Emergency Care and Acute Injury Management
What this domain tests
Recognition and first-line management of time-critical events on the field: cardiac arrest, exertional heat stroke, cervical spine injury, anaphylaxis, and acute musculoskeletal trauma.
Core rules and concepts
- Primary survey ABCDE with simultaneous defibrillation: start CPR immediately, apply an AED as early as possible; survival falls roughly 7–10% per minute without defibrillation.
- Exertional heat stroke: core temperature above ~40.5 °C plus central nervous system dysfunction. Treat with immediate cold-water immersion - cool first, transport second. Rectal temperature is the field gold standard.
- Commotio cordis and sudden cardiac arrest in sport require the same response: CPR and early defibrillation, with the emergency action plan rehearsed before the season.
- Cervical spine: do not routinely immobilise every collision athlete; use selective immobilisation based on mechanism, symptoms and reliable examination.
- Anaphylaxis: intramuscular adrenaline 0.3–0.5 mg (1:1000) into the anterolateral thigh, repeated after 5 minutes if needed; positioning supine with legs raised.
- Wounds and fractures: control bleeding, cover, splint, and reassess neurovascular status distally.
Worked example
A runner collapses near the finish on a hot day, is confused, and has a core temperature of 41 °C. Reasoning: this is exertional heat stroke, not heat exhaustion. Cool immediately by cold-water immersion, monitor airway and vital signs, and transport only once cooling is under way - delaying cooling to complete transport worsens outcome.
Traps that cost marks
- Diagnosing heat stroke from temperature alone without CNS signs, or vice versa.
- Giving oral fluids to a confused or unconscious athlete.
- Waiting for an ambulance before starting CPR or cooling.