Mixed Deck — All DCAS Topics Flashcards

What is the duty of candor for DCAS paramedics?

Answer: To be open and honest with patients when things go wrong and to report errors or near-misses

The duty of candor requires DCAS paramedics to be open and transparent with patients when errors occur or when things go wrong, and to report incidents through proper channels for learning and improvement.

The 'ambulance turnaround time' KPI measured by DCAS reflects:

Answer: Time from arrival at hospital to crew clearance and return to service — a key efficiency metric

Turnaround time at hospital (offload time) is a key performance indicator affecting DCAS operational capacity; delays in ED patient handover reduce ambulance availability for new calls and degrade response time performance.

Complete AV block (third-degree heart block) with bradycardia causing haemodynamic compromise is treated pre-hospital with:

Answer: Transcutaneous pacing (TCP) as first-line, with atropine 0.5mg IV if pacing is unavailable

TCP provides immediate rate control in complete AV block with haemodynamic compromise; atropine may increase ventricular rate as a temporising measure, but the definitive pre-hospital treatment is transcutaneous pacing.

In PALS, the primary cause of cardiac arrest in children differs from adults in that it is most commonly:

Answer: Respiratory failure or shock leading to hypoxic cardiac arrest

Unlike adults where VF/pVT is common, paediatric cardiac arrest is predominantly caused by respiratory failure or shock progressing to hypoxia, making airway management and early oxygenation the most critical interventions.

What is the DCAS protocol for managing acute coronary syndrome (ACS) in the pre-hospital setting?

Answer: Aspirin 300mg, GTN (if systolic BP >90mmHg), morphine for pain, 12-lead ECG, and rapid transport to appropriate facility

DCAS ACS protocol includes aspirin 300mg chewed, sublingual GTN (if systolic BP permits), morphine for pain management, continuous cardiac monitoring with 12-lead ECG, and rapid transport to appropriate cardiac facility.

The 'Medical Treatment Officer' (MTO) role in Dubai MCI response is to:

Answer: Oversee treatment sector operations and coordinate paramedic teams at the casualty collection point

The MTO manages the treatment area, ensuring triage categories are applied, treatment priorities are maintained, patients are moved to transport in order of priority, and paramedic teams are effectively deployed.

A postictal patient is unresponsive but breathing adequately. What is the most appropriate position?

Answer: Recovery (lateral) position

The recovery (lateral) position protects the airway from aspiration and maintains airway patency in a breathing but unresponsive postictal patient.

The pre-hospital 12-lead ECG transmission to the cardiac catheterisation laboratory is important because:

Answer: It enables the cath lab to activate and prepare before the patient arrives, reducing door-to-balloon time

Pre-hospital ECG transmission and 'cath lab activation' protocols allow the interventional cardiology team to be ready before patient arrival, reducing the total ischaemic time (first medical contact to balloon) in STEMI.

The Dubai Health Authority (DHA) role in relation to DCAS includes:

Answer: Regulatory oversight of healthcare standards, licensing of healthcare professionals, and hospital network coordination

DHA regulates healthcare quality and standards across Dubai (including DCAS), licenses healthcare professionals, and coordinates the hospital network — while DCAS maintains operational independence for ambulance services.

Lidocaine 1-1.5mg/kg IV is an alternative to amiodarone for shock-refractory VF/pVT when:

Answer: Amiodarone is unavailable

Lidocaine is recommended as an alternative antiarrhythmic when amiodarone is unavailable for shock-refractory VF/pVT; while amiodarone has superior evidence, lidocaine remains an acceptable alternative.

What is the mechanism of action of salbutamol (Ventolin) used by DCAS paramedics?

Answer: It relaxes bronchial smooth muscle through beta-2 adrenergic receptor stimulation, causing bronchodilation

Salbutamol is a selective beta-2 adrenergic agonist that relaxes bronchial smooth muscle, producing bronchodilation and relieving bronchoconstriction in conditions like asthma and COPD.

Which principle guides the decision to withhold resuscitation (DNR) in the pre-hospital setting in Dubai?

Answer: Valid documented DNR orders or clear signs of irreversible death (rigor mortis, dependent lividity, decapitation)

Pre-hospital withholding of resuscitation requires valid documented advance directives (DNR orders) or unequivocal physical signs of irreversible death; absent these, resuscitation should be initiated and the matter resolved in hospital.

What is the SAMPLE history-taking mnemonic used by Dubai ambulance paramedics?

Answer: Signs, Allergies, Medications, Past history, Last meal, Events leading to illness

SAMPLE stands for Signs/Symptoms, Allergies, Medications, Past medical history, Last oral intake, and Events leading to the present illness, providing a structured approach to patient history-taking.

What is the significance of capillary refill time (CRT) in DCAS patient assessment?

Answer: It indicates peripheral perfusion status; a CRT greater than 2 seconds suggests poor circulation

CRT is assessed by pressing a fingertip and measuring the time for color to return. A CRT exceeding 2 seconds in adults indicates poor peripheral perfusion, possibly from shock or dehydration.

For every 10cm the ETT moves toward the patient's feet (caudally) during movement, the expected change is:

Answer: Endobronchial intubation (right main bronchus) if the tube was near the carina

Head extension causes the ETT to move cephalad (upward), and head flexion causes caudal (downward) movement; a small amount of inadvertent flexion during movement can advance a correctly placed ETT into the right main bronchus.

The ACLS algorithm for stable monomorphic ventricular tachycardia with a pulse includes:

Answer: Amiodarone 150mg IV infusion over 10 minutes, or synchronised cardioversion

Stable monomorphic VT with a pulse can be treated pharmacologically with amiodarone (or procainamide/lidocaine), or electively cardioverted if pharmacological therapy fails or is not preferred.

In the management of suspected cyanide poisoning (e.g., in fire victims with altered consciousness), the antidote is:

Answer: Hydroxocobalamin (Cyanokit) IV — binds cyanide to form cyanocobalamin (vitamin B12)

Hydroxocobalamin binds cyanide ions directly, forming non-toxic cyanocobalamin (vitamin B12) which is renally excreted; it is safe, effective, and compatible with concurrent 100% oxygen administration.

How should DCAS paramedics assess pain using the numeric rating scale?

Answer: Asking the patient to rate their pain from 0 (no pain) to 10 (worst pain imaginable)

The numeric rating scale asks patients to rate their pain intensity from 0 (no pain) to 10 (worst pain imaginable), providing a standardized subjective pain measurement for documentation and treatment decisions.

Termination of resuscitation (TOR) criteria in out-of-hospital cardiac arrest for paramedics typically include:

Answer: Arrest not witnessed, no bystander CPR, no ROSC after 3 analyses, and no shockable rhythm ever

Basic life support TOR rules consider multiple factors: unwitnessed arrest, absence of bystander CPR, failure to achieve ROSC after adequate ALS, and no shockable rhythm — each reducing survival probability to near zero.

What is the DCAS approach to cultural sensitivity when treating diverse patients in Dubai?

Answer: Respect religious and cultural practices including modesty requirements, gender preferences for providers, and dietary restrictions

Dubai's diverse population requires DCAS paramedics to respect cultural and religious practices including modesty considerations, same-gender provider preferences when possible, and awareness of fasting periods like Ramadan.