Core Generalist#



Describe the following;

  • basic pathophysiology of cardiac arrest and the factors leading to circulatory and respiratory failure, and those factors relevant to post resuscitation care
  • basic pathophysiology of shock secondary to cardiogenic, haemorrhagic, hypovolaemic, anaphylactic, mechanical or other causes of shock
  • basic anatomy of the airway, circulatory and respiratory system in relation to life threatening conditions
  • relevant anatomical aspects of the neurological and musculoskeletal systems in relation to medical and surgical conditions
  • special considerations for facial and airway trauma
  • important age-specific differences and the anatomy and physiology of the child relevant to emergencies
  • essentials of acid-base balance and fluid and electrolyte management in emergencies


Discuss the principles of triage, prioritisation of patients for resuscitation, and resource allocation


Discuss personal safety responsibilities and limitations if attending an emergency in the community


Describe hazards identification, assessment and mitigation at a prehospital scene or incident


Identify medical capabilities and the relationship of emergency services police, fire, medical, specialist rescue and voluntary emergency services at a prehospital scene or incident


Describe the steps involved in the management of an acute emergency, proceeding logically through life support while advancing towards definitive diagnosis and management of underlying injury and disease


Discuss the principles of managing the acutely disturbed/agitated patient


Discuss the principles of retrieval, transfer and transport by road and by air


Discuss use of common chemo-therapeutic agents in emergency management particularly in relation to:

  • analgesia
  • sedation
  • antibiotics
  • thrombolysis
  • anticoagulation/platelet inhibition


Identify the contents and general layout of emergency and retrieval kits


Explain the principles of acute forensic presentation particularly with respect to victims of sexual assault and non-accidental injury


Identify the disaster response plan for the hospital and community



Respond and provide initial treatment to emergencies in the hospital and community


Initially stabilise Australian Triage Category 1 and 2 patients with the support of an experienced colleague (which may be through distance technology) pending definitive emergency medical care


Competently provide definitive emergency medical care for most Australian Triage Category 3, 4 and 5 patients and determine when additional support is required.


Undertake the following:

  • organise and allocate resources
  • make appropriate pre-hospital arrival preparations
  • give telephone advice to transporting persons
  • hazard identification, assessment and mitigation
  • conduct initial resuscitation following the ABC algorithm
  • basic life support
  • primary survey
  • conduct further resuscitation as indicated
  • secondary survey
  • necessary investigations
  • definitive treatment where indicated
  • consultation as indicated
  • stabilise and monitor haemodynamics, oxygenation and acid/base balance
  • manage acutely disturbed/agitated/violent behaviour
  • set up and supervise retrieval as indicated


Ensure proper access/egress for all systems, in particular:

  • airway protection
  • adequate venous access
  • naso/orogastric intubation
  • urinary catheterisation
  • spinal stabilisation
  • stabilisation of injuries and fractures


Assist with response to a disaster or multi-trauma


Perform emergency procedures as detailed in the Procedural Skills Logbook








Advanced Specialised#



Describe characteristics of rural and remote settings and their impact on emergency medicine that need to be considered including the differences when compared with metropolitan settings in:

  • prevailing social attitudes to health, illness and health care
  • rural occupations
  • incidence and prevalence of emergency medical conditions
  • Aboriginal and Torres Strait Islander Peoples Health
  • access to physical resources including investigations, medications and treatments
  • working in a resource limited environment
  • access to specialist services


Detail selection criteria, protocols, principles, limitations and interpretation of results of the tests listed in skills section


Be aware of congenital and acquired conditions that may predispose patients to emergency presentations or complicate emergency management including congenital heart disease, congenital maxillofacial and other anatomical abnormalities, acquired anatomical abnormalities


Discuss features of common conditions difficult to diagnose and potentially obscured by patient age, body habitus, co-morbidities etc


Identify diagnostic features and initial management of "less common" conditions for example. endocrine emergencies, environmental emergencies (hypothermia, hyperthermia, barotrauma, high altitude illness etc), neuromuscular disorders (Guillain-Barre disease)


Discuss risk factors for secondary injuries in emergency patients, discuss strategies for reducing these risks, and outline appropriate management for secondary injuries if these occur: renal failure, cardiac failure, adult respiratory distress, syndrome (ARDS), disorders of coagulation, cerebral hypoxia, multi-system failure, sepsis and neurovascular compromise.


