensitive and 100% specific that the speaker is a moron when it comes to antibiotic use, is a sucker for drug company commercials, and/or is blowing smoke up your butt.” - [Mark Crislip](http://www.pusware.com/PW1/PowerfulAntibiotics.html) > - update! He is working on an update using the same platform as this website. Check it out here: [Pus: an owner’s manual, beta edition](https://publish.obsidian.md/pus-an-owners-manual/Index) > - past ACEM papers eg from [Doctorswriting.com](https://www.doctorswriting.com/written.html) (thanks Viet!) > - graphic guide to infectious diseases > - Med school notes > - various Royal Melbourne Hospital clinical resources > - various [resources published by ACEM](https://acem.org.au/Search-Pages/Policy-And-Regulation-Search) > - various "classic" papers for ED > - EMRA publishes yearly [greatest hits](https://www.emra.org/emresident/article/greatest-hits-2023) and a dubious [top 10](https://www.emra.org/students/newsletter-articles/top-10-articles/) list > - [52 articles](https://www.aliem.com/52-articles-in-52-weeks-2nd-edition-2016/) - 2016 > - [EMA](https://onlinelibrary.wiley.com/journal/17426723) is high yield for Australian trainees > - [Resus important papers](https://resus.com.au/important-studies-emergency-medicine/) > - [NEJM emergency medicine](https://www.nejm.org/emergency-medicine) > - [Annals of emergency medicine journal club](https://www.annemergmed.com/journalclub) > - [Emergency Medical Journal Australasia](https://onlinelibrary.wiley.com/journal/17426723) > - therapeutic guidelines australia > - James Hayes' Northern Hospital fellowship guidelines (at [EM DOJO](https://emdojo.com) or [ED Central](https://edcentral.co/james-hayes-northern-guidelines/)) — my homage to these impressive notes is hidden at the top of my [[Pulmonary Embolism]] note > - https://edfellowshipland.webnode.page/ -- (thanks Jana!) > - [Emergency Trauma Manual](https://etmcourse.com/login/?redirect_to=https%3A%2F%2Fetmcourse.com%2Ftraumamanual%2F) -- Andy's solution for modern high acuity trauma management > - [Western Trauma association algorithms](https://www.westerntrauma.org/western-trauma-association-algorithms/) > - [Eastern Trauma management Guidelines](https://www.east.org/education-career-development/practice-management-guidelines) > - Lidia's [Anki deck](https://ankiweb.net/shared/by-author/1529617387) (thanks!) > - [One of my own websites](https://davidlempert.com/medCMS/article/4) that I designed to have similar editing features to this platform before the software to make these notes existed (interestingly, we both use an open source library code codemirror for the editor features) > > → note that I have not included life in the fast lane. I have used this nearly zero in these notes (save for perhaps some ECGs), simply because the content isn’t accountable to the core curriculum for the exam. I do occasionally refer to deranged physiology, which is not an ED source or a recomended resource, but there are certain critical care concepts he explains better than anyone else, but caution that FACEM exam will approach cases differently than CICM exam. > [!pearl]- Application recommendations > I’ve been a bit surprised by the number of people who mentioned this section to me and noted they dislike some of my recommendations. I’ve included it not because I think you need to use ANY of them to study, but because I am a former programmer and I’m keen to share some of the solutions that I’ve personally found to be useful in both my work and my study. Most are not free, but worth the price to me for the quality. > - [obsidian](https://obsidian.md) (used for these notes). Free to use; pay for the “publish” feature. > - [bear](https://bear.app) -- used for a lot of my other notes. Subscription fee. > - [Anki](https://apps.ankiweb.net) -- spaced repetition. Free on desktop, single payment for app that I’ve used since med school. > - [cubox](https://cubox.cc) -- read it later app, payment subscription. [GoodLinks](https://apps.apple.com/us/app/goodlinks/id1474335294) is another nice option with single payment. > - [Bookends](https://www.sonnysoftware.com/bookends-for-mac) -- reference manager like endnote or zotero for pdfs and citations. Single payment, but (low) yearly fee to sync your library across devices > - [DEVONthink](https://www.devontechnologies.com/apps/devonthink) and devonthink to go -- amazing database to store and search all my study materials. Single fee purchase. > - [Collections database](https://collectionsdb.com) - mobile and desktop personal database app, like airtables but better and cheaper. > - [sono ultrasound](https://apps.apple.com/us/app/sono/id1532686897) -- ios app reference for POCUS (there are many but start here) > - [journal club](https://apps.apple.com/us/app/journal-club-medicine/id512153051) -- app that keeps up with important papers in medicine, usually more internal medicine than ED > - [sublux](https://apps.apple.com/us/app/sublux/id1332240487) ortho app -- reference app for fractures > - [eye manual](https://apps.apple.com/us/app/eye-emergency-manual/id777216623) -- for eye emergencies > - [Austin toxicology](https://apps.apple.com/us/app/austin-health-toxicology/id1436266463) -- easier to access than the textbook. note it is also available online > - Update. Sadly they stopped supporting the app, so you need to access the guidelines [online](https://www.austin.org.au/clinical-toxicology-guidelines/) > - palliative care fast facts > - [md on call](http://mdoncalltheapp.com) -- guide for ward call, I've used since intern year and still reference occasionally > - [ProcedureLog](https://apps.apple.com/us/app/procedure-log/id888851773) -- keep a log of procedures > - [Emergency Procedures](https://app.emergencyprocedures.org/Preparation) -- guide for various ED procedures > - [Mochi notes](https://mochi.cards) -- like a mixture of anki and obsidian; I use it for reviewing other people's anki decks > - [FEEEED](https://feeeed.nateparrott.com) -- to get EM blogs (listed below) delivered and other RSS feeds. > - matter -- to convert podcasts to written text (new version of apple podcasts does this now so less value) > - [mdcalc](https://www.mdcalc.com) -- who actually remembers the Glasgow-Blatchford score? > - [Orion browser](https://kagi.com/orion/) > - [Kagi search engine](https://kagi.com) - "premium" search engine that is supported by subscription, rather than advertisements. If you are tired of endless advertisements and marketing from your other search engines, worth the $10/month to me. > [!doses]- ED blogs/FOAM > > use at your own risk; these are not particularly useful for fellowship study > > - [The Bottom Line](https://www.thebottomline.org.uk/category/summaries/em/) -- one of the best IMHO > - [EM Cases](https://emergencymedicinecases.com) > - [EM lit of note](https://www.emlitofnote.com) > - [the NNT](https://thennt.com) > - [first10em](https://first10em.com) > - [EM RAP](https://www.emrap.org/corependium/) > - [rebelEM](https://rebelem.com) > - EM Crit -- link is to ["Functional Heuristics in resus"](https://emcrit.org/emcrit/functional-heuristics-in-resuscitation/), best article on the site > - [em updates](https://emupdates.com) > - [ALEM](https://www.aliem.com) > - [CORE EM](https://coreem.net) > - [St Emlyn's](https://www.stemlynsblog.org) > - [Emdocs](https://www.emdocs.net/) > - [DR Smith ECG blog](https://hqmeded-ecg.blogspot.com) > - [Western Trauma guidelines](https://www.westerntrauma.org/western-trauma-association-algorithms/) > - [Royal Women's hospital Guidelines](https://www.thewomens.org.au/health-professionals/clinical-resources/clinical-guidelines-gps/#a_downloads) > - [Better health victoria - pregnancy guidelines