Click Study Flashcards above to open the flashcard hub — hundreds of CEN cards you can flip, match, type, or quiz yourself on. Every card is drawn from the eleven BCEN content areas and written to the emergency-nursing level, so you study exactly what the Certified Emergency Nurse exam tests.[1]
Pair them with our free practice questions and study guide. Want extra insurance for exam day? Capital Prep’s CEN premium study materials come with a CEN exam pass guarantee: your money back if you don’t pass, plus up to $200 toward your retake fee — and Career Employer students get a special discount.
CEN Flashcard Study Modes
Flip mode walks you through each card front and back for a first pass. Match times you pairing terms with definitions. Type shows the definition and asks you to spell the term back, so a card like Pulsus paradoxus has to come from memory, not recognition. Quiz turns the same cards into multiple-choice questions for a quick check between study blocks.
Why Flashcards Work for the CEN
Cardiovascular Emergencies is the largest domain at 32 cards, drilling bedside findings and decision criteria such as Beck’s triad, STEMI ECG criteria, and Troponin significance. Respiratory Emergencies adds 29 cards on airway and gas-exchange language, including Flail chest, Capnography use, and BiPAP role in COPD. Neurological Emergencies also runs 29 cards, covering stroke and pressure findings like NIHSS, Cushing’s triad, and Last-known-well time.
Medical Emergencies, 27 cards, works through endocrine and sepsis terminology with fronts such as DKA labs, Sepsis bundle, and Myxedema coma. Environment and Toxicology Emergencies, and Communicable Diseases, also 27 cards, mixes burns, temperature extremes, poisons, and isolation practice through Parkland formula, Opioid toxidrome, and Droplet precautions. Professional Issues carries 25 cards on triage and law, including EMTALA, ESI level 1, and SBAR handoff.
Gastrointestinal Emergencies gives you 23 cards of abdominal signs and diagnoses, among them Murphy’s sign, Mallory-Weiss tear, and Peritonitis signs. Genitourinary, Gynecology, and Obstetrical Emergencies matches that size with 23 cards built around HELLP syndrome, Placenta previa, and Renal colic. Musculoskeletal and Wound Emergencies holds 21 cards on splinting, fracture, and wound rules such as Open fracture care, Amputated part care, and Rhabdomyolysis labs.
Head, Eye, Ear, Nose, Throat Emergencies has 21 cards on sight- and airway-threatening problems, including Hyphema, Ludwig’s angina, and Retinal detachment. Mental Health Emergencies closes the deck with 19 cards on assessment, safety, and legal language, with fronts like Medical clearance, Duty to protect, and Serotonin syndrome.
That matters on the CEN, where facts like the STEMI ECG criteria, ESI triage levels, the four shock states, and the Parkland formula must be instantly available. Used alongside our practice questions and study guide, flashcards turn review time into measurable progress.
CEN Flashcards by Topic
The cards are organized by the eleven BCEN content areas. Weight your study toward the heaviest ones — Cardiovascular (18 questions), Respiratory (17), and Neurological (17) together are about a third of the exam:[1]
| BCEN content area | Scored questions |
|---|---|
| Cardiovascular Emergencies | 18 |
| Respiratory Emergencies | 17 |
| Neurological Emergencies | 17 |
| Medical Emergencies | 15 |
| Gastrointestinal Emergencies | 14 |
| Mental Health Emergencies | 13 |
| Environment, Toxicology & Communicable Diseases | 13 |
| Professional Issues | 12 |
| Musculoskeletal and Wound Emergencies | 11 |
| Genitourinary, Gynecology & Obstetrical Emergencies | 10 |
| Head, Eye, Ear, Nose, Throat Emergencies | 10 |
How to Get the Most Out of These Flashcards
- Start with Cardiovascular Emergencies. At 32 cards it is the biggest domain here, and its shock and ECG vocabulary carries straight into Respiratory Emergencies and Medical Emergencies.
- Type-drill the exact ones. Fronts like Parkland formula and STEMI ECG criteria reward precise recall, and typing them back forces the detail that flipping lets you gloss over.
- Use Match for look-alikes. Timed pairing separates confusable card sets fast, such as the triage levels ESI level 1 and ESI level 2 or the precaution cards.
- Move to the practice test once Quiz holds. When your Quiz results stay steady across Neurological Emergencies and Professional Issues, full-length questions will test the prioritization that single cards cannot.
- Keep a steady cadence. With 276 cards, take one or two domains per sitting, Flip the new material, then Quiz the previous sitting’s domain before adding anything else.
