Treat first. Read less.

Normalize ECG now · K⁺ <5.5 mEq/L · prevent rebound and hypoglycemia

Improve severe symptoms · raise Na⁺ 4–6 mEq/L · never exceed 8 mEq/L in 24 h

Close anion gap · glucose 150–250 mg/dL during infusion · K⁺ 4–5 mEq/L

Osmolality fall 3–8 mOsm/kg/h · glucose 200–300 mg/dL initially · mental status improving

Glucose >70 mg/dL (aim ~100) · normal mental status · no recurrence

Restore BP · correct hypoglycemia and hyponatremia · treat precipitant

HR <100–110 · temperature control · resolve end-organ dysfunction

Restore mentation, temperature, and ventilation · avoid ischemia

Restore volume · Ca falling within 12–48 h · treat cause

MAP ≥65 mmHg · antibiotics within 1 h · source control within 6–12 h

SpO₂ 88–95% · plateau ≤30 cmH₂O · driving pressure ≤15 cmH₂O

Stabilize airway and circulation · give the antidote early · monitor for recurrence

NAC within 8 h of ingestion · normalized AST/INR · APAP undetectable

Falling EtCO₂ and temperature · resolution of rigidity and acidosis

Preoxygenate · optimize hemodynamics · first-pass success · confirm with waveform ETCO₂

SpO₂ 93–95% · improving air movement · avoid intubation

SpO₂ 88–92% · pH >7.35 · reduced work of breathing

Control hemorrhage · balanced blood products · calcium and temperature preserved

IM epinephrine now · repeat every 5–15 min · airway and perfusion restored

Stop seizure ≤5 min · full-dose benzodiazepine · load second-line therapy by 20 min

Door-to-needle ≤60 min (goal 30–45) · LVO to thrombectomy · BP to lytic targets

SBP 130–150 mmHg (avoid <130) · reverse anticoagulant · prevent expansion

Dexamethasone + antibiotics within 60 min of arrival

Stop/prevent seizures · BP <160/110 within 30–60 min · delivery planning

Reverse AKI · raise MAP ≥10–15 mmHg · bridge early to liver transplant

Hemodynamic stability · Hgb 7–8 g/dL · endoscopy within 12 h

Restore perfusion in shock · prevent clot extension · identify safe outpatient candidates

ECG ≤10 min · aspirin now · STEMI PCI ≤90 min or transfer ≤120 min

HR <110 at rest · hemodynamic stability · stroke prevention plan

Perfusing HR with resolution of hypotension, AMS, ischemia, or shock

↓ MAP ≤25% in first hour → 160/100 over 2–6 h → normal over 24–48 h

SpO₂ ≥90% · work of breathing improved · net negative diuresis