website](https://www.betterhealth.vic.gov.au/healthyliving/pregnancy) — great general reference material to share with non-medical acquaintances, eg the [pregnancy and diet](https://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-and-diet) guide > - [Emergency Procedures](https://app.emergencyprocedures.org) > - paeds > - [don't forget the bubbles](https://dontforgetthebubbles.com) > - [pediatric EM morsels](https://pedemmorsels.com) > - ICU / anaesthetics > - [pulmCCM](https://www.pulmccm.org) > - [deranged physiology](https://derangedphysiology.com/main/home) > - [Propofol dreams](https://propofoldreams.wordpress.com) > - [ketamine nightmares](https://ketaminenightmares.com) > - [wikiem](https://wikem.org/wiki/Main_Page) > - [google foam](https://googlefoam.com/#gsc.tab=0) -- search engine for FOAM > [!warning] Disclaimer > These are my *personal* notes for a medical exam; these are not validated guidelines or treatment recommendations. This is not medical advice. This is not a replacement for seeking appropriate medical care, calling an ambulance in an emergency, or referring to your local department or other offical management guidelines for conditions discussed in these notes. ***Pros and Cons of using this resource:*** | Pros | Cons | | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ | | - has many [[High Yield Tables]]<br>- easy to search and also organised by system in the hamburger menu<br>- decent overview of curriculum<br>- based almost entirely on "core texts" endorsed by the college<br>- currently the only wiki-like resource for FACEM-specific content, as opposed to collections of pdfs | - Is not a replacement for sifting the content and organising your mental connections between the material how it is logical to you<br>- The links to textbook chapters and "related questions" won't work for you<br>- Is not peer-reviewed<br>- the emphasis is on subtle fringe concepts; for example, I hardly have any notes about adult DKA because I knew it to an appropriate level of detail<br>- may become out of date in a few years | # Recently Added %% DATAVIEW_PUBLISHER: start ``` TABLE file.folder AS "Folder", dateformat(file.ctime, "dd.MM.yyyy") AS "created" FROM "" WHERE file.name != this.file.name AND file.folder !="attachments" SORT file.ctime DESC LIMIT 20 ``` %% | File | Folder | created | | ------------------------------------------------------------------------------------------- | ------------------- | ---------- | | [[Ortho/Elbow dislocation.md\|Elbow dislocation]] | Ortho | 15.03.2025 | | [[Ob-Gyn/Pregnancy risks.md\|Pregnancy risks]] | Ob-Gyn | 11.03.2025 | | [[Symptoms/Abdominal pain (paeds).md\|Abdominal pain (paeds)]] | Symptoms | 11.03.2025 | | [[Symptoms/Blurry vision.md\|Blurry vision]] | Symptoms | 10.03.2025 | | [[Symptoms/Dizziness.md\|Dizziness]] | Symptoms | 09.03.2025 | | [[Admin/Phone advice.md\|Phone advice]] | Admin | 03.03.2025 | | [[Admin/Mass Casualty Incident.md\|Mass Casualty Incident]] | Admin | 02.03.2025 | | [[Haem/CAR-T therapy.md\|CAR-T therapy]] | Haem | 02.03.2025 | | [[Surgery/Stercoral colitis.md\|Stercoral colitis]] | Surgery | 01.03.2025 | | [[Radiology/Invasive devices CXR.md\|Invasive devices CXR]] | Radiology | 23.02.2025 | | [[ENT/epistaxis.md\|epistaxis]] | ENT | 21.02.2025 | | [[Haem/Blood transfusion.md\|Blood transfusion]] | Haem | 20.02.2025 | | [[Infectious Diseases/Botulism.md\|Botulism]] | Infectious Diseases | 17.02.2025 | | [[Trauma/Face trauma.md\|Face trauma]] | Trauma | 10.02.2025 | | [[Procedures/Balloon Tamponade GI varices.md\|Balloon Tamponade GI varices]] | Procedures | 09.02.2025 | | [[Cardiology/ECG/ECG artifact.md\|ECG artifact]] | Cardiology/ECG | 09.02.2025 | | [[Psych/Postnatal depression.md\|Postnatal depression]] | Psych | 06.02.2025 | | [[Procedures/Central Venous Catheter.md\|Central Venous Catheter]] | Procedures | 06.02.2025 | | [[Infectious Diseases/Sexually transmitted