CEN Flashcards FAQ
Hundreds of free CEN flashcards, organized across all eleven BCEN content areas tested on the Certified Emergency Nurse exam — from cardiovascular and respiratory emergencies through toxicology and professional issues. They're free to use with no account required.
Yes. Flashcards use active recall — retrieving an answer from memory — which research shows is one of the most effective ways to make information stick, especially in short sessions spread over several days. That matters for facts like the STEMI ECG criteria, ESI triage levels, ACLS drug doses, the shock states, and the Parkland formula.
Every BCEN content area: Cardiovascular, Respiratory, Neurological, Gastrointestinal, Genitourinary/Gynecology/Obstetrical, Mental Health, Medical, Musculoskeletal and Wound, Head/Eye/Ear/Nose/Throat, Environment/Toxicology/Communicable Diseases, and Professional Issues — covering ESI triage, ACS, stroke, sepsis, anaphylaxis, toxidromes, and more.
Yes. Every card is written to the BCEN CEN content outline that takes effect in July 2026 — the eleven content areas across 150 scored items — and reflects current emergency-nursing care: rapid recognition of life threats and the first, safest action across every body system.
Mix the modes: flip to learn, type to test recall, match for speed, and quiz to check yourself. Spend the most time on Cardiovascular (18 questions), Respiratory (17), and Neurological (17) — together they are about a third of the exam — then Medical and Gastrointestinal.
Yes — 100% free, all four study modes, no paywall.
CEN flashcard bank
All 276 cards, by topic
A reference copy of every card in this deck. Each answer stays hidden until you choose to show it. To study with Flip, Match, Type and Quiz modes and track what you have mastered, use Study Flashcards at the top of the page.
Cardiovascular Emergencies (32)
- Beck's triad
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Hypotension + jugular venous distension + muffled heart sounds = cardiac tamponade.
- STEMI ECG criteria
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ST elevation ≥1 mm in ≥2 contiguous leads, or a new left bundle branch block.
- Door-to-balloon goal for STEMI
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Primary PCI within 90 minutes of first medical contact.
- ED chest-pain bundle
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12-lead ECG within 10 minutes, aspirin, O₂ only if hypoxic, nitroglycerin, serial troponins.
- When to withhold nitroglycerin
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Inferior/right-ventricular MI, hypotension, or recent PDE-5 inhibitor (sildenafil) use.
- NSTEMI vs unstable angina
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Both lack ST elevation; NSTEMI has an elevated troponin, unstable angina does not.
- Leads for an inferior MI
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II, III, and aVF (right coronary artery territory).
- Epinephrine dose in cardiac arrest
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1 mg IV/IO every 3–5 minutes.
- Amiodarone dose in VF/pulseless VT
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300 mg IV/IO first dose, then 150 mg.
- Shockable arrest rhythms
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Ventricular fibrillation and pulseless ventricular tachycardia.
- Non-shockable arrest rhythms
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Asystole and pulseless electrical activity (PEA) — CPR + epinephrine.
- First treatment for symptomatic bradycardia
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Atropine 1 mg IV (max 3 mg), then transcutaneous pacing.
- Treatment for stable narrow-complex SVT
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Vagal maneuvers, then adenosine 6 mg rapid push, then 12 mg.
- Treatment for UNSTABLE tachycardia
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Synchronized cardioversion.
- Drug for torsades de pointes
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Magnesium sulfate 1–2 g IV.
- Adenosine administration tip
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Rapid IV push followed by a saline flush; a brief pause/asystole is expected.
- Pulsus paradoxus
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Systolic BP drop >10 mmHg on inspiration — seen in tamponade and severe asthma.
- Treatment of cardiac tamponade
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Pericardiocentesis (or thoracotomy in penetrating trauma).
- Cardiogenic shock
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Pump failure (large MI) → cold, clammy skin, pulmonary edema, low output.
- Acute pulmonary edema treatment
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Sit upright, oxygen/BiPAP, nitrates, and diuretics.
- Aortic dissection classic signs
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Sudden tearing chest/back pain with a BP difference between arms.
- Aortic dissection management
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Aggressively lower heart rate and blood pressure; arrange imaging and surgery.
- Leaking abdominal aortic aneurysm
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Abdominal/flank pain + pulsatile mass + hypotension = surgical emergency.
- Hypertensive emergency
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Severe hypertension WITH end-organ damage; lower BP gradually, not abruptly.
- Hypertensive urgency vs emergency
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Urgency = high BP, no organ damage; emergency = high BP WITH organ damage.
