NZREX Emergency and Acute Medicine 2

Question 1

In NZ resuscitation guidelines, what is the recommended compression-to-ventilation ratio for adult CPR?

Accepted Answer

30 compressions to 2 ventilations

Answer

NZ follows the ANZCOR (Australian and New Zealand Committee on Resuscitation) guidelines recommending 30 chest compressions to 2 ventilations for adult CPR. Compressions should be at a rate of 100-120 per minute with a depth of approximately 5 cm.

Question 2

A patient in a NZ ED presents with diabetic ketoacidosis (DKA). What are the key management priorities?

Accepted Answer

IV fluid resuscitation, IV insulin infusion, potassium replacement, and monitoring of blood glucose, ketones, and electrolytes

Answer

DKA management in NZ involves aggressive IV fluid resuscitation (0.9% saline initially), IV insulin infusion (fixed rate), careful potassium replacement (as insulin drives K+ intracellularly), and regular monitoring of blood glucose, ketones, electrolytes, and acid-base status.

Question 3

In NZ, what is the initial management of a tension pneumothorax?

Accepted Answer

Immediate needle decompression in the 2nd intercostal space, midclavicular line (or 4th/5th ICS, anterior axillary line), followed by chest drain insertion

Answer

Tension pneumothorax is a clinical diagnosis requiring immediate treatment. Needle decompression should be performed urgently (2nd ICS, midclavicular line, or 4th/5th ICS, anterior axillary line) followed by definitive management with a chest drain (intercostal catheter).

Question 4

What is the NZ approach to managing acute upper gastrointestinal bleeding?

Accepted Answer

ABCDE assessment, IV access with fluid resuscitation, blood transfusion if needed, IV proton pump inhibitor, and urgent endoscopy within 24 hours

Answer

NZ management of acute upper GI bleeding includes ABCDE assessment, establishing IV access (two large-bore cannulae), fluid resuscitation, blood transfusion if haemoglobin is critically low, IV proton pump inhibitor (pantoprazole/omeprazole), and urgent endoscopy within 24 hours.

Question 5

In NZ emergency medicine, what is the FAST assessment in trauma?

Accepted Answer

Focused Assessment with Sonography for Trauma — a bedside ultrasound looking for free fluid in the abdomen, pelvis, and pericardium

Answer

FAST (Focused Assessment with Sonography for Trauma) is a bedside ultrasound examination used in NZ EDs to rapidly detect free fluid (blood) in the peritoneal cavity (four views), pelvis, and pericardium in trauma patients.

NZREX Practice Test

NZREX Practice Test

NZREX Emergency and Acute Medicine 2