DMTR Final Exam 14-09-2022 Quiz

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Which of these answers are most reasonable ?1
ATLS
- As an experienced DMT you should utilse less medically trained personel in the vincinity if required.
- The DMT must wait to provide medical care, they need to operate under medic instruction.
- The DMT must deal with casualties. They have no medical authority to give instructions.
- Legally, only offshore personnel with medic training can deal with casualties.
What is the function of the pleural cavity?1
ANATOMY & PHYSIOLOGY
- to create a low friction zone to decrease respiratory effort.
- To stop air seeping in from the chest wall.
- To aid in alveolar gas transfer
- To protect the pulmonary circulation
Symptoms of CNS oxygen toxicity include;1
GAS TOXICITY
- The casualty appear intoxicated
- Diarrhoea and vomiting
- Tinnitus, tunnel vision, nausea and convulsions.
- A persistent cough with sub-sternal burning
A strong smell of rotten eggs that disappears quickly whilst well head diving is of no concern.1
GAS TOXICITY
- These are all potential H₂S symptoms.
- These are all potential CO₂ poisoning symptoms.
- These are all potential CO poisoning symptoms.
- These are all potential stroke symptoms.
Finger tingling may be symptoms of hyperventilation1
DMT Immediate Care
- This is potentially CO₂ toxicity
- Low CO₂ & Calcium levels can cause these symptoms.
- This is more likely to be DCI
- This is potentially H₂S toxicity
When is Pulmonary Oxygen Toxicity likely1
GAS TOXICITY
- Prolonged exposure to ppO₂ above 0.6b is likely to cause lung damage.
- The diver breathes 2.8 bar ppO₂ for over 15 minutes
- The divers UPTD ≥ 500
- When the breathing gas is cold
What is the correct Ratio for CPR.1
Intermediate Life Support
- Hands only CPR is now preferred
- 15 compressions to 1 breath is the correct Ratio for CPR.
- 30 compressions to 2 breaths is the correct Ratio for CPR.
- 30 compressions to 5 breaths is the correct Ratio for CPR.
How long is it safe to administer oxygen for ?1
Oxygen Therapy
- 0.6 bar for greater than 24hrs will exceed UPTD limits.
- It is safe to give 100% O₂ for 36 hrs if the patient is at the surface.
- It is safe to give 100% O₂ for 24 hrs if the patient is at the surface.
- 0.4 bar for greater than 18 hrs will exceed UPTD limits.
When should a B.M.V. (Bag & Mask Valve) be used ?1
Oxygen Therapy
- A B.M.V. (Bag & Mask Valve) is appropriate if a casualty has 6 breaths per minute.
- A B.M.V. (Bag & Mask Valve) is inappropriate if a casualty has 18 breaths per minute.
- Should only be used when the casualty is NOT breathing
- A B.M.V. (Bag & Mask Valve) is appropriate if a casualty has 40 breaths per minute.
Is it safe to use the iGEL airway in a Hyperbaric environment.1
AIRWAY CARE
- Yes. Its the preferred Supraglotal Airway.
- No. The LMA (Laryngeal Mask Airway) is preferred.
- Yes. However, silicone based lubricant must be used.
- With caution. The iGEL is subject to the effects of Dalton's law.
The iGEL is a popular choice in pre-hospital emergency care. Which of these statement is correct:1
AIRWAY CARE
- The iGEL can be placed without the need for sedation or anaesthesia.
- The iGEL can be maintained for ≥ 48 hours
- The iGEL is the airway of choice if the casualty has inhaled hot gasses
- Caution is needed. The casualty can still aspirate gastric content even when the iGEL is correctly placed.
Why is Pre-oxygenation used prior to intubation ?1
AIRWAY CARE
- It has a sedation effect
- The patient is profoundly hypoxic during the intubation process. Pre-oxygenation increases metabolic oxygen reserves.
- To relax the larynx
- To give the AIRWAY Team Member time to prepare
Is sedation always necessary when intubating a casualty ?1
AIRWAY CARE
- The only casualty you can intubate without drugs is the dead casualty (GCS 3)
- Most casualty’s do not need to be sedated prior to intubation.
