Week 13: Disaster/ Retrieval/ Pre-Hospital
1. 2006.1 Q2
You are the consultant in charge of the emergency department in a tertiary
hospital. The ambulance service calls at 1000 hours on a weekday warning that
they are at the scene of a major motor vehicle crash. They have 6 patients – 5
adults and a 12-month-old infant, all in a serious condition. They will be arriving
at your department in 10 minutes.
Question
Describe your response to this situation
(100%)
2. 2008.2 Q6
You have been advised by Emergency Medical Services of a bus versus petrol
tanker accident with mass casualties.
Describe how you would configure and deploy a medical team to the accident
scene.
3. 2011.2 Q2
A morbidly obese but otherwise healthy 30 year old woman is brought to your
emergency department suffering from shortness of breath after a 3 day viral
(100%)
prodrome. You estimate her weight to be 150kg.
Her vital signs are:
A chest X-ray reveals an extensive bilateral infiltrate
Question
Describe your management of this patient
(100%)
4. 2012.2 Q5
5. 2013.1 Q6
After your routine morning handover you are approached by one of your night
registrars who reports that another of your hospital’s emergency department
specialists was seen overnight in the emergency department after a suspected
recreational drug overdose. The specialist discharged himself against medical
advice after a few hours in the emergency department. A urine toxicology sample
obtained overnight was positive for the presence of amphetamines and
benzodiazepines.
Describe how you would deal with this situation (100%)
6. 2013.1 Q8
You are working in a tertiary referral centre that houses the local hyperbaric
chamber. You are contacted by a GP working in a remote GP staffed medical
centre located 150 km away. They have a 30 year old male diver with suspected
decompression illness and suspected aspiration. The GP is requesting advice and
your retrieval of this patient.
Current observations:
GCS 14 (V4)
HR 60 /min
BP 95/50 mmHg
RR 28 /min
Temperature 34.0 oC
O2 Saturation 92 % 8L/min Oxygen by Hudson mask
a) Outline your instructions for patient management prior to your arrival (30%)
b) Describe the important steps in the retrieval of this patient (70%)
7. 2012.2 Q5
A member of the police force presents to your urban district hospital
emergency department after being stabbed in the shoulder with a freshly
used hypodermic needle whilst working. Assessment of the patient shows
no acute wound repair is needed.
Describe your management of this patient (100%)
8. 2013.2 Q4
A morbidly obese (200kg) male was a front seat passenger involved in a high speed
motor vehicle crash. The car was extensively damaged. He is complaining of severe
chest pain and has abdominal seatbelt bruising.
Observations are:
P 130 beats/min (regular)
BP 103/64 mmHg
RR 32 /min
SaO2 91 % on non-rebreathing oxygen mask
GCS 14
Outline the problems you anticipate in his
(a) Investigation (50%)
(b) Management (50%)