Discuss anaesthetics, procedural sedation and analgesic decision-making and delivery, including factors involved in making difficult anaesthetics decisions; neonates, young children, elderly, shock, obesity, co-morbidities and burns


Describe clinical and medico-legal requirements for consent, management of physical and/or sexual assault cases, including:

  • sexual assault examination and specimen collection
  • recognition of non-accidental injury patterns in children and domestic partners
  • understanding the coronial investigation process
  • writing medico-legal reports
  • giving evidence in court
  • treatment of minors and persons in custody
  • guardianship, advanced care directives, mentally impaired patients
  • duty of care for alcohol/recreational drug affected patients


Illustrate the principles of triage and their application to emergency situations


Interpret the Australasian Triage Score and its application to the clinical setting


Identify potential complications (including possible treatment failure) of the emergency procedures and definitive therapies


Describe signs and symptoms of the following complications and outline appropriate rescue plans.

  • post-procedural complications – haemorrhage, thromboembolism, vascular insufficiency, infection/sepsis, wound breakdown, perforation/obstruction, mechanical failure, pneumothorax, spinal headache, renal failure, uncontrolled pain
  • complications of therapeutics, for example, adverse reaction, allergy/anaphylaxis, toxicity, drug interactions, GI bleeding, excessive sedation, dystonic reactions, neuroleptic malignant syndrome, transfusion reactions, over-hydration, over-anticoagulation, medication non-compliance and polypharmacy
  • complications of dialysis.


Describe the epidemiologic characteristics, prevention and control measures for infectious disease outbreaks, including:

  • immunisation and post-exposure prophylaxis
  • community epidemics
  • nosocomial outbreaks
  • tropical and exotic infections
  • sexually transmitted infections
  • patients requiring isolation
  • personal protective equipment and safe working practices for other staff


Discuss the principles for disaster prevention, preparedness, response and recovery in rural and remote communities


Discuss principles of injury prevention in rural and remote contexts, including implementing an injury prevention program


Discuss ethical issues around end of life presentations (either medical, surgical, oncological, geriatric based or trauma)



Competently provide definitive emergency medical care including emergency medicine procedural interventions for individual patients across all presentations, of all age groups across all Australian Triage categories.


Undertake initial assessment and triage of patients with acute or life-threatening conditions, including:

  • seriously unwell conscious patients
  • patients with undifferentiated severe acute pain
  • undifferentiated unconscious patients
  • patients with undifferentiated shock
  • patients with undifferentiated fever or infective illness
  • undifferentiated sick children
  • major or complicated trauma – multiple trauma, head trauma, pelvic fracture, ENT, maxillofacial, abdominal (blunt and penetrating) and genital trauma
  • acutely psychotic patients, other mental illness including attempted self-harm and suicide


Recognition of the seriously unwell conscious patient, appropriate prioritisation and sequencing of assessments, investigations and management tasks in emergency cases


Recognise and evaluate variations in emergency presentations among Aboriginal and Torres Strait Islander patients that differ from the non- Aboriginal and Torres Strait Islander peoples including:

  • young age at presentation with acute coronary syndrome
  • stroke or acute kidney failure
  • acute rheumatic fever
  • severe pneumonia
  • crusted scabies, and
  • disseminated strongyloidiasis


Utilisation of relevant diagnostic and imaging modalities including performing bedside imaging and interpretation of Point of Care Ultrasound (POCUS) and CT imaging without immediate access to radiology reporting


Arrange with consideration of urgency, onward transfer for higher-level diagnostic services e.g. MRI, invasive cardiology, and complex endoscopic procedures


Provide high-level pain management skills including oral, intramuscular, intravenous and intranasal analgesia: topical and local infiltration analgesia: common nerve blocks, regional anaesthesia, including management of analgesia complications and adverse reactions


Competent in techniques for difficult peripheral and central intravenous or intraosseous access, including with ultrasound guided access


Competent in techniques for vital signs monitoring including invasive; intra-arterial BP measurement, ventilation monitoring, and temperature monitoring


Stabilise critically ill patients and provide primary and secondary care for emergency conditions including:

Airway and respiratory emergencies:

  • advanced airway management options and techniques
  • use of portable ventilators
  • use of non-invasive ventilation
  • techniques for pneumothorax drainage techniques including needle thoracostomy, Seldinger guided catheters and large intercostal catheters

Circulatory and cardiovascular emergencies:

  • application of Advanced Cardiac Life Support (ACLS) algorithms
  • defibrillation, cardioversion and external cardiac pacing
  • advanced thrombolytic therapy, including management of complications
  • platelet inhibitor and anticoagulant therapy
  • advanced hypotensive therapy
  • pericardiocentesis with on-site or distant guidance
  • advanced haemostatic therapy
  • advanced anti-arrhythmic therapy
  • competent and confident administration of inotropes
  • principles of angioplasty and stenting
  • principles of occult blood loss in trauma
  • competent and confident fluid resuscitation including minimum volume fluid resuscitation, use of blood products and Massive Transfusion Protocol

Neurological emergencies:

