UTC Emergency Procedures & Response 3 — Questions and Answers
Question 1: A pregnant patient at 20 weeks gestation becomes hypotensive and pale during a supine abdominal ultrasound. The most likely cause is:
- Aortic dissection
- Aortocaval compression syndrome (Correct answer)
- Placental abruption
- Pre-eclampsia
Correct answer: Aortocaval compression syndrome
Supine hypotensive syndrome occurs when the gravid uterus compresses the inferior vena cava; repositioning to left lateral decubitus relieves symptoms.
Question 2: During contrast-enhanced ultrasound (CEUS), a patient develops urticaria, bronchospasm, and hypotension within minutes of injection. This reaction is classified as:
- Mild local reaction
- Anaphylactic reaction (Correct answer)
- Vasovagal response
- Contrast nephropathy
Correct answer: Anaphylactic reaction
Urticaria, bronchospasm, and hypotension together constitute anaphylaxis, a severe systemic allergic reaction requiring epinephrine administration.
Question 3: When performing ultrasound on a patient who has experienced trauma, which finding requires the most urgent communication to the trauma team?
- Mild hepatomegaly
- Free fluid in the hepatorenal space (Morrison's pouch) (Correct answer)
- Gallbladder wall edema
- Bilateral pleural effusions
Correct answer: Free fluid in the hepatorenal space (Morrison's pouch)
Free fluid in Morrison's pouch in a trauma patient indicates hemoperitoneum, a life-threatening emergency requiring immediate surgical evaluation.
Question 4: A patient undergoing ultrasound-guided biopsy suddenly develops a rapid heart rate, pallor, and near-syncope. The sonographer should first:
- Continue the procedure with increased monitoring
- Stop the procedure and place the patient in Trendelenburg position (Correct answer)
- Administer IV fluids immediately
- Document the vasovagal episode and reschedule
Correct answer: Stop the procedure and place the patient in Trendelenburg position
Vasovagal syncope during procedures is managed by stopping the procedure and lowering the patient's head to improve cerebral perfusion.
Question 5: Which medication is the first-line treatment for anaphylaxis in a clinical setting?
- Diphenhydramine (Benadryl)
- Hydrocortisone
- Epinephrine (adrenaline) (Correct answer)
- Albuterol inhaler
Correct answer: Epinephrine (adrenaline)
Epinephrine is the only first-line treatment for anaphylaxis, acting to reverse bronchospasm, vasodilation, and urticaria rapidly.
Question 6: A sonographer notices a patient's oxygen saturation drops from 98% to 84% mid-examination. The next appropriate step is to:
- Complete the scan quickly to minimize patient stress
- Reposition the probe and continue monitoring
- Halt the examination, administer supplemental oxygen, and notify staff (Correct answer)
- Assume it is a probe artifact and continue
Correct answer: Halt the examination, administer supplemental oxygen, and notify staff
An SpO2 of 84% represents significant hypoxemia requiring immediate examination cessation, oxygen delivery, and physician notification.
Question 7: During a neonatal cranial ultrasound, the infant stops breathing and turns cyanotic. The sonographer's immediate response should be:
- Continue scanning while calling for help
- Activate the emergency response system and begin infant BLS (Correct answer)
- Apply oxygen by mask and wait for color improvement
- Rub the infant's back to stimulate breathing
Correct answer: Activate the emergency response system and begin infant BLS
Respiratory arrest in a neonate is a full emergency requiring immediate activation of the emergency team and commencement of infant basic life support.
UTC Emergency Procedures & Response 3
A pregnant patient at 20 weeks gestation becomes hypotensive and pale during a supine abdominal ultrasound.
The most likely cause is: