Pre-Hospital Emergency Care Flashcards

In pre-hospital care, which intravenous fluid is considered first-line for hypovolaemic shock resuscitation?

Answer: Isotonic crystalloid (e.g., 0.9% sodium chloride or Lactated Ringer's)

Isotonic crystalloids are used for initial volume replacement in hypovolaemic shock; however, modern damage control resuscitation increasingly favours blood products for haemorrhagic shock to prevent dilutional coagulopathy.

Intraosseous (IO) access is indicated when:

Answer: IV access cannot be obtained within 2 attempts or 90 seconds in a critically ill patient

IO access provides rapid vascular access when IV insertion fails in time-critical emergencies, with flow rates and drug delivery comparable to central venous access — appropriate for all age groups in critical care.

The pre-hospital management of suspected tension pneumothorax includes:

Answer: Needle thoracostomy at the 2nd intercostal space, midclavicular line

Tension pneumothorax is immediately life-threatening and requires emergency needle thoracostomy (or finger thoracostomy in ventilated patients) to decompress the pleural space before formal chest tube insertion.

The purpose of the 'Cincinnati Pre-hospital Stroke Scale' is to:

Answer: Identify stroke patients using facial droop, arm drift, and speech abnormality

The Cincinnati scale uses three findings — facial droop (asymmetry), arm drift (one arm drifts down), and speech (slurred or wrong words) — to rapidly identify probable stroke in the pre-hospital setting.

Which medication is the first-line treatment for suspected opioid overdose with respiratory depression in the pre-hospital setting?

Answer: Naloxone (Narcan) — opioid antagonist

Naloxone competitively antagonises opioid receptors, rapidly reversing respiratory depression, sedation, and miosis caused by opioid overdose; multiple doses may be needed for long-acting opioids.

The 'FAST' acronym used by DCAS paramedics to communicate stroke recognition stands for:

Answer: Face drooping, Arm weakness, Speech difficulty, Time to call

FAST (Face, Arm, Speech, Time) is the internationally adopted pre-hospital stroke recognition tool that guides paramedics to note the time of symptom onset — critical for thrombolysis eligibility.