Chapter 21 Toxicology

After administering activated charcoal to a patient, it is MOST important to:

be alert for vomiting. Chapter 21, Emergency Medical Care, Page 756

The major side effect associated with administration of activated charcoal is:

black stools. Chapter 21, Emergency Medical Care, Page 756

Signs and symptoms of a sympathomimetic drug overdose include:

tachycardia. Chapter 21, Identifying the Patient and the Poison, Page 746

You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Immediate management for this patient should include:

thoroughly suctioning her oropharynx. Chapter 21, Specific Poisons, Page 763-764

A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing:

tolerance. Chapter 21, page 756, Specific Poisons

Which of the following statements regarding the Salmonella bacterium is correct?

The Salmonella bacterium itself causes food poisoning. Chapter 21, page 766, Food Poisoning

How do poisons typically act to harm the body?

By changing the normal metabolism of cells or by destroying them Chapter 21, page 745, Identifying the Patient and the Poison

Activated charcoal may be indicated for a patient who ingested:

aspirin. Chapter 21, Emergency Medical Care, Page 755

As you enter the residence of a patient who has possibly overdosed, you should:

be alert for personal hazards. Chapter 21, page 753, Patient Assessment

Most poisonings occur via the __________ route.

ingestion Chapter 21, page 751, How Poisons Enter the Body

Substance abuse is MOST accurately defined as:

knowingly misusing a substance to produce a desired effect. Chapter 21, Identifying the Patient and the Poison, Page 745

Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of:

oxycodone (Percocet). Chapter 21, page 758, Specific Poisons

The recommended treatment for absorbed or contact poisons includes _________.

safely removing or diluting the poisonous substance Chapter 21, page 750, How Poisons Enter the Body

Which of the following sets of vital signs would the EMT MOST likely encounter in a patient with acute cocaine overdose?

BP, 200/100 mm Hg; pulse, 150 beats/min Chapter 21, page 762, Specific Poisons

Heroin is an example of a(n):

Opioid Chapter 21, page 758, Specific Poisons

Victims of inhaled poisoning will require which of the following?

Transport to an emergency department for evaluation Chapter 21, page 749, How Poisons Enter the Body

Which of the following questions would be LEAST pertinent during the initial questioning of a patient who ingested a substance?

Why was the substance ingested? Chapter 21, page 754, Patient Assessment

You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and hydrocodone (Vicodin). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient should include:

assisted ventilation and naloxone (Narcan). Chapter 21, pages 758-759, Specific Poisons

You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient's dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes:

attempting to calm him and giving him oxygen if tolerated. Chapter 21, Specific Poisons, Page 761

Your priority in caring for a patient with a surface contact poisoning is to:

avoid contaminating yourself. Chapter 21, How Poisons Enter the Body, Page 750

Airborne substances should be diluted with:

oxygen. Chapter 21, How Poisons Enter the Body, Page 755

Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which of the following side effects would you expect the patient to experience?

Dry mucous membranes Chapter 21, Identifying the Patient and the Poison, Page 746

Common names for activated charcoal include all of the following, EXCEPT:

Fructose. Chapter 21, Emergency Medical Care, Page 755 Includes: B. Actidose. C. LiquiChar. D. InstaChar.

In general, injected poisons are impossible to dilute or remove because they:

are usually absorbed quickly into the body. Chapter 21, How Poisons Enter the Body, Page 751

Activated charcoal is given to patients who have ingested certain substances because it:

binds to the substance and prevents absorption. Chapter 21, page 755, Emergency Medical Care

A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient's wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is MOST likely experiencing:

delirium tremens. Chapter 21, page 758, Specific Poisons

Of the four avenues of poisoning, generally ___________ is the most worrisome in terms of treatment to the EMS provider.

injection Chapter 21, page 751, How Poisons Enter the Body

A 25-year-old man overdosed on heroin and is unresponsive. His breathing is slow and shallow and he is bradycardic. He has track marks on both arms. The EMT should:

insert a nasal airway and ventilate with a BVM. Chapter 21, Specific Poisons, Page 759

When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that:

internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot. Chapter 21, page 757, Specific Poisons

The poison control center will be able to provide you with the most information regarding the appropriate treatment for a patient with a drug overdose if the center:

is aware of the substance that is involved. Chapter 21, How Poisons Enter the Body, Page 748

An overdose of acetaminophen, the active ingredient in Tylenol, will MOST likely cause:

liver failure. Chapter 21, page 764, Specific Poisons

Before giving activated charcoal, you should:

obtain approval from medical control. Chapter 21, Emergency Medical Care, Page 756

In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be MOST alert for:

seizures and cardiac arrhythmias. Chapter 21, page 763, Specific Poisons

If the victim of a toxicologic emergency vomits, an EMT should _________.

use appropriate personal protective equipment and examine the vomitus for pill fragments or other clues for patient care. Chapter 21, page 747, Identifying the Patient and the Poison

You receive a call to a residence where a man found his wife unresponsive on the couch. The patient's respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should:

ventilate her with a BVM. Chapter 21, page 753, Patient Assessment