Critical Care MCQs – Importance of Golden Hour in Emergencies
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1. What is the ‘Golden Hour’ in emergency medicine?
a. The first 60 minutes after hospital admission
b. The first 60 minutes after a traumatic injury
c. The first 30 minutes after medication administration
d. The time of cardiac arrest
2. The concept of the ‘Golden Hour’ emphasizes which of the following?
a. Delaying care until diagnostics are completed
b. Rapid assessment and initiation of treatment
c. Avoiding intervention to allow stabilization
d. Immediate surgical operation in all cases
3. In a polytrauma patient, what is the most critical goal within the Golden Hour?
a. Administering painkillers
b. Preventing infection
c. Stabilizing airway, breathing, and circulation (ABC)
d. Providing psychological support
4. Which emergency condition also follows a similar concept of ‘Golden Hour’ due to time-sensitive treatment?
a. Migraine
b. Stroke
c. Appendicitis
d. Constipation
5. In myocardial infarction (MI), what is the “golden time” frame to restore perfusion to minimize myocardial damage?
a. Within 6 hours
b. Within 90 minutes
c. Within 12 hours
d. Within 24 hours
6. Which of the following is a primary focus during the Golden Hour in trauma care?
a. Detailed past medical history
b. Administering antibiotics
c. Controlling hemorrhage
d. Checking insurance details
7. The term “Golden Hour” was first introduced by which of the following individuals?
a. Florence Nightingale
b. R Adams Cowley
c. William Osler
d. Clara Barton
8. A delay in treatment beyond the Golden Hour in trauma patients primarily increases the risk of:
a. Muscle cramps
b. Chronic pain
c. Mortality and morbidity
d. Obesity
9. Which of the following best describes the pre-hospital priority in the Golden Hour?
a. Extensive diagnostic tests
b. Scene safety and rapid transport
c. Waiting for family consent
d. Delivering food and fluids
10. The goal of trauma systems during the Golden Hour is to:
a. Transfer patients to the nearest clinic
b. Maximize insurance reimbursement
c. Minimize time to definitive care
d. Promote bed rest
11. A 28-year-old male arrives via EMS after a high-speed MVc. He is tachycardic (HR 120), hypotensive (BP 80/50), and has decreased breath sounds on the left. What is the priority intervention?
a. Administer IV fluids rapidly
b. Prepare for immediate chest tube insertion
c. Perform a FAST ultrasound
d. Obtain a chest X-ray
12. During mass casualty triage, which patient should be prioritized as “Red” (immediate) using the START protocol?
a. Ambulatory with a leg fracture
b. Unresponsive, apneic after repositioning
c. Respiratory rate 8/min, capillary refill >2 sec
d. Severe burns without airway compromise
13. A 65-year-old female presents with sudden left-sided weakness and slurred speech, last known well 90 minutes ago. BP is 180/100. What is the next step?
a. Administer aspirin 325 mg
b. Lower BP aggressively to <140/90 mmHg
c. Prepare for alteplase if imaging excludes hemorrhage
d. Wait for neurology consult before treatment
14. Which stroke mimic should be ruled out before thrombolysis?
a. Bell’s palsy
b. Hypoglycemia
c. Migraine with aura
d. Seizure
15. A 55-year-old male has crushing chest pain, ST elevation in leads II, III, aVF. What is the priority medication?
a. Morphine
b. Nitroglycerin
c. Aspirin 325 mg chewed
d. Metoprolol
16. A patient with STEMI develops ventricular fibrillation during transport. What is the first action?
a. Administer amiodarone
b. Defibrillate at 200J
c. Start CPR for 2 minutes
d. Intubate for airway protection
17. Which triage system uses color-coding for mass casualties?
a. APGAR
b. START
c. Glasgow Coma Scale
d. Modified Early Warning Score (MEWS)
18. In disaster preparedness, what does the “HICS” framework stand for?
a. Hospital Incident Command System
b. Hemorrhage Control in Critical Situations
c. Hypothermia Intervention for Cardiac Arrest
d. Hazard Identification and Control Strategy
19. During the Golden Hour of a pediatric burn injury, the priority is to:
a. Apply ointment
b. Cover with ice
c. Begin fluid resuscitation and prevent hypothermia
d. Delay IV line
20. In neonatal resuscitation, what is the most crucial time to initiate life-saving interventions?
a. Within 10 minutes of birth
b. Within the first 30 minutes
c. Within the first 60 minutes
d. Within the first minute
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