DCAS Pre-Hospital Emergency Care 4

Question 1

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

Accepted Answer

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

Answer

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.

Question 2

Intraosseous (IO) access is indicated when:

Accepted Answer

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

Answer

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.

Question 3

The pre-hospital management of suspected tension pneumothorax includes:

Accepted Answer

Needle thoracostomy at the 2nd intercostal space, midclavicular line

Answer

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.

Question 4

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

Accepted Answer

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

Answer

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.

Question 5

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

Accepted Answer

Naloxone (Narcan) — opioid antagonist

Answer

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.

DCAS Practice Test

DCAS Practice Test

DCAS Pre-Hospital Emergency Care 4