- Endocarditis classic finding
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New murmur + fever; risk with IV drug use and prosthetic valves.
- Pericarditis ECG
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Diffuse ST elevation and PR depression; pleuritic pain relieved by sitting forward.
- Deep vein thrombosis signs
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Unilateral leg swelling, warmth, pain; risk for pulmonary embolism.
- Right-sided vs left-sided heart failure
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Right = peripheral edema/JVD; left = pulmonary congestion/crackles.
- Troponin significance
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A cardiac biomarker that rises with myocardial injury; trend with serial draws.
- Cardioversion vs defibrillation
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Cardioversion is synchronized to the R wave; defibrillation is unsynchronized.
- Earliest sign of hypovolemic shock
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Tachycardia and a narrowing pulse pressure; hypotension is late.
Respiratory Emergencies (29)
- Silent chest in asthma
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An ominous sign of severe obstruction and impending respiratory failure — prepare to intubate.
- Asthma/COPD first-line treatment
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Inhaled bronchodilators (albuterol + ipratropium) and systemic steroids.
- BiPAP role in COPD
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Non-invasive ventilation that can prevent intubation in respiratory acidosis.
- Tension pneumothorax signs
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Absent breath sounds + hyperresonance one side, hypotension, JVD, late tracheal deviation.
- Tension pneumothorax treatment
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Immediate needle decompression, then a chest tube — don't wait for an X-ray.
- Needle decompression sites
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2nd intercostal space midclavicular line, or 4th/5th anterior axillary line.
- Open pneumothorax treatment
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Three-sided occlusive dressing, then a chest tube.
- Pulmonary embolism presentation
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Sudden dyspnea + pleuritic pain, tachycardia, hypoxia, often clear lungs.
- Pulmonary embolism risk factors
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Immobility, recent surgery, cancer, oral contraceptives, prior clots.
- Massive PE with shock treatment
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Thrombolytics (in addition to anticoagulation).
- ARDS definition
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Refractory hypoxemia with bilateral infiltrates, non-cardiogenic edema.
- ARDS ventilation strategy
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Lung-protective, low-tidal-volume ventilation.
- Rapid sequence intubation
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A sedative + a paralytic given together to secure an emergency airway.
- Capnography use
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Confirms ET tube placement and tracks perfusion and return of circulation.
- Croup hallmark
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A barking, seal-like cough with inspiratory stridor in a young child.
- Pneumonia treatment basics
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Oxygen, fluids, and timely antibiotics; assess severity.
- Aspiration risk
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Decreased level of consciousness or impaired gag reflex; protect the airway.
- Flail chest
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≥3 adjacent ribs broken in ≥2 places → paradoxical movement + pulmonary contusion.
- Hemothorax (massive)
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>1,500 mL initial chest-tube output → tube + surgery.
- CO₂ narcosis sign
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Rising CO₂ with drowsiness in a tiring COPD patient — heading for failure.
- Normal arterial pH
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7.35–7.45.
- Normal PaCO₂ and HCO₃⁻
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PaCO₂ 35–45 mmHg; HCO₃⁻ 22–26 mEq/L.
- Respiratory acidosis
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Low pH, high PaCO₂ — hypoventilation (COPD, opioid overdose, fatigue).
- Respiratory alkalosis
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High pH, low PaCO₂ — hyperventilation (anxiety, PE, pain, sepsis).
- Metabolic acidosis
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Low pH, low HCO₃⁻ — DKA, lactic acidosis, renal failure, diarrhea; check the anion gap.
- Metabolic alkalosis
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High pH, high HCO₃⁻ — vomiting, NG suction, diuretics.
- How to read an ABG
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Check pH first, then decide whether the CO₂ or the bicarbonate matches the pH direction.
- Inhalation injury clues
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Facial burns, singed nasal hairs, soot, hoarseness — intubate early.
- First priority in any respiratory emergency
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Airway and oxygenation.
Neurological Emergencies (29)
- BE-FAST stroke screen
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Balance, Eyes, Face, Arms, Speech, Time — recognize stroke fast.
- Why CT comes first in stroke
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To rule out a hemorrhagic stroke before giving clot-busting thrombolytics.
- Ischemic vs hemorrhagic stroke
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Ischemic = a clot blocks flow; hemorrhagic = bleeding into/around the brain.
- Ischemic stroke treatment
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IV thrombolytics within the window; thrombectomy for a large-vessel occlusion.
- Last-known-well time
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When the patient was last seen normal; it sets treatment eligibility for stroke.
