EMT Chapter 32: Environmental Emergencies

A person's ability to shiver is lost when his or her body temperature falls below:

90°F (32°C)

Which of the following medications increases a person's risk of a heat-related emergency?

Diuretics

____ is the body's reaction to inhaling very small amounts of water.

Laryngospasm

Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?

Tachycardia

To assess a patient's general body temperature, pull back on your glove and place the back of your hand on his or her skin at the:

abdomen

The MOST prominent symptom of decompression sickness is:

abdominal or joint pain.

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should:

assess for a carotid pulse for up to 60 seconds.

Most spinal injuries in diving incidents affect the:

cervical spine

Signs of envenomation by a pit viper include all of the following EXCEPT:

chest pain

Never assume that a(n) ______, pulseless patient is dead.

cold

The direct transfer of heat from his body to the cold ground is called:

conduction

When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:

conduction

Drowning is MOST accurately defined as:

death from suffocation after submersion in water.

In a diving emergency, _____ occurs when bubbles of gas, especially nitrogen, obstruct the blood vessels.

decompression sickness

The three phases of a dive, in the order they occur, are:

descent, bottom, and ascent

When the body loses sweat, it also loses:

electrolytes

High humidity reduces the body's ability to lose heat through:

evaporation

The body's natural cooling mechanism, in which sweat is converted to a gas, is called:

evaporation

All of the following terms refer to a body part that is cold but not frozen, EXCEPT:

frostbite

As you assess a patient, he has cold, clammy skin and a dry tongue. You suspect that:

he has suffered heat exhaustion

When the heat gain exceeds heat loss, ___ results

hyperthermia

Contributing factors to the development of heat illnesses include all of the following EXCEPT:

increased fluid intake

The rate and amount of heat loss by the body can be modified by all of the following, EXCEPT:

increasing fluid intake

To obtain the MOST accurate reading of a patient's core body temperature, you should place a special hypothermia thermometer:

into the patient's rectum

In contrast to the brown recluse spider, the black widow spider:

is large and has a red-orange hourglass mark on its abdomen.

In order for sweating to be an effective cooling mechanism:

it must be able to evaporate from the body

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. You should:

load him into the ambulance and begin rapid cooling interventions.

Which of the following is an early sign of pit viper envenomation?

local swelling and ecchymosis

Hypothermia is more common among all of the following EXCEPT:

long-distance athletes

Management of hypothermia in the field consists of all of the following EXCEPT:

massaging the cold extremities

The venom of a black widow spider is toxic to the:

nervous system

Signs and symptoms of heat exhaustion and associated hypovolemia include all of the following, EXCEPT:

normal thirst

Sings and symptoms of heat exhaustion and associated hypovolemia include all of the following EXCEPT:

normal thirst

Coral snake venom is a powerful toxin that causes ___ of the nervous system

paralysis

The EMT must assume that any unwitnessed water-related incident is accompanied by:

possible spinal injury

You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should:

protect the affected part from further injury.

Treatment for a snake bite from a pit viper includes all of the following EXCEPT:

providing water to drink

High air temperature reduces the body's ability to lose heat by:

radiation

In the United States, the most common form of pit viper is the _______

rattlesnake

Treatment of drowning or near drowning begins with:

rescue and removal from the water

Burns associated with lightning strikes are typically:

superficial.

A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:

supine positioning, splinting the leg, and transporting.

Heat stroke occurs when:

the body's heat-eliminating mechanisms are overwhelmed.

An air embolism associated with diving occurs when:

the diver holds his or her breath during a rapid ascent.

Areas usually affected by descent problems include:

the lungs

Removal of a tick should be accomplished by:

using fine tweezers to pull it straight out of the skin

Heat loss from the body through respiration occurs when:

warm air is exhaled into the atmosphere.

Covering a patient's _________ will significantly minimize radiation heat loss.

head

Potential problems associated with rupture of the lungs include all of the following EXCEPT:

hemopneumothorax

Common signs and symptoms of heat exhaustion include all of the following, EXCEPT:

hot, dry skin

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT:

relatively small surface area

Rocky Mountain spotted fever Lyme disease are both spread through the tick's:

saliva

You are assessing a man with suspected hypothermia. The patient is conscious and alert, and is actively shivering. His respiratory rate is increased, but his breathing is unlabored, and the pulse oximeter reads 72%. The pulse oximetry reading is MOST likely:

secondary to decreased perfusion in the extremities.

Signs and symptoms of severe systemic hypothermia include all of the following, EXCEPT:

shivering

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should:

suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.

The two MOST efficient ways for the body to eliminate excess heat are:

sweating and vasodilation

You should never give up on resuscitating a cold-water drowning victim because:

the resulting hypothermia can protect vital organs from the lack of oxygen.

When obtaining a SAMPLE history for a patient with a diving emergency, pay special attention to all of the following diving parameters EXCEPT:

time of day

Most of the serious injuries associated with scuba diving are caused by:

too rapid of an ascent

The body's natural protective mechanisms against heat loss are:

vasoconstriction and shivering

Young children can drown in as little as ___ of water if left unattended

1 inch

Most heat stroke cases occur when the temperature is around _____°F and the humidity is 80%.

80

Hypothermia occurs when the core body temperature falls below:

95°F (35°C).

Black widow spiders may be found in all of the following EXCEPT:

Alaska

_____ is the least common but most serious illness caused by heat exposure, occurring when the body is subjected to more heat than it can handle and normal mechanisms for getting rid of the excess heat are overwhelmed.

Heat stroke

Which of the following conditions would be the LEAST likely to increase a person's risk of hypothermia?

Hyperglycemia

Which of the following statements regarding the brown recluse spider is NOT true?

It is larger than the black widow spider

Which of the following MOST accurately describes hyperthermia?

The body is exposed to more heat than it can lose.

Which of the following statements about heat cramps is FALSE?

They only occur when it is hot outdoors

Often, the first sign of heat stroke is:

a change in behavior

You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should:

assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.

Patients with generalized hypothermia are at an increased risk of a local cold injury because:

blood is shunted away from the extremities to the body's core.

The characteristic appearance of blue lips and/or fingertips seen in hypothermia is the result of:

blood vessels constricting

Hypothermia can worsen internal bleeding secondary to:

blood-clotting abnormalities.

The organs most severely affected by air embolism are the:

brain and spinal cord

In contrast to Lyme disease, Rocky Mountain spotted fever:

can cause paralysis and cardiorespiratory collapse.