 | Brain Food is a project to drip feed clinical knowledge (in the form of mock SAQs) to satisfy those hungry neurons. Sources are SA/NT Trial Exam 2021.2 and Monash 2022.1. Answers are prone to ageing. Leave a comment if you don't understand or something doesn't seem right... PS we don't use the mock questions uploaded to ACEMs official mocks |
You receive a pre-notification call from the ambulance service, about a 5 year old boy who had a drowning episode in a pool nearby your rural emergency department.
1. List three 93) pieces of information you would seek from the paramedics? (3 marks)
- Immersion time
- Any ?or time to and type of BLS delivered
- Presence of cardiac arrest
- Time to first respiratory effort
- Details of treatment used
2. On arrival to ED, list two (2) predictors of a poor outcome for a drowning patient? (2 marks)
- Asystole
- CPR >25 minutes
- Dilated, non reactive pupils and pH <7.0
- Dilated, non reactive pupils and GCS <5
- Lactate
The child arrives and he is awake GCS15 with vitals:
HR 90
BP 90/50
Temp 34 degrees
Sats 99% on room air
RR20
He looks well and does not have any recollection of what happened.
You have been told that he is a competent swimmer and was found submerged for 2 minutes by his coach during training session in the pool.
HR 90
BP 90/50
Temp 34 degrees
Sats 99% on room air
RR20
He looks well and does not have any recollection of what happened.
You have been told that he is a competent swimmer and was found submerged for 2 minutes by his coach during training session in the pool.
3. List three (3) possible causes for his drowning. (3 marks)
- Neurological event (seizure)
- Hypoglycaemia
- Cardiac event (long QT syndrome, arrythmias, HOCM)
- Intoxication/drug ingestion
- Misadventure/foul play
- Inadequate supervision
- Trauma
You decide to admit him to your short stay unit for observation overnight.
4. Once a sinister cause has been excluded for his drowning, please state four (4) discharge criteria you would consider before discharging him the next day. (4 marks)
4. Once a sinister cause has been excluded for his drowning, please state four (4) discharge criteria you would consider before discharging him the next day. (4 marks)
- Observed for 8 hours from the time of drowning
- Asymptomatic
- Normal respiratory examination
- SpO2 >95%
- Education about water safety provided (handout)
- No ongoing safety concerns
- Referral to social work has been made if deemed appropriate
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