Pre-Hospital Emergency Care Flashcards

In pre-hospital spinal immobilisation, the current evidence-based approach suggests:

Answer: Selective spinal immobilisation based on validated clinical criteria rather than universal backboard application

Evidence supports selective spinal immobilisation using criteria such as the Canadian C-Spine Rule or similar tools — unnecessary immobilisation causes harm (respiratory compromise, pressure injuries, delayed transport).

Hypoglycaemia in a responsive pre-hospital patient is best treated with:

Answer: Oral glucose gel or glucose tablets if the patient can swallow safely

If the patient is conscious and can safely swallow, oral glucose is the preferred first-line treatment for hypoglycaemia; IV dextrose or IM glucagon are alternatives for patients unable to take oral glucose.

The 'START' triage system categorises patients into which four groups?

Answer: Immediate (Red), Delayed (Yellow), Minor (Green), Expectant/Deceased (Black)

START (Simple Triage and Rapid Treatment) uses colour coding: Red (immediate life-threatening, saveable), Yellow (delayed, serious but stable), Green (minor/walking wounded), Black (deceased or unsurvivable injuries).

When managing a patient with suspected increased intracranial pressure (ICP) pre-hospital, ventilation should target ETCO2 of:

Answer: 35-45 mmHg (normal range, avoiding hyperventilation)

Normal ETCO2 (35-45 mmHg) is the target; deliberate hyperventilation causing hypocapnia is reserved only for herniation syndromes as a temporising measure, as it reduces cerebral blood flow and can worsen outcomes.

Pre-hospital analgesia for a conscious trauma patient with a suspected long bone fracture should include:

Answer: Titrated IV/IN opioids (e.g., morphine or fentanyl) and splinting of the fracture

Titrated opioid analgesia reduces pain and patient movement that can worsen injury; intranasal fentanyl is particularly useful in patients with poor IV access, and splinting reduces pain and blood loss.

Which pre-hospital intervention is MOST important in improving outcomes for out-of-hospital cardiac arrest (OHCA)?

Answer: Early high-quality CPR and early defibrillation

The chain of survival is anchored by early high-quality CPR maintaining perfusion and early defibrillation for shockable rhythms — both have the strongest evidence base for improving OHCA survival.