OSCE Emergency Response Procedures 2 — Questions and Answers
Question 1: A patient in the ED suddenly becomes unresponsive and apneic with no pulse. What is the correct sequence to initiate ACLS?
- Call for help, begin CPR, attach defibrillator, establish IV access (Correct answer)
- Establish IV access, call for help, attach defibrillator, begin CPR
- Attach defibrillator first, then call for help and begin CPR
- Begin CPR, establish IV access, call for help, attach defibrillator
Correct answer: Call for help, begin CPR, attach defibrillator, establish IV access
The ACLS sequence prioritizes calling for help and immediate CPR, then defibrillation and vascular access.
Question 2: During a mass casualty incident (MCI), a patient is breathing at 8 breaths/min, has a radial pulse, and cannot follow commands. Using START triage, what color tag is assigned?
- Red (Immediate) (Correct answer)
- Yellow (Delayed)
- Green (Minor)
- Black (Expectant/Deceased)
Correct answer: Red (Immediate)
Respiratory rate <10 or >30, absent radial pulse, or inability to follow commands each independently classify a patient as Red (Immediate) in START triage.
Question 3: When performing a needle thoracostomy for tension pneumothorax, the preferred landmark in the US is:
- 2nd intercostal space, midclavicular line (Correct answer)
- 4th intercostal space, anterior axillary line
- 2nd intercostal space, midaxillary line
- 5th intercostal space, midclavicular line
Correct answer: 2nd intercostal space, midclavicular line
The 2nd intercostal space at the midclavicular line (above the 3rd rib) is the standard US landmark for emergency needle decompression.
Question 4: A nurse discovers a patient with an O2 sat of 72% and increasing respiratory distress. The rapid response team arrives. Which action has the HIGHEST priority?
- Open the airway and apply high-flow oxygen (Correct answer)
- Draw an ABG and await results before intervening
- Notify the attending physician before touching the patient
- Obtain IV access and start a fluid bolus
Correct answer: Open the airway and apply high-flow oxygen
Airway and oxygenation are always the first priority; a sat of 72% represents life-threatening hypoxemia requiring immediate oxygen delivery.
Question 5: A code blue is called in a hospital corridor. The AED arrives and analyzes the rhythm as 'No Shock Advised.' The next step is:
- Resume CPR immediately for 2 minutes (Correct answer)
- Check for a pulse and, if present, begin rescue breathing only
- Administer epinephrine 1 mg IV/IO
- Reanalyze the rhythm every 30 seconds
Correct answer: Resume CPR immediately for 2 minutes
When the AED advises no shock, CPR must resume immediately; interruptions to chest compressions worsen outcomes in non-shockable rhythms like PEA and asystole.
Question 6: A patient is brought in after a house fire with suspected inhalation injury. Which clinical sign most urgently indicates impending airway compromise?
- Stridor and hoarse voice (Correct answer)
- Singed nasal hairs only
- Mild soot around the nares
- SpO2 of 95% on room air
Correct answer: Stridor and hoarse voice
Stridor and hoarseness indicate supraglottic edema and impending airway occlusion, requiring immediate intubation before the airway closes completely.
Question 7: During a pediatric emergency, a child's weight cannot be obtained. Which tool is standardly used in the US to estimate drug doses and equipment sizes?
- Broselow tape (Correct answer)
- Pediatric Glasgow scale
- APGAR scoring system
- Ballard maturity scale
Correct answer: Broselow tape
The Broselow tape uses the child's length as a surrogate for weight to provide color-coded drug doses and equipment sizes in pediatric emergencies.
OSCE Emergency Response Procedures 2
A patient in the ED suddenly becomes unresponsive and apneic with no pulse.
What is the correct sequence to initiate ACLS?