  • seizure monitoring and control
  • competent lumbar puncture for diagnostic and therapeutic procedures
  • basic surgical skills to undertake decompressive cranial burr holes with distant guidance from a neurosurgeon

Musculo-skeletal emergencies:

  • independent splinting, casting and reduction of simple fractures and dislocations
  • reduction of complex fractures/dislocations under distant or on-site guidance, including minimisation of neurovascular compromise
  • competent and confident initial management of compound wounds
  • competent and confident initial management of spinal injuries, including awareness of patterns of spinal injury without radiological abnormality
  • independent joint aspiration

Soft tissue emergencies and burns:

  • removal of superficial foreign bodies
  • independent abscess drainage
  • independent wound management, including prophylactic antibiotic administration, local anaesthetic, tetanus injections, wound cleaning, debridement and complex wound closure techniques
  • independent management of minor burns
  • initial management of moderate or severe burns including special area burns e.g. face, neck, airway, hands, genitalia, circumferential burns, chemical, electrical, other associated injury with on-site or distant guidance
  • management of rhabdomyolysis/acidosis
  • monitoring and management of compartment pressure, including escharotomy with distant or on-site guidance
  • pressure care of soft tissues at risk from ischaemia and infection
  • regulation of body temperature in patients with dermatological emergencies

Obstetric and gynaecologic emergencies:

  • competent and confident initial management of haemorrhage in early pregnancy
  • initial management of trauma in pregnancy
  • competent and confident management of miscarriage
  • timely recognition and transfer of patients requiring surgical intervention
  • competent and confident management of common labour and delivery complications
  • seizure control in eclampsia
  • management of precipitate delivery with distant guidance
  • initial management of post-partum problems

Abdominal and genitourinary emergencies:

  • competent and confident initial management of acute renal failure
  • recognition of gastrointestinal foreign bodies requiring removal
  • urethral and suprapubic catheterisation
  • control of oesophageal varices
  • drainage of abdominal ascites for symptom control
  • reduction of paraphimosis with on-site or distant guidance

Metabolic and endocrine emergencies:

  • competent and independent insulin infusion
  • competent and independent intravenous potassium replacement
  • competent and independent IV fluids for endocrine emergencies

Acute infections:

  • chemotherapeutics for undifferentiated sepsis
  • be aware of and able to follow protocol for management of needle stick injury and other body fluid exposure
  • competent and confident application of infection control procedures, public health reporting procedures and management of contact persons

Toxicologic and toxinological emergencies:

  • competent application of pressure immobilisation bandage
  • competent and independent antivenom and antidote administration
  • competent use of venom detection kit (VDK) with distance guidance
  • safety and decontamination procedures for deliberate CBR incidents – for patients, staff members and in an emergency department

Environmental emergencies:

  • re-warming techniques
  • cooling techniques
  • temperature monitoring
  • initial management of diving injuries, including hyperbaric medicine

Ophthalmological emergencies:

  • competent use of slit lamp
  • competent measurement of intra-ocular pressures
  • competent removal of simple superficial corneal foreign bodies
  • refer for removal of difficult foreign bodies
  • repair onsite or referral for repair peri-ocular lacerations

ENT and dental emergencies:

  • tooth preservation techniques
  • infection prevention and management
  • competent and independent management of anterior and posterior epistaxis
  • removal of simple nasal and aural foreign bodies and identification difficult foreign bodies

Psychiatric emergencies:

  • competent and confident differentiation between an acute severe behavioural disturbance due to acute delirium (including substance intoxication and withdrawal) and psychosis
  • competent and confident risk assessment, engagement and acute counselling skill


Competent verbal de-escalation techniques in high stress and potentially violent situations

  • competent and confident administration of rapid-acting antipsychotics sedatives and other medication where appropriate
  • appropriate administration of chemical restraint
  • use of relevant legislation for involuntary treatment admission
  • leadership to manage Code Black situation


Recognise and manage emergencies in all ages including the elderly, paediatric and neonatal groups and cover all emergency conditions including toxicology, obstetrics and psychiatric disease


Competent, sensitive and age-appropriate communication skills with anxious and distressed paediatric patients, parents and other carers including breaking bad news, onward referral, and engaging other support services


Competent and confident paediatric and neonatal emergency care, including:

  • initiation of Advanced Life Support
  • paediatric calculations – appropriate dosages and equipment size
  • estimation and administration of fluid requirements for resuscitation and ongoing maintenance
  • lumbar puncture, clean catch urine and phlebotomy in children
  • procedural sedation
  • warming techniques in children and neonates
  • paediatric pain management techniques
  • seizure management, including diagnosis of the underlying cause/s
  • airway management in children and neonates, including wound repair, foreign body removal, management of stridor, croup and epiglottitis, paediatric intubation
  • advanced intravenous access techniques – intraosseous infusion and neonatal umbilical catheterisation
  • management of acute infections in children, including neonatal infections, sepsis and meningitis
  • management of diabetic ketoacidosis (DKA) in children
  • management of serious gastro-intestinal conditions, including pyloric stenosis and intussusception
  • management of serious neonatal conditions including prematurity, sepsis, respiratory failure and congenital abnormalities