- TIA
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A transient neurologic deficit that fully resolves — a warning of future stroke.
- NIHSS
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A standardized score quantifying stroke deficit severity.
- Cushing's triad
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Hypertension with widening pulse pressure + bradycardia + irregular respirations = rising ICP.
- Normal intracranial pressure
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About 5–15 mmHg.
- Rising ICP management
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Head of bed elevated, head midline, normocapnia, normothermia, osmotic therapy.
- Glasgow Coma Scale range
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3 (lowest) to 15 (highest); ≤8 is severe impairment.
- GCS components
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Eye opening (1–4) + verbal response (1–5) + best motor response (1–6).
- Status epilepticus definition
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A seizure >5 minutes, or repeated seizures without recovery of consciousness.
- Status epilepticus first drug
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A benzodiazepine (lorazepam/diazepam/midazolam), then a longer-acting antiepileptic.
- Bacterial meningitis signs
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Fever, headache, neck stiffness, Kernig and Brudzinski signs, photophobia.
- Meningitis priorities
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Early antibiotics and droplet precautions (don't wait for the LP).
- Thunderclap headache
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A sudden 'worst headache of life' — suspect subarachnoid hemorrhage.
- Temporal arteritis
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New headache + jaw claudication in an older adult; risk of vision loss → steroids.
- Myasthenic crisis warning
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Worsening respiratory muscle weakness; monitor vital capacity, not just SpO₂.
- Guillain-Barré syndrome
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Ascending weakness; watch for respiratory failure and autonomic instability.
- Epidural vs subdural hematoma
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Epidural = arterial, biconvex, lucid interval; subdural = venous, crescent, older/anticoagulated.
- Subarachnoid hemorrhage CT
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Blood in the sulci/cisterns (star pattern); thunderclap headache.
- Neurogenic shock
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After a high cord injury: hypotension WITH bradycardia and warm, dry skin.
- Spinal shock vs neurogenic shock
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Spinal shock = temporary loss of reflexes/function; neurogenic = a blood-pressure problem.
- Cerebral perfusion pressure
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CPP = MAP − ICP; keep it adequate to protect the brain.
- Seizure safety
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Protect from injury, position on the side, don't restrain or put anything in the mouth.
- First priority in altered mental status
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Check a glucose (and airway) — hypoglycemia is a quick, reversible cause.
- Decorticate vs decerebrate posturing
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Decorticate = flexion toward the core; decerebrate = extension — decerebrate is worse.
- Autonomic dysreflexia
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In cord injuries ≥T6: a hypertensive crisis from a stimulus below the lesion → sit up, remove the trigger.
Gastrointestinal Emergencies (23)
- Hematemesis vs melena
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Hematemesis = vomiting blood/coffee grounds; melena = black, tarry stools (upper GI bleed).
- Upper GI bleed priorities
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Airway, two large-bore IVs, fluid then blood resuscitation, early endoscopy.
- Esophageal varices
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High-mortality upper GI bleed in cirrhosis → octreotide, antibiotics, banding.
- Lower GI bleed sign
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Bright-red blood per rectum (hematochezia).
- Peritonitis signs
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Rigid, board-like abdomen with rebound tenderness = surgical emergency.
- Appendicitis
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RLQ pain, rebound at McBurney's point, low-grade fever; keep NPO, surgical consult.
- Cholecystitis
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RUQ pain after a fatty meal with a positive Murphy's sign.
- Pancreatitis
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Severe epigastric pain radiating to the back, vomiting, elevated lipase.
- Pancreatitis treatment
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NPO, aggressive IV fluids, and pain control.
- Bowel obstruction signs
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Distension, vomiting, no stool or flatus → NPO + NG decompression.
- GI perforation
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Sudden severe pain, rigid abdomen, free air → resuscitate, antibiotics, surgery.
- Hepatic encephalopathy
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Confusion and asterixis from ammonia in liver failure → lactulose.
- Spontaneous bacterial peritonitis
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Infection of ascitic fluid in cirrhosis → antibiotics.
- Diverticulitis
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LLQ pain, fever; treat with antibiotics, watch for perforation/abscess.
- Intussusception (peds)
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Telescoping bowel → currant-jelly stools and a sausage-shaped mass.
- Acute abdomen pain control myth
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Analgesia does NOT mask the diagnosis — treat the pain.
- Murphy's sign
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Inspiratory arrest on RUQ palpation — suggests cholecystitis.