- Yes
- Practically never
What will you have to do with an ET tube in a DDC / Sat chamber1
AIRWAY CARE
- Try to use a LMA
- The cuff of an E.T. tube should be filled with water
- Leave the cuff deflated
- Compensate for depth changes by adding & filling cuff
What is the correct procedure for administering an Intra-Muscular Injection ?1
INJECTIONS
- Sterilise, Select correct area, Insert needle (21g), aspirate, Inject & release traction, Remove, dispose in sharps bin.
- Sterilise, Select correct area, apply traction to achieve Z track, Insert needle (21g), Inject & release traction, Remove.
- Sterilise, Select correct area, apply traction to achieve Z track, Insert needle (23g / 21g), aspirate (abandon if flashback), Inject & release traction, Remove, dispose in sharps bin.
- Sterilise, Select correct area, apply traction to achieve x track, Insert needle (25g), aspirate (abandon if flashback), Inject & release traction, Remove, dispose in sharps bin.
The management of a compressible bleed is:1
HAEMORRHAGE CONTROL
- Raise limb, apply indirect pressure. Place a field dressing on, bandage. If bleed through, apply another bandage onto of primary dressing.
- Raise limb, apply direct pressure with a dressing or gauze, for a maximum of 3 minutes, bandage when bleeding has stopped.
- Raise limb, apply direct pressure with a dressing or gauze. If bleeding has not stopped after 1 minute apply an arterial tourniquet
- Raise limb, apply direct pressure (at least 150mmHg) with a dressing or gauze, for a minimum of 3 minutes, bandage when bleeding has stopped.
What is the appearance of an arterial bleed ?1
HAEMORRHAGE CONTROL
- Dark red and gushes
- Red and slight
- Dark red and oozes
- Bright red & spurts in time with the heart rate.
The casualty has a catastrophic large limb haemorrhage1
HAEMORRHAGE CONTROL
- Apply a CAT Tourniquet. Release pressure every 20 minutes.
- Rapidly apply a CAT Tourniquet & seek medical help
- Elevate. Apply a pressure bandage for a minimum of 3 minutes apply tourniquet if the patient still has blood
- Only trained medical staff (Doctors / nurses / paramedics) are allowed to use a C.A.T. tourniquet.
What is most likely to kill a casualty ?1
ATLS
- A respiratory rate of 8 BPM
- A systolic B/P of 80mmHg
- A heart rate of 180 BPM
- A GCS < 4
What cannula choice is most appropriate in an emergency1
VASCULAR ACCESS
- A 22g (blue) cannula is the first choice in resuscitation.
- A 18g (Green) cannula is the first choice in resuscitation.
- Two 16g (Grey) cannulas are the first choice in resuscitation.
- Two 20g (pink) cannulas are the first choice in resuscitation.
What veins are preferred when obtaining a blood sample.1
VASCULAR ACCESS
- The anti-cubital fossa
- The Basilic veins
- The metacarpal veins
- The cephalic veins
Who can the Fast1 I.O. Device be used on ?1
VASCULAR ACCESS
- The Fast1 may be used on a casualty who has had a heart attack.
- The Fast1 may be used on a casualty who has a fractured sternum.
- The Fast1 may be used on a small adult who weighs 41kg.
- The Fast1 may be used on a casualty who has a cervical spinal collar.
Where would you place a FAST1 I.O. Device ?1
VASCULAR ACCESS
- The Fast1 should be inserted in the manubrium of the sternum.
- The Fast1 should be inserted in the Femoral Bone.
- The Fast1 should be inserted in the Tibial Tuberosity.
