SAQ ANSWER GUIDE
SAQ 1
Should be a relatively easy administration question for most with the audit/QA cycle forming the
foundation to the process.
Candidates will have an administration workshop next week in which to review some of these
details.
Answers should include acknowledgement, investigation, privacy/confidentiality. Meeting with the
registrar as part of the investigation.
To make a decision on the severity of the allegations and whether to include human resources,
Director of Medical Services or equivalent, union reps etc.
The management plan of identifying the problems and some supervision or review process within a
reasonable timeframe. Completing the cycle.
Explore personal and professional issues that may be factors
SAQ 2
Management should address local factors of the epistaxis and direct management which includes,
direct pressure, vasoconstrictor sprays, tamponades, cautery, surgical ligation.
Management of the coagulopathy including complete temporary reversal of the INR with vitamin K,
FFP, prothrombinex. Assessment of the need for packed cells transfusion.
Most candidates should score well to pass the discriminator comes from the extent of the detail and
the number of options they consider.
SAQ 3
An administrator question that is also current topic in the emergency medicine field. How far do we
need to go to track patients down with abnormal findings? This has been the basis of coronial
inquiries, RCA’s and other inquiries in all states.
Candidates should recognize the severity of the potential diagnoses and therefore the extent they
should go to. This should include activation of the police force to locate and return the patient to
hospital. Arrangements with cardiology, respiratory or other service for early involvement when
the patient returns.
Additional marks for consideration of strategies to minimise the potential for future events to
include radiological notification of abnormal findings
SAQ 4
This question should explore the thinking of candidates in terms of trauma priorities in regards to
pelvic and abdominal injuries. By telling the candidates of the injuries they should focus on the
detail rather than attempting to cover all injury possibilities. Considerations of radiological control
of the bleeding or surgical fixation that will depend on the type of institution and therefore need
transfer in most cases. What would be used as temporary measures, splinting/binding of long bone
and pelvic fractures. Always considering the ongoing intrabdominal bleeding and repeat FAST
examinations.
Fluid resuscitation and the point of blood replacement instead of crystalloid.
SAQ 5
Explores the knowledge of containment of infectious agents within the ED environment as well as
the assessment and treatment of the patient. A risk assessment for the rest of the department and
planning for multiple presentations with similarly infectious condition; better candidates will
consider departmental factors within part (a) as well as the patient’s condition.
Part(b) involves the hospital approach and consultation/liaison with intensive care, respiratory
physicians, public health and hospital management. A process of triage and isolation with
movement away from the ED unless needing resuscitation which may also include moving patients
to intensive care as an alternative. Similar scenarios to the SARS, bird flu situations that were asked
a few years ago.
Question taken from 2007/2 exam
Good answers identified standard measures including PPE, isolation options, early diagnosis and consultation with
Public Health, ID etc. Part B required a more systems approach to mass presentation of possibly infective patients
and included designation of specific areas, staff etc and early activation of disaster/pandemic plan options.
Failed answers either did not address PPE/masks or did not involve Public Health.
SAQ 6
This has previously been asked and applied to a trauma scenario but this time it is applied to a
breathless patient and therefore the focus of the answer should be along these lines. The major
anatomical and physiological factors pertaining to the possible causes of breathlessness in a 3rd
trimester pregnancy. A core topic and should allow the good candidates to show off their structured
approach.
SAQ 7
Asked previously in various guises so should be core knowledge for most but better answers will
use the literature and provide more critical analysis.
SAQ 8
An old favorite but always shows some discrimination between candidates . The main differential
they should consider being ischaemia, retroperitoneal bleeding, obstructions and other colonic
inflammatory conditions such as diverticulosis. Answers should look for relevant positives and
negatives for their differential list.