- Cullen's / Grey-Turner's sign
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Periumbilical / flank bruising — suggests retroperitoneal or pancreatic hemorrhage.
- Blood loss sign before hypotension
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Tachycardia and a narrowing pulse pressure precede a falling BP.
- GI bleed lab to send early
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Type and crossmatch (plus CBC and coags).
- Mallory-Weiss tear
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An esophageal mucosal tear from forceful vomiting → upper GI bleeding.
- Hepatitis transmission
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A and E are fecal-oral; B, C, and D are bloodborne/body-fluid.
- Cholangitis (Charcot's triad)
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Fever, RUQ pain, and jaundice from biliary infection — a sepsis risk.
Genitourinary, Gynecology, and Obstetrical Emergencies (23)
- Ectopic pregnancy triad
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Amenorrhea + unilateral pelvic pain + vaginal bleeding; rupture → shock.
- Ectopic pregnancy risk factors
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Prior PID/STI, previous ectopic, tubal surgery, IUD in place.
- Abruptio placenta
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PAINFUL vaginal bleeding with a rigid, tender uterus.
- Placenta previa
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PAINLESS bright-red bleeding; NO vaginal exam.
- Preeclampsia
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Hypertension + proteinuria after 20 weeks; risk of seizures (eclampsia).
- Eclampsia/preeclampsia drug
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Magnesium sulfate for seizure prophylaxis, plus blood-pressure control.
- Magnesium toxicity sign
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Loss of deep tendon reflexes; antidote is calcium gluconate.
- HELLP syndrome
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Hemolysis, Elevated Liver enzymes, Low Platelets — a severe preeclampsia variant.
- Postpartum hemorrhage cause
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Most often uterine atony → fundal massage and uterotonics.
- Preterm labor
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Regular contractions before 37 weeks; may use tocolytics and steroids for fetal lungs.
- Uterine rupture
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Sudden severe abdominal pain, loss of fetal station, fetal distress — emergency.
- Ovarian torsion
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Sudden severe unilateral pelvic pain → surgical emergency.
- Testicular torsion
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Sudden severe scrotal pain, high-riding testis, absent cremasteric reflex → urology now.
- Renal colic
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Severe colicky flank pain radiating to the groin with hematuria (kidney stone).
- Sexual-assault care priorities
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Safety, medical care, trauma-informed support, forensic evidence with consent.
- Hyperkalemia ECG
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Peaked T waves → widening QRS → sine wave.
- Hyperkalemia treatment order
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Calcium (cardioprotection), then insulin/glucose, then removal.
- Priapism
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A persistent painful erection; an emergency that can cause permanent damage.
- Pregnancy test in any woman with abdominal pain
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Always check — an ectopic is the can't-miss diagnosis.
- Perimortem cesarean timing
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Considered within ~4 minutes of maternal arrest after ~20–24 weeks.
- Left lateral tilt in pregnancy
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After ~20 weeks, relieves aortocaval compression that lowers cardiac output.
- Acute urinary retention
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Sudden inability to void with a distended bladder → catheterize for relief.
- Pyelonephritis
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Flank pain, fever, and dysuria — an upper urinary-tract infection.
Mental Health Emergencies (19)
- First priority in a mental health emergency
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Safety — of the patient and of the staff.
- Asking about suicide
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Does NOT plant the idea; ask directly about thoughts, plan, means, and intent.
- Highest suicide risk markers
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A specific plan, available means, and clear intent.
- Suicidal patient safety steps
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Continuous observation, remove means, document the risk assessment.
- Medical clearance
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Rule out medical mimics (hypoglycemia, hypoxia, infection, toxic ingestion) before psych disposition.
- Agitation first approach
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Verbal de-escalation: calm voice, space, clear limits, remove triggers.
- Restraint principles
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Last resort; provider order, least restrictive type, continuous monitoring, remove ASAP.
- Chemical sedation
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Used when de-escalation fails and the patient endangers self or others.
- Acute psychosis
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Disorganized thinking, hallucinations, delusions; ensure safety and psychiatric care.
- Mania (bipolar)
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Elevated mood, decreased sleep, risky behavior; protect from harm.
- Serotonin syndrome
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Agitation, hyperthermia, clonus, autonomic instability from serotonergic drugs.
- Neuroleptic malignant syndrome
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Rigidity, hyperthermia, altered mental status with antipsychotics.
- Panic attack vs medical cause
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Diagnose panic only after ruling out hypoxia, ACS, PE, and other causes.
- Excited delirium caution
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Severe agitation with hyperthermia; high risk of sudden deterioration — monitor closely.
