PHEM curriculum unit B.2 · Cross-cutting theme B: Team Resource Management
The DipIMC is blueprinted against phase 1 of the UK Pre-hospital Emergency Medicine (PHEM) curriculum. This page covers unit B.2, Maintain situational awareness.
Below are 2 free practice questions from the DipIMC.Ninja bank, in the Part A single best answer format. Every answer names the textbook page, guideline or statute it was written from, so you can check it rather than take it on trust. The bank holds 5 questions on this unit.
Question 1 · Law, Ethics & Human Factors · Moderate
As the helicopter lifts from the scene with your patient, a team member in the cabin starts a discussion about the dose of ketamine that was given. There is no immediate clinical concern and the pilot has said nothing. What is the correct response?
AAnswer the dose question in full now, before the aircraft has reached the cruise
BAsk the pilot over the intercom whether the discussion can go ahead straight away
CAnswer the dose question briefly now, over the intercom so that the pilot hears it
DDefer the dose discussion until after take-off, speaking meanwhile only of hazards
EStay silent on every topic for the whole flight, until the aircraft has landed
Show answer
Answer: D
Defer the dose discussion until after take-off, speaking meanwhile only of hazards
The ABC of Prehospital Emergency Medicine: take-off and landing are the most hazardous periods of a helicopter emergency medical service (HEMS) flight, so talking should be kept to a minimum during those phases unless a hazard is being noted. The question about the ketamine dose is legitimate but not time-critical, so it waits until take-off is complete. Answering now, whether in full or briefly over the intercom, adds exactly the talk the rule is meant to prevent, and asking the pilot for permission is itself non-essential speech at the worst moment. The restriction applies to the critical phases, not to the whole flight: once take-off is complete, a structured drug and dose check within the team is appropriate.
Where this comes from
ABC of Prehospital Emergency Medicine
Ch. 2 Activation and Deployment · Deployment by helicopter · p. 6“Take-off and landing are the most hazardous periods of a HEMS flight”
Ch. 2 Activation and Deployment · Deployment by helicopter · p. 6“talking should be kept to a minimum during these phases”
law-059 · Law, Ethics & Human Factors · Human Factors · Moderate · v3
Question 2 · Law, Ethics & Human Factors · Moderate
You are the medical adviser at a Tactical Co-ordinating Group (TCG) after a partial building collapse. How many people remain inside is unclear, and the police and fire commanders are working from different estimates. According to the JESIP Joint Doctrine, which behaviour by those present makes shared situational awareness more likely?
AShare only information that has been confirmed by a second source
BAdopt the lead organisation's estimate as the single working figure
CSave challenges to others' understanding for the post-incident debrief
DPass each update only through the organisation's own control room
EMake any uncertainties and assumptions absolutely clear when sharing
Show answer
Answer: E
Make any uncertainties and assumptions absolutely clear when sharing
The JESIP Joint Doctrine defines shared situational awareness as a common understanding of the circumstances, immediate consequences and implications of the emergency, together with an appreciation of the available capabilities and the priorities of the responder organisations. It states that the behaviour of individuals and teams will either enable or impede it, and that it is more likely if people freely share what they know, make uncertainties and assumptions absolutely clear, challenge their own understanding and that of others, and are critical and rigorous. Each distractor inverts one of those behaviours: holding back unconfirmed information defeats free sharing (in an emergency much information is of uncertain quality, which is why the doctrine asks for it to be assessed and its uncertainty flagged rather than withheld); adopting one agency's figure without scrutiny abandons challenge; deferring challenge to the debrief is too late; and routing everything through single-agency control rooms undermines the face-to-face exchange that co-location at the TCG exists to provide. Two differing casualty estimates, each stated with its source and assumptions, give the group a far better picture than one unexplained number.
Where this comes from
JESIP Joint Doctrine: The Interoperability Framework (Edition 3.1)JESIP (Joint Emergency Services Interoperability Principles), Joint Doctrine Edition 3.1, April 2024·8.2 Information assessment and use: behaviours that enable shared situational awareness“Make uncertainties and assumptions absolutely clear”
JESIP Joint Doctrine: The Interoperability Framework (Edition 3.1)JESIP (Joint Emergency Services Interoperability Principles), Joint Doctrine Edition 3.1, April 2024·4.6 Shared situational awareness“Shared situational awareness is a common understanding of the circumstances”
law-232 · Law, Ethics & Human Factors · Human Factors · Moderate · v2