SAQ- Administration

 ADMINISTRATION WEEK 1

2004/1/SAQ1: You are the director of an emergency department. Your staff have brought to your attention the case of a 24 year old woman who has presented to your emergency department on 15 occasions in the past two weeks. On each occassion she complains of sever abdominal pain. Investigations have failed to find a cause. She has recently moved to your area from interstate, where she states 'the doctors couldn't help me. When given analgesia, she usually leaves the department without further assessment. How would you deal with this problem? 

2008/2/SAQ2: You have been called to assist a junior doctor dealing with an upset family. The family is unhappy with the proposal of a “Do Not Resuscitate” order for their elderly mother. Outline your approach to this situation. (100%)

2001/2/SAQ1: Following an adverse event involving excessive use of intravenous analgesia by a junior medical officer in your emergency department, you are asked to review practices and develop a procedural sedation policy for emergency department patients. Describe the processes and issues specific to the development of such a policy

2003/1/SAQ1: You are the ED director. Your CEO has told you that in order to save costs, he wishes to set up a GP clinic in the hospital grounds beside your ED to see category 4 & 5 patients. Outline your advice to him on this issue

worked answers

ADMINISTRATION WEEK 2

2004/2/SAQ1: You are notified by the director of an ICU from another hospital about a 63 year old male who presented to your ED with a large subarachnoid haemorrhage. He is now in the ICU with a poor prognosis. This patient attended your department 48 hours earlier with the presenting complaint of "headache". He left the waiting prior to being seen. How would you manage this incident? (100%)

2005/1/SAQ6: The mother of a child makes a complaint. She states that three days previously, her 5 year old son had presented to the emergency department with elbow pain after a fall onto his outstretched hand. Following X-rays, the treating doctor had “pulled on the elbow several times causing him to cry”. The doctor stated that he had suffered a “sprained elbow” and to return if the pain did not settle. The mother is distressed that her son had received no analgesia for the sprain and that he continued to not move the elbow because of pain. She also complained that the doctor spoke in a rude and insulting manner, and was very rough in his examination. During your investigation, you find that the official report of the X-ray revealed a supracondylar fracture.Describe your management of this situation.

2005/2/SAQ1: You are the Director of the emergency department with the following problem. The hospital’s access block is 47% and its bed occupancy is 92%. Describe your strategies to reduce access block in this situation. (100%)

2006/1/SAQ1: Outline the evidence for therapeutic hypothermia in post cardiac arrest patients (30%). Describe a protocol for therapeutic hypothermia in your emergency department (70%)

worked answers

ADMINISTRATION WEEK 3

2006/2/SAQ8: The table shown describes the performance by Australasian Triage Scale (ATS) of your emergency department over a one month period. Describe the performance of your emergency department in this month with reference to the Australasian College for Emergency Medicine’s recommended performance indicator thresholds. (30%). What measures could be used to improve your emergency department’s performance in relation to the data presented above. (70%)

2007/2/SAQ4: Following a period of prolonged resuscitation, a 4 year old child has died in your emergency department as a result of a home pool drowning. The child’s parents have just arrived at triage and are unaware of what has happened. Outline how you would deal with the important issues raised in this situation. (100%)

2007/2/SAQ7: Outline the spectrum of possible emergency department presentations resulting from metamphetamine use (30%). Outline your approach to the treatment of acute behavioural disturbance caused by methamphetamine toxicity (70%)

1996/1/SAQ2: Describe how you would recognise and manage a case of domestic violence. (100%)

worked answers

ADMINISTRATION WEEK 4-PROTOCOL

2009/1/SAQ1: Write a guideline for the assessment of first trimester bleeding (100%).

2006/1/SAQ1: a. Outline the evidence for therapeutic hypothermia in post cardiac arrest patients (30%). b. Describe a protocol for therapeutic hypothermia in your ED. (70%)

2005/2/SAQ8: Describe a detailed protocol for the emergency department management of paediatric gastroenteritis. (100%)

2005/1/SAQ4: Describe a detailed protocol for the use of propofol in the emergency department. (100%)

2011/1/5: There have been a number of incidents in your emergency department short stay unit where patients have unexpectedly deteriorated during their stay. You have been asked to find solutions to this problem. a) List the factors that may contribute to this situation (30%). b) Describe the strategies you could implement to prevent their recurrence (70%).

examiner's comments

2010/2/SAQ1: You have been telephoned by a 45 year old man who received treatment in you emergency department three days ago for neck pain after a motor vehicle collision.  At that time, he was told the cervical spine X-rays were normal and was discharged home.  His neck pain persisted, so his GP checked the hospital radiology result which reported a unifacet dislocation of C4 on C5. Describe how you would deal with this patient (50%). Outline other actions you would take in following up this error (50%).

2010/1/SAQ 2: You are the Director of an emergency department. You have received allegations from the Head of the Division of Medicine that an emergency physician in your department has been consistently rude and condescending to its medical registrars. Describe the actions you would take in response to these allegations. (100%)

examiner's comments

2009/2/SAQ 3: A 45 year old man with chronic pancreatitis has presented to your emergency department on multiple occasions in the last two months requesting analgesia for abdominal pain. His behaviour has become increasingly demanding and belligerent. A personalised management plan is now required. Describe the process for the development of this management plan (50%). Outline the important features to be included in this plan (50%).

examiner's comments

2008/1/SAQ7: You are the Director of Emergency Medicine in a 150 bed district hospital. Your Chief Executive Officer is concerned about your ‘did not wait’ (DNW) rate of 15%. Describe your approach to this situation.   (100%)

examiner's comments

2008/1/SAQ5: Write a set of guidelines for the use of physical restraints on a patient in the emergency department. (100%)

examiner's comments

2007/1/SAQ3: A number of staff have been assaulted over the last 6 months in your emergency department. Outline strategies to improve staff safety from violence in your emergency department.(100%)

examiner's comments

2001/2/SAQ1: Following an adverse event involving excessive use of IV sedation by a junior medical officer, you are asked to review practices and develop a procedural sedation policy for ED patients. Describe the process and issues specific to the development of such a policy (100%)

examiner's comments

2001/1/SAQ3: Discuss the management of a Junior Medical Officer who, while working in your Emergency Department, has sustained a needle stick injury from a patient known to be HIV positive. (100%)

examiner's comments

2001/1/SAQ 4: Discuss the advantages and disadvantages of setting up a chest pain evaluation unit in an Emergency Department.(100%)

examiner's comments