DCAS Pre-Hospital Emergency Care 3 — Questions and Answers
Question 1: The revised trauma score (RTS) uses which three physiological parameters?
- Glasgow Coma Scale, systolic blood pressure, and respiratory rate (Correct answer)
- Heart rate, oxygen saturation, and temperature
- GCS, pulse oximetry, and ETCO2
- Blood pressure, heart rate, and capillary refill time
Correct answer: Glasgow Coma Scale, systolic blood pressure, and respiratory rate
The RTS combines coded values of GCS, systolic BP, and respiratory rate to produce a physiological score used for triage and predicting survival probability in trauma patients.
Question 2: Which haemorrhage control technique is appropriate for a suspected pelvic fracture with haemodynamic instability?
- Pelvic binder application to reduce pelvic volume and tamponade haemorrhage (Correct answer)
- Direct pressure with gauze only
- Elevation of the pelvis
- Tourniquet application to the pelvis
Correct answer: Pelvic binder application to reduce pelvic volume and tamponade haemorrhage
A pelvic binder closes the pelvic ring, reducing the potential space for haemorrhage and providing tamponade effect to control life-threatening internal bleeding from pelvic fractures.
Question 3: The 'permissive hypotension' strategy in penetrating trauma without head injury aims to maintain systolic BP at:
- 80-90 mmHg (Correct answer)
- 120-130 mmHg
- 60-70 mmHg
- 100-110 mmHg
Correct answer: 80-90 mmHg
In penetrating trauma without TBI, permissive hypotension targets SBP 80-90 mmHg to maintain perfusion of vital organs while avoiding the dilution of clotting factors and clot disruption that aggressive fluid resuscitation causes.
Question 4: Rapid Sequence Intubation (RSI) involves:
- Simultaneous administration of an induction agent and neuromuscular blocking agent to facilitate intubation (Correct answer)
- Intubation without any drugs in a conscious patient
- Awake fibreoptic intubation technique
- Sedation alone without muscle relaxation
Correct answer: Simultaneous administration of an induction agent and neuromuscular blocking agent to facilitate intubation
RSI uses concurrent administration of an induction agent (e.g., ketamine, etomidate) and succinylcholine or rocuronium to rapidly achieve unconsciousness and paralysis, creating optimal intubation conditions while minimising aspiration risk.
Question 5: Which is the most reliable indicator of adequate ventilation in the intubated patient?
- Waveform capnography (ETCO2 35-45 mmHg) (Correct answer)
- Chest rise observed bilaterally
- Oxygen saturation by pulse oximetry
- Auscultation of breath sounds bilaterally
Correct answer: Waveform capnography (ETCO2 35-45 mmHg)
Waveform capnography with a normal ETCO2 (35-45 mmHg) confirms tube placement, monitors ventilation continuously, and detects complications such as oesophageal intubation, hyperventilation, or cardiac arrest.
Question 6: The 'AVPU' scale is used in pre-hospital care to quickly assess:
- Level of consciousness (Alert, Voice, Pain, Unresponsive) (Correct answer)
- Airway status
- Blood pressure
- Pain severity
Correct answer: Level of consciousness (Alert, Voice, Pain, Unresponsive)
AVPU is a rapid consciousness assessment: Alert (normal), responds to Voice, responds to Pain only, or Unresponsive — providing a quick four-level scale for serial neurological monitoring during assessment.
DCAS Pre-Hospital Emergency Care 3
The revised trauma score (RTS) uses which three physiological parameters?