How an you distinguish between Syncope and shock?1
ATLS
- Fast respiratory rate
- Dilated pupils
- Slow bounding pulse & quick spontaneous recovery
- Low blood pressure and fast pulse
Which electrical shock injury may be more dangerous1
ATLS
- Left leg entry, right leg exit
- Right arm entry, right leg exit
- Right arm entry, left leg exit
- Right leg entry, left leg exit
Neurogenic shock may be caused by:1
ATLS
- A spinal bend
- A viral infection
- A traumatic liver laceration
- A myocardial infarction
Category 3 shock will present when the casualty has lost how much blood?1
ATLS
- 2000ml
- 1500ml
- 250ml
- 1200ml
What thing might NOT cause hypovolaemic shock1
ATLS
- Spinal Bend
- Heat exhaustion
- Severe bleeding
- Severe burns
You discover a casualty. He has been working on a clothes dryer .A) His airway is compromised. B) His breathing rate is 3 BPM, agnolial pattern C) He has no radial pulse. He has no pulse. He is very clammy to the touch. D) He is not responding. Pupils are both size 8, unreactive e) No other injures.1
ATLS
- Signal For help. A) Place in recovery position. B) Give High flow O₂ via BMV. C) Elevate legs, then recheck C. E) Give CPR at 30:2
- Signal For help. A) Place an O/A airway. B) Give High flow O₂ via face-mask C) Elevate legs, then recheck C. E) Give CPR at 30:2
- Signal For help. A) Place an airway. B) Give High flow O₂ via BMV. C) Elevate legs D) Administer Oxygen
- Call for medic, report your finding, ask for an AED. Signal For help. Give CPR at 30:2 ratio until medic & supplies arrive. Attach AED & follow instructions. Run the ABCDE's
Which of the following are symptoms of neurological DCI ?1
DIVE MEDICINE
- Rash & itchy chest
- Pain in the knee
- Pain in elbow
- Weakness & Fatigue
You discover a casualty. He has been working on deck as a standby Diver for the last 6 hours.A) His airway is partially compromised. B) His breathing rat is 40 BPM. C) He has no radial pulse. His femoral pulse is 160 BPM. He is very hot & dry to the touch. D) He is responding to voice, but is confused & incomprehensible. Pupils Normal. e) No other injures. His whole body is hot & dry. What are your Immediate actions ?1
ATLS
- Signal For help. A) Place an NP airway. B) Give High flow O₂ via mask. C) Elevate legs, then recheck C. E) Move to shaded area, cool casualty
- Signal For help. A) Place an OP airway. B) Give High flow O₂ via BMV C) Give oral fluids E) Move to shaded area, cool casualty
- A) Place an iGEL airway. B) Give High flow O₂ via BMV C) Gain Vascular Access, Administer IV Fluid in pulses of 750mls, then recheck C. D) Administer an RSI E) Move to shaded area, cool casualty internally
- Signal For help. A) Place an iGEL airway. B) Give High flow O₂ via mask. C) Gain Vascular Access, Administer IV Fluid in pulses of 1000mls, then recheck C. E) Move to shaded area
Following successful treatment for DCI, a diver should not fly above 8000 ft1
DIVE MEDICINE
- 12 hours
- 24 hours
- 7 days
- 72 hours
The most common type of DCI is:1
DIVING MEDICINE
- Neurological
- Pulmonary
- Musculo-skeletal
- Spinal
What percentage of DCI symptoms present within 3 hours?1
DIVING MEDICINE
- 60%
- 4%
- 19%
- 86%
You are a standby diver helping in Sat Control on a DSV. You suspect a diver decompressing in the chamber from a bounce dive has a pneumothorax, would you ?1
DIVING MEDICINE
- Give him a higher ppO₂ on BIBS
- Recompress to 50m and call the medic
- Stop decompression immediately, alert DMT & lock in DMAC 15 Kit
- Switch to saturation decompression
A pneumothorax is caused by :1
DIVING MEDICINE
- Escape of air from lungs into the right atrium.
- Air escaping through the lung surface and collecting in the pleural cavity
- Air escaping from the lungs into the surrounding tissue
- Escape of air from lungs into the bloodstream
Where would you place a needle to treat a tension pneumothorax?1
DIVING MEDICINE
- 22g cannula. 2nd Intercostal Space / Clavicular line
- 18g cannula. 3rd Intercostal Space / Mid Clavicular line
- 16g cannula. 5th Intercostal Space / Mid Axillary line
- 14g cannula. 2nd Intercostal Space / Mid Clavicular line
After a pulmonary barotrauma, a diver may not return to diving before…?1
DIVING MEDICINE
- At least 1 month after full recovery
- At least 1 week after full recovery
- At least 12 months after full recovery
- At least 3 months after full recovery
What is barotrauma?1
DIVING MEDICINE
- Emphysema
- Decompression sickness
- Pneumothorax
- Pressure related injury
Choose the correct statement about Intra-Osseous Devices1
VASCULAR ACCESS
- A disadvantage to an I.O. is that only a small volume of I.V. fluid & no I.V. drugs can be administered.
