CET CET Emergency Response & Patient Safety 1 — Questions and Answers
Question 1: During endoscopy, which finding on continuous monitoring most directly indicates respiratory compromise?
- Rising blood pressure
- Decreasing oxygen saturation on pulse oximetry (Correct answer)
- Onset of bradycardia
- Diaphoresis
Correct answer: Decreasing oxygen saturation on pulse oximetry
A declining SpO2 on pulse oximetry is the primary objective indicator of respiratory compromise and requires immediate intervention during endoscopy sedation.
Question 2: When a patient experiences vasovagal syncope during endoscopy, the FIRST positional intervention is to:
- Sit the patient upright
- Place the patient in Trendelenburg (legs elevated) position (Correct answer)
- Roll the patient prone
- Keep the patient in left lateral decubitus
Correct answer: Place the patient in Trendelenburg (legs elevated) position
Trendelenburg positioning uses gravity to restore cerebral blood flow, which is the immediate priority in vasovagal syncope.
Question 3: Which emergency equipment must be immediately accessible in every endoscopy suite?
- Portable CT scanner
- Crash cart with defibrillator (Correct answer)
- Fluoroscopy unit
- Mechanical ventilator
Correct answer: Crash cart with defibrillator
A crash cart with defibrillator must be immediately available in every endoscopy suite to manage cardiac arrest or life-threatening arrhythmias during sedation.
Question 4: Per current AHA guidelines, what is the correct compression-to-ventilation ratio for 2-rescuer adult CPR?
- 15:2
- 30:2 (Correct answer)
- 30:1
- 15:1
Correct answer: 30:2
Current AHA guidelines specify a 30:2 compression-to-ventilation ratio for 2-rescuer adult CPR to optimize coronary perfusion pressure.
Question 5: A patient develops fever, rigors, and hypotension within hours of endoscopy — the most likely diagnosis is:
- Anaphylaxis
- Post-procedural bacteremia or sepsis (Correct answer)
- Propofol infusion syndrome
- Bowel preparation reaction
Correct answer: Post-procedural bacteremia or sepsis
Fever, rigors, and hypotension following endoscopy are the classic triad of post-procedural bacteremia or sepsis, requiring urgent blood cultures and antibiotic therapy.
Question 6: When perforation is suspected after upper endoscopy, the endoscopy technician should immediately:
- Continue the procedure to confirm the finding
- Notify the physician and prepare for emergent intervention (Correct answer)
- Administer additional sedation
- Document the event and observe the patient for 30 minutes
Correct answer: Notify the physician and prepare for emergent intervention
Perforation is a life-threatening emergency requiring immediate physician notification and preparation for emergent endoscopic or surgical intervention.
CET CET Emergency Response & Patient Safety 1
During endoscopy, which finding on continuous monitoring most directly indicates respiratory compromise?