EMT-B Chapter 20 - Immunologic Emergencies (Multiple)
Because the stinger of a honeybee remains in the wound following a sting:
it can continue to inject venom for up to 20 minutes.
Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction?
the environment in which the patient is found
The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the pediatric auto-injector delivers ______ mg.
0.3, 0.15
Urticaria is the medical term for:
hives.
The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the pediatric auto-injector delivers ______ mg. a) 0.03, 0.3 b) 0.3, 0.15 c) 0.01, 0.1 d) 0.1, 0.01
0.3, 0.15
The effects of epinephrine are typically observed within _________ following administration.
1 minute
The effects of epinephrine are typically observed within _________ following administration. a) 30 seconds b) 1 hour c) 30 minutes d) 1 minute
1 minute
When administering epinephrine via auto-injector, you should hold the injector in place for: a) 5 seconds. b) 10 seconds. c) 20 seconds. d) 15 seconds.
10 seconds.
Most patients who die of anaphylaxis do so within the first __________ following exposure.
30 minutes
Most patients who die of anaphylaxis do so within the first __________ following exposure. a) 90 minutes b) 5 minutes c) 60 minutes d) 30 minutes
30 minutes
A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?
Administer oxygen, transport at once, and request a paramedic intercept.
A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient? a) Remain at the scene with the patient and request a paramedic ambulance. b) Quickly determine if there are any bystanders who may carry epinephrine. c) Administer oxygen, transport at once, and request a paramedic intercept. d) Ask the patient if he has any diphenhydramine (Benadryl) tablets that you can administer.
Administer oxygen, transport at once, and request a paramedic intercept.
Urticaria is the medical term for: a) a wheal. b) hives. c) burning d) swelling.
hives.
Which of the following MOST accurately defines an allergic reaction?
an exaggerated immune system response to any substance
Which of the following patients would MOST likely have a delayed onset of an allergic reaction?
a 45-year-old male who ingested penicillin
Which of the following patients would MOST likely have a delayed onset of an allergic reaction? a) a 21-year-old female who inhaled pollen b) a 45-year-old male who ingested penicillin c) a 50-year-old male who was exposed to latex d) a 30-year-old male who was stung by a bee
a 45-year-old male who ingested penicillin
A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:
a wheal.
A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called: a) purpura. b) urticaria. c) a wheal. d) a pustule.
a wheal.
A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should
administer oxygen and transport her to the hospital.
A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should: a) advise her to see her physician as soon as possible. b) position her legs well above the level of her heart. c) administer oxygen and transport her to the hospital. d) request a paramedic unit to administer epinephrine.
administer oxygen and transport her to the hospital.
The foreign substance responsible for causing an allergic reaction is called a(n):
allergen.
The foreign substance responsible for causing an allergic reaction is called a(n): a) allergen. b) leukotriene. c) antibody. d) histamine.
allergen.
Which of the following MOST accurately defines an allergic reaction? a) an exaggerated immune system response to any substance b) destruction of the immune system by an external substance c) a direct negative effect on the body by an external substance d) a release of erythrocytes in response to a foreign substance
an exaggerated immune system response to any substance
You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should: a) apply high-flow oxygen, obtain approval from medical control to assist him with his epinephrine, and transport. b) assess his ABCs and vital signs in 15 minutes and allow him to drive himself to the hospital if he remains stable. c) apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital. d) apply high-flow oxygen, apply a chemical cold pack directly to the injection site, and transport at once.
apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.
You respond to the residence of a 55-year-old female with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should: a) ask her when her last allergic reaction occurred. b) obtain a complete set of baseline vital signs. c) ask her if she has prescribed epinephrine. d) ascertain if she has a family history of allergies.
ask her if she has prescribed epinephrine.
A 38-year-old female was bitten by fire ants while at the park with her kids. Your primary assessment reveals that she is semiconscious, has profoundly labored breathing, and has a rapid, thready pulse. She has a red rash on her entire body and her face is very swollen. You should:
assist her ventilations with 100% oxygen.
A 38-year-old female was bitten by fire ants while at the park with her kids. Your primary assessment reveals that she is semiconscious, has profoundly labored breathing, and has a rapid, thready pulse. She has a red rash on her entire body and her face is very swollen. You should: a) administer 0.3 mg of epinephrine. b) place her supine with her legs elevated 6″ to 12″. c) perform a rapid secondary assessment. d) assist her ventilations with 100% oxygen.
assist her ventilations with 100% oxygen.
