First aid, emergency care, and patient safety in pharmaceutical settings
What the exam tests
This domain tests immediate response to emergencies in a pharmacy: anaphylaxis, syncope, hypoglycaemia, seizures, bleeding, and poisoning. It also tests patient-safety systems, including incident reporting and prevention of avoidable harm.
Core rules
- Use a structured approach: danger, response, airway, breathing, circulation, and disability.
- Call emergency services early; do not delay life-saving treatment while completing paperwork.
- Anaphylaxis is treated with intramuscular adrenaline into the anterolateral thigh, plus oxygen and monitoring; antihistamines are not first-line.
- Position the patient appropriately: supine with legs raised for syncope, recovery position if breathing and unconscious, and no oral intake if airway is threatened.
- Report incidents and near misses through the pharmacy safety system and document care given.
Worked example
Five minutes after a penicillin injection, a patient becomes breathless, wheezy, and hypotensive with facial swelling. What do you do?
Reasoning: this is anaphylaxis. Give adrenaline 0.5 mg intramuscularly (0.5 mL of 1:1000) to an adult into the anterolateral thigh, call emergency services, give high-flow oxygen, monitor breathing and circulation, and repeat adrenaline after 5 minutes if needed according to protocol. Keep the patient lying flat unless breathing is compromised. Document the time, dose, and response. Antihistamines and corticosteroids are adjuncts, not substitutes.
Traps that cost marks
- Giving an antihistamine first and delaying adrenaline.
- Making a seated or standing patient with syncope stand up quickly.
- Failing to call for help or to assign someone to bring the emergency kit.
- No documentation of the incident or the medicines administered.
- Blaming an individual instead of examining the system that allowed the error.
Exam focus
Sequence the actions and name the first-line drug, dose, route, and site.