Arab Board Emergency & Disaster Nursing Part 1 common mistakes
Arab Board Emergency & Disaster Nursing Part 1 · Understand the traps and how to avoid them.
Deriving the triage acuity from the diagnostic label in the vignette (for example, treating every asthmatic or every chest-pain patient as the same priority) instead of from the measured objective data, and ranking simultaneous arrivals by order of presentation rather than by physiologic threat.
Candidates memorise category labels as a vocabulary list and then pattern-match the diagnosis, because that is faster under time pressure. Exam vignettes deliberately bury the decisive value (SpO2, respiratory rate, work of breathing, capillary refill) in the final clause, so the diagnosis is the most salient cue available.
What to do instead
Adopt a fixed reading order: read the last sentence of the item first, copy every vital sign and objective finding into a small table on the scratch sheet, then apply the triage algorithm's danger-zone criteria and resource prediction to that table. Practise at least 30 items in which the diagnosis points one way and the objective data point the other, and justify each answer with the specific value that set the level.
Applying the mass-casualty sorting sequence out of order, most often writing off an apnoeic casualty as deceased before repositioning the airway and giving two rescue breaths, or awarding a delayed category to a casualty who can walk because the visible injury looks severe.
The sorting algorithm is learned as a list of labels rather than as a strict sequence with decision points, and emotional response to dramatic injuries overrides the physiological criteria. Under timed conditions, skipping the airway step feels efficient.
What to do instead
Rehearse the sequence verbatim as a motor routine: walking casualties first, then breathing after airway repositioning, then respiratory rate, then perfusion, then mental status, and only then a category. Drill 20 casualty cards in under four minutes each, verbalising every decision point aloud, until the airway step is never skipped.
Calculating burn resuscitation fluid from the clock time at arrival or from the time the drip is started, rather than from the time of injury, and applying adult weight-based percentage formulas unchanged to a small child.
The formula is recalled as a single equation, and the two clocks (time of injury, time of arrival) are not distinguished when the item presents them close together. Paediatric percentages are learned separately and are not retrieved when the vignette does not say 'child' in the first line.
What to do instead
Write the equation with its clock explicitly attached: total volume over 24 hours from the time of the burn, with half in the first eight hours from injury, so the elapsed prehospital time must be subtracted. Before calculating, state the patient's age band and the surface-area chart you are using, then check the answer against a urine-output target rather than trusting the arithmetic alone.
Selecting an algorithm from the rhythm description before confirming whether a pulse is present, for example moving straight to synchronised cardioversion for a wide-complex tachycardia without first establishing that the patient has a pulse and is unstable.
Rhythm recognition is the most visually memorable part of resuscitation teaching, so it anchors the response. The pulse check is a one-line detail in the stem and is easily absorbed into the assumption that a monitored rhythm implies arrest.
What to do instead
Use a two-column scratch layout headed 'pulse present' and 'no pulse'. Fill the column only after locating an explicit statement about pulse, consciousness and blood pressure in the stem; if any of the three is absent, treat the item as unanswerable until reread. Rehearse aloud: rhythm, then pulse, then stability, then treatment.
Reading a blood gas as normal because the pH falls inside the reference range, without checking whether the carbon dioxide and bicarbonate indicate compensation, and without calculating the expected compensatory change.
The pH is printed first and is visually dominant, and the candidate has learned 'normal pH means normal gas' as a shortcut. Compensation is taught as a separate lecture, so it is not retrieved at the point of interpretation.
What to do instead
Use a strict three-step routine on every gas: name the primary acid-base derangement from the pH and carbon dioxide or bicarbonate, then test whether the other value moves in the compensatory direction, then compare the measured value with the expected value using the appropriate formula. Practise with ten gases where the pH is normal but the physiology is not.
Scoring the Glasgow Coma Scale mechanically, for example recording eye opening as one for an intubated or sedated patient without the tube or sedation modifier, summing the components when a component cannot be tested, or describing the total score as a diagnosis of coma.
The scale is learned as three numbers to be added, and the caveats about untestable components are seen as trivia. The total is easier to remember than the component pattern, so the total substitutes for clinical reasoning.
What to do instead
Always record the three components separately with the modifier attached, for example eye, verbal and motor with a T or sedation note, and state that an untestable component is not scored rather than scored as the lowest value. Before answering, ask what the component pattern means for airway protection and for the trend compared with the previous observation.
Managing a pregnant trauma patient supine on the stretcher with the focus on fetal monitoring, while haemorrhage control, airway and blood pressure support for the mother are delayed or deprioritised.
The pregnancy is the salient feature of the vignette and attracts attention, and fetal heart tones feel like the most urgent piece of data to obtain. Left uterine displacement is taught in obstetric teaching and is not retrieved during trauma scenarios.
What to do instead
State the governing rule before answering: the fetus is resuscitated through the mother, so maternal airway, breathing, circulation and haemorrhage control come first. Then apply left lateral tilt or manual uterine displacement, and place fetal assessment after the maternal primary survey. Rehearse three obstetric trauma vignettes using that fixed order.
Matching an antidote to the wrong toxidrome, or prescribing activated charcoal for every ingestion without checking the contraindications of altered consciousness, unprotected airway, corrosives or a late presentation.
Antidotes are memorised as a paired list rather than as a consequence of recognising the syndrome, and charcoal is remembered as the generic 'decontamination' answer. The contraindications are a short list that is easily compressed out of memory.
What to do instead
Work from the syndrome to the drug: identify the toxidrome from the cluster of findings, name the receptor or physiology involved, then produce the antidote or the supportive measure. Keep a one-page contraindication grid for charcoal, and answer every ingestion item by first stating time since ingestion, airway status and substance class.
Completing a mental-health or intentional-overdose assessment without asking directly about suicidal ideation, intent, plan, means and protective factors, and accepting a medical clearance as sufficient for discharge without a documented risk formulation and safety plan.
Candidates fear that asking directly will be intrusive or will 'plant' the idea, and the medical disposition dominates the vignette. Risk assessment is also treated as a form to be completed rather than a clinical judgement to be argued.
What to do instead
Ask directly and document the answers: ideation, intent, plan, means, previous attempts, protective factors, and collateral information. Then state a formulated risk level and the disposition that follows from it, including means restriction and follow-up. Practise writing a four-line risk formulation for five vignettes.
Withholding or delaying emergency treatment because a consent form is absent, or treating autonomy as absolute in situations where the emergency exception, best-interests judgement or statutory hold applies, and failing to document the reasoning.
Consent is learned as a legal formality attached to procedures rather than as a process with defined exceptions, and the candidate fears the disciplinary consequence of acting without a signature more than the consequence of delay.
What to do instead
Learn the exceptions as a checklist: life-threatening emergency with no available surrogate, implied consent for the clearly necessary intervention, statutory provisions for mental-health or public-health risk, and the mature-minor rules in the local jurisdiction. For each ethics item, write the exception you are invoking and the sentence you would document in the record.