- Depression red flag
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Hopelessness with suicidal ideation; assess and ensure safety.
- Therapeutic communication
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A calm, nonjudgmental, validating approach reduces agitation.
- Duty to protect
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Credible threats to identifiable others may require warning/protective action.
- Involuntary hold criteria
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Danger to self, danger to others, or grave disability from mental illness.
- De-escalation body language
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Open posture, calm tone, give space, avoid sudden moves or cornering the patient.
Medical Emergencies (27)
- Anaphylaxis first-line treatment
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Intramuscular epinephrine — given immediately, before antihistamines.
- Anaphylaxis signs
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Hives, swelling, wheeze/stridor, hypotension within minutes of exposure.
- Sepsis definition
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Life-threatening organ dysfunction from a dysregulated response to infection.
- Septic shock
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Sepsis with fluid-refractory hypotension needing vasopressors + lactate >2.
- Sepsis bundle
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Lactate, blood cultures before antibiotics, early broad-spectrum antibiotics, 30 mL/kg fluids.
- First-line vasopressor in septic shock
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Norepinephrine (target MAP ≥65 mmHg).
- Lactate meaning
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A marker of tissue hypoperfusion; it should fall with effective resuscitation.
- DKA labs
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High glucose + anion-gap metabolic acidosis + ketones.
- DKA treatment order
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Fluids first, then insulin infusion, with careful potassium replacement.
- Insulin and potassium
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Insulin drives K⁺ into cells; don't start it if K⁺ is low until replaced.
- HHS
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Hyperosmolar hyperglycemic state — very high glucose, minimal ketosis/acidosis.
- Hypoglycemia treatment
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IV dextrose (D50), or glucagon if no IV access.
- Thyroid storm
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Hyperthyroid crisis: high fever, tachycardia, altered mental status.
- Adrenal (Addisonian) crisis
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Hypotension, hyponatremia, hyperkalemia → IV fluids and hydrocortisone.
- Hyperkalemia ECG
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Peaked T waves, then a widening QRS; give calcium first.
- Hyponatremia caution
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Correct sodium SLOWLY to avoid osmotic demyelination.
- Hypocalcemia signs
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Chvostek and Trousseau signs, tetany, prolonged QT.
- DIC
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Simultaneous clotting and bleeding; treat the underlying cause and replace products.
- Sickle cell crisis care
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Aggressive analgesia, hydration, oxygen, and treat triggers like infection.
- Neutropenic fever
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Fever in an immunocompromised patient → urgent broad-spectrum antibiotics.
- Alcohol withdrawal tool & drug
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CIWA score guides symptom-triggered benzodiazepines.
- Delirium tremens
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Severe alcohol withdrawal: confusion, agitation, autonomic instability — high mortality.
- Opioid overdose reversal
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Naloxone; watch for re-sedation (short half-life).
- Anaphylaxis vs anaphylactoid
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Treatment is the same — IM epinephrine first regardless of mechanism.
- Myxedema coma
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Severe hypothyroid crisis: hypothermia, bradycardia, altered mental status.
- SIADH vs diabetes insipidus
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SIADH = water retention, low sodium; DI = water loss, high sodium, dilute urine.
- Tumor lysis syndrome
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After chemo: high potassium, phosphate, uric acid; low calcium → acute kidney injury.
Musculoskeletal and Wound Emergencies (21)
- Compartment syndrome 6 P's
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Pain (out of proportion/on stretch), Paresthesia, Pallor, Pulselessness, Paralysis, Poikilothermia.
- Earliest sign of compartment syndrome
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Pain out of proportion and pain on passive stretch.
- Compartment syndrome treatment
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Emergent fasciotomy; do NOT elevate above the heart or apply ice.
- Open fracture care
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Early antibiotics, tetanus prophylaxis, and a sterile dressing.
- Neurovascular checks for fractures
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Assess pulses, sensation, and motor before AND after splinting.
- Fat embolism syndrome
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Hypoxia, confusion, and a petechial rash 24–72 h after a long-bone fracture.
- Amputated part care
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Wrap in saline-moistened gauze, seal in a bag, place the bag on ice (never frozen/direct ice).
- Extremity hemorrhage control
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Direct pressure, then a tourniquet (note the time applied).
- Crush injury complication
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Rhabdomyolysis → acute kidney injury → aggressive IV fluids.
- Rhabdomyolysis labs
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Elevated CK and dark, tea-colored urine.
- Dislocation priority
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Assess neurovascular status; reduce promptly and reassess after reduction.