- ≥ 125ml per minute flow. I.V. RSI & opiates can be administered
- ≥ 125ml per hour flow. I.V. RSI & opiates can be administered
- An advantage is that a large amount of IV fluids can be administer. A disadvantage is only small volumes of IV drugs can be administered.
The casualty is in the middle of an intubation using RSI Drugs. The Circulation Team member declares that the patients B/P has dropped to 70/45 mmHg. What do you do?1
ATLS
- Give Epinephrine 5000mcgs IV (as instructed). Check B/P & prepare to give a 2nd 5000mcg dose.
- Give Saline 0-9% 250mls IV (as instructed). Check B/P & prepare to give a 2nd 250mls
- Give Gelifusion 250mls IV (as instructed). Check B/P & prepare to give a 2nd 250mls
- Investigate casualty for sudden blood loss.
You are treating this diver who has a weeping wound under his arm pit. He deteriorates. Refer to the Obs Chart. What is happening?1
CONTINUING CARE
- He has Septic Shock.
- He has Cardio-Genic Shock
- He is having a stroke.
- He is clinically dehydrated.
Complications of a rapid I.V. fluid resuscitation include:1
ATLS
- Pulmonary odeama, haemo-dilution & increased bleeding risk.
- It's relatively safe. The fluid will be absorbed rapidly.
- Sudden cardiac arrest
- Embolic stroke
What Vital Sign will alert you first in a casualty suffering from shock ?1
ATLS
- A Capillary Refill Time ≥5 seconds
- A drop in Respiratory Rate
- A drop in Blood Pressure
- A drop in Urine output.
What are the signs of a tension pneumothorax ?1
TENSION PNEUMOTHORAX
- Absence of breath sounds in affected lung
- Sudden Breathlessness
- Pulmonary oedema & collapse shortly after a dive.
- Hyper-resonance on affected side, distended neck veins, shifting trachea & Signs of cardiovascular compromise.
The diver has suffered a over expansion injury to his Right Lung after a dive. It was a Simple Pneumothorax. He was ABCDE treated. He has Oxygen via a Face Mask & has vascular access. He deteriorates suddenly. Refer to the Obs Chart. What is happening ?1
CONTINUING CARE
- This is a Vast-Vagal Attack. Elevate his legs, give a bolus of crystalloid. He will rapidly respond.
- He's developed a Tension Pneumothorax. Immediate needle decompression is necessary.
- He's having a stroke.You need immediate medical assistance & intubate.
- An alveolar leak has caused a Pulmonary Arterial Gas Embolism. You need to compress him in a DDC immediately
An air diver has rapidly ascended to the surface from 28m following a lift bag incident. He collapses shortly after exiting water. He has a seizure flops around on ground. What is he probably suffering from ?1
ATLS
- P.A.G.E.
- Tension Pneumothorax
- C.A.G.E.
- Cerebral Oxygen Toxicity
What is the purpose of a venous tourniquet when cannulating or taking blood?1
VASCULAR ACCESS
- To minimise bleeding during vascular access process.
- To reduce microbial infection rate.
- The stop venous return. Engorge veins to aid vascular access.
- To stop arterial & venous supply to aid vascular access process.
the iGEL tube has a Naso-Gastric port. What would you use this for ?1
AIRWAY CARE
- It actually equalises the pressure as you ventilate the casualty
- The port allows ETCO₂ measurements.
- To insert a NG Tube, remove gastric content to reduce risk of gastric aspiration.
- To feed the casualty at the 6hr mark.
Why would you want to feed a shocked casualty via an NG tube WITHIN 4 hours of their incident ?1
IMMEDIATE CARE
- You do not. This is a dangerous practice
- To perfuse the gut and reduce the risk of Bacterial Translocation of the Gut / sepsis
- To avoid refeeding syndrome.
- To meet the calorific requirements the casualty needs.

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