DHA Emergency Medical Services 2

Question 1

A 25-year-old male is brought to the ED after a road traffic accident.
He is unresponsive, BP 70/40 mmHg, HR 130 bpm, and has absent breath sounds on the right side with tracheal deviation to the left.
What is the immediate management?

Accepted Answer

Immediate needle thoracostomy in the right 2nd intercostal space, midclavicular line

Answer

Chest X-ray to confirm diagnosis

Answer

Insertion of bilateral chest drains

Answer

IV fluid resuscitation with 2L normal saline

Question 2

An adult patient in cardiac arrest is receiving CPR. After the second defibrillation shock, which medication should be administered next according to ACLS guidelines?

Accepted Answer

Epinephrine 1mg IV every 3–5 minutes

Answer

Atropine 1mg IV

Answer

Amiodarone 300mg IV bolus

Answer

Calcium gluconate 1g IV

Question 3

A 60-year-old male presents with sudden onset severe headache described as 'the worst headache of my life.' Neurological exam is normal. CT head is negative. What is the next most important step?

Accepted Answer

Lumbar puncture

Answer

MRI brain with contrast

Answer

Prescribe analgesics and discharge

Answer

CT angiography of cerebral vessels

Question 4

In the ED, a patient presents with anaphylaxis with urticaria, angioedema, and bronchospasm after a bee sting. What is the first-line treatment?

Accepted Answer

IM epinephrine 0.3–0.5mg (1:1000) in the outer thigh

Answer

IV hydrocortisone 200mg

Answer

IV diphenhydramine 50mg

Answer

Nebulized salbutamol

Question 5

A patient presents with heat stroke: core temperature 41.5°C, confusion, and hot dry skin after outdoor work in Dubai summer. What is the most effective cooling method?

Accepted Answer

Ice water immersion or aggressive evaporative cooling

Answer

Oral rehydration with cold fluids

Answer

Antipyretic medications (paracetamol/ibuprofen)

Answer

IV normal saline at room temperature

Question 6

A trauma patient arrives in the ED with open fracture of the right femur, BP 85/50, HR 145, and active bleeding. In the initial management, what is the correct order of priorities per ATLS?

Accepted Answer

Airway → Breathing → Circulation → Disability → Exposure

Answer

Control bleeding first, then airway management

Answer

Fluid resuscitation, then splinting the femur

Answer

Immediate surgical consultation before any intervention