- Tetanus-prone wound
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Dirty, deep, or puncture wounds; update tetanus based on history.
- Impaled object rule
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Never remove it in the ED — stabilize it in place.
- Necrotizing soft-tissue infection
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Pain out of proportion + crepitus + systemic toxicity → surgical emergency.
- Splint principle
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Immobilize the joint above and below the injury.
- Wound closure timing
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Most clean wounds close within hours; high-risk wounds may be left open.
- Osteomyelitis
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Bone infection — pain, fever, local signs; needs prolonged antibiotics.
- Sprain vs strain
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Sprain = ligament injury; strain = muscle/tendon injury.
- RICE for soft-tissue injury
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Rest, ice, compression, elevation (for sprains/strains, NOT compartment syndrome).
- Tendon laceration sign
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Inability to move the distal joint; assess function before closure.
- Gout vs septic joint
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Both cause a hot, swollen joint; aspirate to exclude a septic joint (an emergency).
Head, Eye, Ear, Nose, Throat Emergencies (21)
- Chemical eye burn first action
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Immediate, copious irrigation BEFORE anything else.
- Acute angle-closure glaucoma
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Severe eye pain, halos, a red eye, a mid-dilated fixed pupil, nausea.
- Glaucoma do-not
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Do not patch the eye or give a pupil-dilating drug — it can worsen it.
- Central retinal artery occlusion
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Sudden, painless loss of vision in one eye — a time-critical emergency.
- Retinal detachment
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Flashes, floaters, and a curtain over the vision — urgent ophthalmology.
- Ruptured globe care
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Shield the eye, do NOT press; keep the patient calm and NPO for surgery.
- Hyphema
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Blood in the anterior chamber after trauma → upright positioning, ophthalmology.
- Corneal abrasion
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Pain, tearing, foreign-body sensation; diagnosed with fluorescein.
- Anterior epistaxis control
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Lean forward, pinch the soft part of the nose, apply pressure; packing if needed.
- Posterior epistaxis risk
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Can be heavy and threaten the airway — may need posterior packing/balloon.
- Epiglottitis signs
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High fever, drooling, tripod position, stridor — an airway emergency.
- Epiglottitis nursing rule
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Keep the child calm; do NOT examine the throat or agitate the patient.
- Peritonsillar abscess
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Severe sore throat, 'hot potato' voice, uvular deviation — airway risk.
- Ludwig's angina
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Rapidly spreading floor-of-mouth infection — an airway emergency.
- Bell's palsy
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Sudden one-sided facial weakness including the forehead (peripheral CN VII).
- Avulsed permanent tooth
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Handle by the crown, gently rinse, reimplant or store in milk/saliva.
- Vertigo causes
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Peripheral (benign positional, Ménière's, labyrinthitis) vs central (stroke) — rule out central.
- Maxillofacial trauma priority
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The airway — blood, broken teeth, and edema can obstruct rapidly.
- Foreign body in the ear/nose
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Remove carefully; button batteries are a true emergency (tissue damage).
- Dental avulsion time matters
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Reimplant a knocked-out permanent tooth as fast as possible to save it.
- Sudden painful vs painless vision loss
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Painful → glaucoma/trauma; painless → CRAO or retinal detachment.
Environment and Toxicology Emergencies, and Communicable Diseases (27)
- First priority in a major burn
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The airway — intubate early if inhalation injury is suspected.
- Rule of Nines (adult)
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Head 9%, each arm 9%, each leg 18%, front trunk 18%, back trunk 18%, perineum 1%.
- Parkland formula
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4 mL lactated Ringer's × kg × %TBSA; half in the first 8 hours from the burn.
- Burn fluid titration
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Titrate to a urine output of about 0.5 mL/kg/hr in adults.
- Carbon monoxide poisoning trap
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Pulse oximetry reads falsely NORMAL → give high-flow oxygen.
- CO poisoning treatment
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100% high-flow oxygen; hyperbaric oxygen for severe cases; check carboxyhemoglobin.
- Cyanide poisoning
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Suspect in enclosed-space fires; treat with hydroxocobalamin.
- Heat stroke
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High core temperature WITH altered mental status → rapid cooling.
- Hypothermia rewarming
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Gradual rewarming and gentle handling (a cold heart is irritable).
- Frostbite care
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Rapid rewarming in warm water; do not rub or refreeze the tissue.
- Drowning/submersion priority
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Airway and oxygenation; watch for delayed respiratory deterioration.
