Intro to Emergency Med

Question 1

What is the AVPU scale of consciousness? (aka what do the letters mean?)

Answer 1

Alert
Verbal stimuli
Painful stimuli

Question 2

What are Decision points A, B, & C when triaging a patient?

Answer 2

A= Requires immediate assessment and intervention (intubation, Brady/tachy, unresponsive)

B= Pt has abnormal vital signs

C= Multiple tests/resources are needed

Question 3

What does the EMTALA law ensure?

Answer 3

Ensures that all patients receive a medical screening exam regardless of their ability to pay

Question 4

What 5 things are required in order to transfer a patient?

Answer 4

• Patient request: must have written request signed
• Benefit of transfer outweighs risk of non-transfer
• Stable means
• Must have accepting provider w/ available resources
• Send copied of diagnostic test results

Question 5

What is the 250 yards rule?

Answer 5

A person dropped off within 250 yard of an ER must be seen

Question 6

What is implied consent? Expressed consent?

Answer 6

Implied= pt acts in such a way as to indicate agreement w/ plan

Expressed= orally or written agreement

Question 7

How do you obtain informed consent? (AKA what do you need to do in order to make it “informed”)

Answer 7

• notify pt of reasonable risks, benefits, and alternative to treatment
• shared decision making
• explain in a manner in which the pt can understand

Question 8

What type of pt is unable to consent of refuse their own treatment?

Answer 8

Incapacitated pts (drug/alcohol intoxication, severe depression, AMS, SI, head injury)

Question 9

What must be documented if a patient would like to refuse/leave AMA?

Answer 9

Must document pt is competent to refuse care

Question 10

45 y.o. M presents w/ abd pain x 2 days. PMHx unremarkable. 90/60, 114, 20, 102 F, 96%.
What ESI number would you assign?

Answer 10

2

Question 11

73 y.o. M w/ sutures places in arm 10 days ago & presents for suture removal. No other complains, nl vitals.
What ESI level would you assign?

Answer 11

5

Question 12

A pt presents to your ED w/ eye injury. You do not have ophthalmology services available but determine he should be seen by a specialist/ What process do you need to do to get him transferred?

Answer 12

EMTALA

Question 13

Pt w/ risk factors for CAD, who is being evaluated for CP. He becomes belligerent w/ staff and demands to leave. The nurse hands you the AMA paperwork and discharges him, Should you be concerned, why/why not?

Answer 13

YES! AMA paperwork does not mean they can’t sue you. This is a very high risk pt.