Infections.md\|Sexually transmitted Infections]] | Infectious Diseases | 02.02.2025 | | [[Toxicology/Warfarin overdose.md\|Warfarin overdose]] | Toxicology | 27.01.2025 | %% DATAVIEW_PUBLISHER: end %% # Recently modified %% DATAVIEW_PUBLISHER: start ``` TABLE file.folder AS "Folder", dateformat(file.mtime, "dd.MM.yyyy") AS "Last modified" FROM "" WHERE file.name != this.file.name AND file.folder != "Dataview queries" SORT file.mtime DESC LIMIT 10 ``` %% | File | Folder | Last modified | | ------------------------------------------------------------------ | ---------------------- | ------------- | | [[Ortho/Ortho.md\|Ortho]] | Ortho | 22.03.2025 | | [[Procedures/Procedures.md\|Procedures]] | Procedures | 22.03.2025 | | [[Radiology/Radiology.md\|Radiology]] | Radiology | 22.03.2025 | | [[High Yield Tables.md\|High Yield Tables]] | | 22.03.2025 | | [[Day of exam cheat sheet.md\|Day of exam cheat sheet]] | | 22.03.2025 | | [[Metabolic/Electrolytes/hyponatremia.md\|hyponatremia]] | Metabolic/Electrolytes | 22.03.2025 | | [[Endocrine/Hyperaldosteronism.md\|Hyperaldosteronism]] | Endocrine | 22.03.2025 | | [[Investigations/Blood gas.md\|Blood gas]] | Investigations | 22.03.2025 | | [[Paeds/Neonates/Neonatal life support.md\|Neonatal life support]] | Paeds/Neonates | 21.03.2025 | | [[Resus/Airway.md\|Airway]] | Resus | 21.03.2025 | %% DATAVIEW_PUBLISHER: end %% # Changelog - 21 Mar 2025 -- HUGE change that won't change anything for how you use this site! I have *finally* written some (very) hacky changes so that links in "Related Questions" as well as references I often include in "see also" at the beginning of notes are clickable links if the file size is <15 mg (they didn't work for users before because of how I used to manage urls for items in my private vault). However, because these are often private resources or textbook chapters that aren't my business to share online, they are still behind password-protection on a personal domain. I also kept the "related questions" greyed out simply because I don't think they are very useful anymore. - This begs a question: why did I even bother fixing the links if I put the content behind a password? Overall, while I studied, I mostly updated the website for content, with only minor tweaks to its function. However, I want to ensure that I am also gradually developing the platform to be a more robust way to share an EM "wiki" online, and for that type of platform, is critical in that it is at least possible to maintain external content that I can both manage locally as well as distribute online. So this functionality is important for any future modifications I might make to the website in terms of how external content is managed. - It was fairly important to me to go out of my way to ensure I'm not inadvertently sharing other people's work, which is why this content is behind a password on a personal server so only I have access to it. - 28 Dec 2024 -- I also made several changes to improve the appearance of lists in tables. Also a hack with the javascript and hopefully it doesn't break anything - 27 Dec 2024 -- Changed the way the table of contents for single pages appears on mobile. it was a major hack so please let me know if it doesn't work - 19 Dec 2024 -- fortunately, I passed the written exam. What a gauntlet. Newer updates after this date will likely be a) more OSCE-focused, b) more general ED focused, and c) more editorialised. - 20 Sept 2024 — launched on oscepass.org. This is because I already owned the domain from an OSCE exam preparation app I made in med school but no longer maintain, so decided to pivot the domain to host these notes instead. - 30 April 2024 -- Notes from George's statistics talk in Admin section - 15 April 2024 -- some new topics and folders - 17 March 2024 -- ongoing content updates, update resource recommendations - 19 Feb 2024 -- initial upload