DCAS Pre-Hospital Emergency Care 2 — Questions and Answers
Question 1: The Glasgow Coma Scale (GCS) assesses which three parameters?
- Eye opening, verbal response, and motor response (Correct answer)
- Pulse rate, respiratory rate, and blood pressure
- Pupil size, reflexes, and consciousness level
- Airway patency, breathing effort, and circulation adequacy
Correct answer: Eye opening, verbal response, and motor response
The GCS scores eye opening (1-4), best verbal response (1-5), and best motor response (1-6), giving a total of 3-15; scores help quantify neurological function and guide management decisions.
Question 2: A GCS score of 8 or less indicates the need for:
- Definitive airway management (intubation) (Correct answer)
- Supplemental oxygen via non-rebreather mask only
- IV fluid administration only
- Rapid transport without airway intervention
Correct answer: Definitive airway management (intubation)
A GCS of 8 or less indicates severe neurological compromise with inadequate protective airway reflexes, requiring definitive airway management — typically endotracheal intubation — to secure and protect the airway.
Question 3: The 'SAMPLE' history mnemonic stands for:
- Signs/symptoms, Allergies, Medications, Past medical history, Last meal, Events leading to incident (Correct answer)
- Scene assessment, Assessment findings, Medical interventions, Patient location, Lab results, Examination findings
- Severity, Age, Mechanism, Pulse, Level of consciousness, Exit route
- Situation, Age, Medical history, Pain scale, Lifestyle, Emergency contacts
Correct answer: Signs/symptoms, Allergies, Medications, Past medical history, Last meal, Events leading to incident
SAMPLE provides a structured secondary assessment history: Signs/symptoms, Allergies, current Medications, Past medical history, Last oral intake (meal), and Events or environment leading to the emergency.
Question 4: In the pre-hospital setting, the maximum recommended on-scene time for a critical trauma patient is:
- Less than 10 minutes (platinum 10 minutes) (Correct answer)
- 30 minutes
- 1 hour
- As long as needed to stabilise the patient fully
Correct answer: Less than 10 minutes (platinum 10 minutes)
The 'Platinum 10 Minutes' guideline aims to keep on-scene time under 10 minutes for critical trauma patients, limiting field interventions to essential life-saving measures before transport to definitive care.
Question 5: Which position is appropriate for a responsive patient in shock with no suspected spinal injury?
- Supine with legs elevated 10-15 degrees (modified Trendelenburg) (Correct answer)
- Sitting upright at 90 degrees
- Full Trendelenburg (steep head-down tilt)
- Recovery position (lateral)
Correct answer: Supine with legs elevated 10-15 degrees (modified Trendelenburg)
Modest leg elevation in a supine patient increases venous return from the lower limbs to the central circulation, supporting blood pressure in hypovolaemic shock without the respiratory compromise of steep Trendelenburg.
Question 6: The 'mechanism of injury' assessment helps paramedics predict:
- Likely injury patterns and guide physical examination priorities (Correct answer)
- Exact diagnoses without physical examination
- Drug ingestion history
- Exact GCS score before assessment
Correct answer: Likely injury patterns and guide physical examination priorities
Understanding the mechanism (e.g., high-speed MVA with ejection, fall from height, stab wound) allows paramedics to predict likely injury patterns and ensure systematic examination does not miss occult injuries.
DCAS Pre-Hospital Emergency Care 2
The Glasgow Coma Scale (GCS) assesses which three parameters?