ABFAS Emergency Response Procedures 2

Question 1

A patient develops sudden severe chest pain and diaphoresis during a foot and ankle procedure under local anesthesia. What is the FIRST priority action?

Accepted Answer

Stop the procedure and activate the emergency response system

Answer

Stopping the procedure and activating emergency services is the first priority to ensure timely advanced care for a potential myocardial infarction.

Question 2

Which vasopressor is the FIRST-LINE agent for anaphylactic shock in the surgical setting?

Accepted Answer

Epinephrine 0.3-0.5 mg IM (1:1,000 solution)

Answer

Epinephrine 1:1,000 solution given intramuscularly is the first-line treatment for anaphylaxis due to its rapid alpha and beta adrenergic effects.

Question 3

During a foot procedure, a patient on warfarin develops uncontrolled hemorrhage. In addition to direct pressure, which agent most rapidly reverses warfarin anticoagulation?

Accepted Answer

4-factor prothrombin complex concentrate (PCC)

Answer

4-factor PCC provides rapid reversal of warfarin by replacing factors II, VII, IX, and X and has faster onset than FFP.

Question 4

A patient undergoing regional nerve block develops sudden tinnitus, perioral numbness, and confusion. This presentation is most consistent with:

Accepted Answer

Local anesthetic systemic toxicity (LAST)

Answer

Tinnitus, perioral numbness, and CNS excitation followed by depression are classic early signs of local anesthetic systemic toxicity (LAST).

Question 5

What is the recommended initial treatment for local anesthetic systemic toxicity (LAST) with cardiovascular collapse?

Accepted Answer

20% lipid emulsion therapy (Intralipid)

Answer

20% lipid emulsion (Intralipid) acts as a 'lipid sink,' sequestering the lipid-soluble local anesthetic and is the specific antidote for LAST.

(ABFAS) American Board of Foot and Ankle Surgery Practice Test

(ABFAS) American Board of Foot and Ankle Surgery Practice Test

ABFAS Emergency Response Procedures 2