Coordinate, work with and/or provide leadership (clinical and operational) as appropriate to multidisciplinary and/or inter-professional teams encompassing emergency services (police, fire brigade, ambulance), retrieval services, emergency department staff members, inpatient services and community members


Establish and maintain appropriate emergency department systems and procedures

  • trauma and priority team organisation
  • multi-casualty preparedness and response
  • co-ordination with police and other agencies
  • risk management, critical decision making and dealing with uncertainty
  • use of electronic record systems
  • quality assurance and audit policies and procedures
  • storage and handling of blood products
  • organ donation and transplantation protocols
  • pharmaceutical dispensing
  • staff management and communication skills
  • inter-professional co-operation skills
  • complaint management
  • occupational health and safety measures


Perform emergency procedures as detailed in the AST Emergency Medicine Procedural Skills Logbook








Emergency presentations and conditions#

  • Airway and respiratory emergencies: airway obstruction difficult foreign bodies, severe asthma, respiratory distress, tension pneumothorax, compromised airways, hypoventilation, hypoxia and chest trauma
  • Circulatory and cardiovascular emergencies: chest pain, acute coronary syndromes, cardiogenic shock, hypovolaemic shock, hypertensive emergencies, haemorrhagic emergencies, cardiac tamponade, acute myocardial infarction, thrombo-embolic emergencies including pulmonary embolism, gas embolism and anaphylaxis:
  • Neurological emergencies: neurologic trauma, coma, stroke, cerebral ischaemia, space occupying lesions, intracranial haemorrhage, subarachnoid haemorrhage, altered mental status, acute confusional states, delirium, undifferentiated headache, Guillain-Barre Syndrome, seizures, status epilepticus, meningitis and neurogenic shock:
  • Musculo-skeletal emergencies: simple and complex fractures and dislocations, crush injuries, compound wounds, spinal injuries, ischaemic limbs (including compartment syndrome), degloving injury, amputated digits, acute back pain/sciatica and maxillofacial injury:
  • Soft tissue emergencies and burns: foreign bodies, abscesses, burns (thermal, chemical and electrical), frostbite, necrotising infections, bite wounds, crush injury, neurovascular injury, degloving injury and acute desquamating conditions:
  • Obstetric and gynaecologic emergencies: haemorrhage in early pregnancy, trauma in pregnancy, miscarriage, precipitate delivery, common labour and delivery complications, hypertensive urgencies, hyperemesis, pre-eclampsia, eclampsia and post-partum problems including fluid embolus, uterine rupture, haemorrhage, sepsis and retained products of conception (POC):
  • Abdominal and genitourinary emergencies: acute renal failure, foreign body ingestion, abdominal trauma, acute urinary retention, abdominal ascites causing significant discomfort and/or respiratory compromise, oesophageal varices and paraphimosis:
  • Metabolic and endocrine emergencies: hypoglycaemia, diabetic ketoacidosis (DKA), hyperosmolar non-ketotic states, hypokalaemia, hyperkalaemia, hypocalcaemia, hypercalcaemia, hyponatraemia, Addisonian crisis, hypothermia and hyperthermia:
  • Acute infections: undifferentiated sepsis, septicaemia, urosepsis, neutropenic sepsis, febrile convulsion, septic shock, exotic infectious diseases, nosocomial infections, needle stick injury and other body fluid exposure:
  • Toxicologic and toxinological emergencies: drug/alcohol overdose, accidental and deliberate toxic ingestion, terrestrial and marine envenomation, deliberate chemical biological or radiological (CBR) incidents, polypharmacy overdose and delayed presentations:
  • Environmental emergencies: hypothermia, hyperthermia, barotrauma, near drowning, electrical injury and smoke/gas inhalation:
  • Ophthalmological emergencies: chemical and thermal trauma, blunt and penetrating trauma, hyphema, blowout fracture, ultra violet trauma, snow blindness, acute vision loss, acute chalazion, glaucoma, viral and bacterial infections, foreign bodies and peri-ocular lacerations:
  • ENT and dental emergencies: dental trauma, acute infection, maxillofacial trauma, anterior and posterior epistaxis, aural and nasal foreign bodies and quinsy:
  • Psychiatric emergencies: acute psychosis, suicide threat or attempt, violent self-harm
Last updated on by acrrmbot