- Electrical injury hidden danger
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Deep tissue damage and dysrhythmias beyond the visible burn.
- Toxidrome definition
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A symptom cluster pointing to a poison class to identify the agent.
- Cholinergic toxidrome
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SLUDGE secretions, bradycardia, miosis (organophosphates) → atropine + pralidoxime.
- Anticholinergic toxidrome
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'Hot, red, dry, and mad' — flushed, dry skin, dilated pupils, delirium.
- Opioid toxidrome
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Pinpoint pupils, slow shallow breathing, sedation → naloxone.
- Sympathomimetic toxidrome
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Agitation, tachycardia, hypertension, dilated pupils, diaphoresis.
- Acetaminophen antidote
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N-acetylcysteine (NAC).
- Tricyclic antidepressant overdose
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Wide QRS, seizures, hypotension → sodium bicarbonate.
- Contact precautions
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Gown and gloves — C. difficile, MRSA.
- Droplet precautions
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A surgical mask — influenza, pertussis, meningococcus.
- Airborne precautions
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An N95 in a negative-pressure room — TB, measles, varicella.
- C. difficile hand hygiene
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Soap and water — alcohol gel does NOT kill the spores.
- Snakebite/animal bite care
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Wound care, immobilize, antivenom where indicated, rabies prophylaxis as needed.
- Hypothermia core temperature
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A core temperature below 35°C (95°F); severe below 28°C.
- Decontamination before treatment
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For chemical exposure, decontaminate first to protect the patient and staff.
- Lightning/high-voltage cardiac risk
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Can cause cardiac arrest and dysrhythmias — monitor on telemetry.
Professional Issues (25)
- ESI level 1
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Resuscitation — the patient needs an immediate life-saving intervention.
- ESI level 2
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Emergent — a high-risk situation, confusion/lethargy, or severe pain/distress.
- ESI level 3 vs 4 vs 5
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Level 3 = ≥2 resources, Level 4 = 1 resource, Level 5 = 0 resources.
- ESI danger-zone vitals
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For potential Level 3: HR >100, RR >20, or SpO₂ <92% up-triages to Level 2.
- ESI resource examples
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Labs, ECG, imaging, IV fluids, IV/IM/neb meds, consults, procedures.
- Not counted as ESI resources
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History/physical, point-of-care tests, PO meds, a tetanus shot, simple dressings.
- START triage
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Mass-casualty triage by respirations, perfusion, and mental status.
- START color categories
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Red (immediate), yellow (delayed), green (minor), black (expectant/deceased).
- Mass-casualty goal
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Do the most good for the most people (not the most for each individual).
- EMTALA
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Federal law: screen and stabilize ANY ED patient regardless of ability to pay; governs transfers.
- Implied consent
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An emergency in a patient who cannot consent proceeds under implied consent.
- Informed consent / refusal
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A competent adult may refuse care after understanding the risks.
- Mandatory reporting
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Suspected abuse/neglect of children, elders, and vulnerable adults must be reported.
- Forensic evidence
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Preserve evidence and maintain chain of custody; document wounds objectively.
- HIPAA
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Protects patient privacy and limits disclosure of health information.
- Advance directives
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Honor a patient's documented wishes (living will, healthcare proxy).
- Patient throughput
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Strategies to move patients efficiently through the ED while keeping them safe.
- Cultural humility
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Respecting and adapting care to a patient's values, beliefs, and language needs.
- Workplace violence
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Recognize warning signs, de-escalate, and use safety measures and reporting.
- Impaired colleague
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A duty to act for patient safety; report drug diversion or impairment per policy.
- Just culture
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A non-punitive culture of error reporting that improves safety.
- End-of-life / palliative care
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Comfort, family support, and honoring goals of care.
- Organ/tissue donation
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Support the process per protocol after a non-survivable injury.
- Verbal vs written consent
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Document consent; in a true emergency, act under implied consent.
- SBAR handoff
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Situation, Background, Assessment, Recommendation — a structured transition of care.
References
- 1.Board of Certification for Emergency Nursing. “CEN Examination Content Outline (effective July 2026).” BCEN.org. ↑
- 2.Board of Certification for Emergency Nursing. “Certified Emergency Nurse (CEN).” BCEN.org. ↑
- 3.Agency for Healthcare Research and Quality (AHRQ). “Emergency Severity Index (ESI): A Triage Tool for EDs.” ahrq.gov. ↑
- 4.American Heart Association. “Advanced Cardiovascular Life Support (ACLS) Algorithms.” cpr.heart.org. ↑
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