A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. In addition to administering oxygen, you should:
contact medical control if needed, transport the patient, and monitor him for signs of deterioration.
Which of the following medications blocks the release of histamines?
diphenhydramine (Benadryl)
Which of the following medications blocks the release of histamines? a) epinephrine b) diphenhydramine (Benadryl) c) albuterol (Ventolin) d) acetaminophen (Tylenol)
diphenhydramine (Benadryl)
Common side effects of epinephrine include all of the following, EXCEPT:
drowsiness.
Common side effects of epinephrine include all of the following, EXCEPT: a) headache. b) dizziness. c) drowsiness. d) tachycardia.
drowsiness.
Common signs and symptoms of an allergic reaction include all of the following, EXCEPT:
drying of the eyes.
Common signs and symptoms of an allergic reaction include all of the following, EXCEPT: a) drying of the eyes. b) persistent dry cough. c) abdominal cramps. d) flushing of the skin.
drying of the eyes.
Anaphylaxis is MOST accurately defined as a(n):
extreme allergic reaction that may affect multiple body systems.
Anaphylaxis is MOST accurately defined as a(n): a) moderate allergic reaction that primarily affects the vasculature. b) severe allergic reaction that typically resolves without treatment. c) extreme allergic reaction that may affect multiple body systems. d) allergic reaction that causes bronchodilation and vasoconstriction.
extreme allergic reaction that may affect multiple body systems.
Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include:
histamines and leukotrienes.
Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include: a) histamines and leukotrienes. b) adrenaline and histamines. c) the bee venom itself. d) leukocytes and epinephrine.
histamines and leukotrienes.
Because the stinger of a honeybee remains in the wound following a sting: a) the toxicity of the venom decreases within 10 minutes. b) the stinger can easily be removed with tweezers. c) the body's immune system deactivates the venom. d) it can continue to inject venom for up to 20 minutes.
it can continue to inject venom for up to 20 minutes.
A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should:
maintain his airway and assist his ventilations.
A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should: a) apply the automated external defibrillator (AED) in the event that cardiac arrest occurs. b) ask his wife if he has any known allergies. c) perform a detailed secondary assessment. d) maintain his airway and assist his ventilations.
maintain his airway and assist his ventilations.
After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should:
monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.
After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should: a) monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. b) transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine. c) consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction. d) contact medical control and obtain authorization to administer another 0.3 mg of epinephrine.
monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.
While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates:
narrowing of the bronchioles in the lungs.
While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates: a) narrowing of the bronchioles in the lungs. b) enlargement of the bronchioles in the lungs. c) a significant amount of fluid in the alveoli. d) rapid swelling of the upper airway tissues.
narrowing of the bronchioles in the lungs.
Immediately after giving an epinephrine injection, you should:
properly dispose of the syringe.
Immediately after giving an epinephrine injection, you should: a) record the time and dose given. b) properly dispose of the syringe. c) reassess the patient's vital signs. d) notify medical control of your action.
properly dispose of the syringe.
A 50-year-old male was stung by a honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to: a) record the time and dose of the injection, and transport promptly. b) reassess his breathing and blood pressure in 15 minutes. c) notify medical control of the patient's response to your treatment. d) visualize his airway to assess for oropharyngeal swelling.
record the time and dose of the injection, and transport promptly.
You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should:
request permission from medical control to give another dose of epinephrine.
You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should: a) administer a nebulized bronchodilator to improve the status of her breathing. b) monitor her en route to the hospital and call medical control if she worsens. c) crush up an antihistamine tablet and place it in between her cheek and gum. d) request permission from medical control to give another dose of epinephrine.
request permission from medical control to give another dose of epinephrine.
The stinger from a honeybee should be:
scraped away from the skin.
The stinger from a honeybee should be: a) squeezed with tweezers and removed. b) scraped away from the skin. c) irrigated with copious amounts of water. d) left in place and covered.
scraped away from the skin.
Which of the following sounds indicates swelling of the upper airway? a) stridor b) wheezing c) rhonchi d) rales
stridor
Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction? a) the time of season in which the exposure occurred b) the environment in which the patient is found c) the patient's family history d) the patient's general physical appearance
the environment in which the patient is found
Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately? a) diffuse urticaria b) systemic vasodilation c) severe hypotension d) upper airway swelling
upper airway swelling
Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?
vasoconstriction and bronchodilation
Epinephrine is indicated for patients with an allergic reaction when:
wheezing and hypotension are present
Epinephrine is indicated for patients with an allergic reaction when: a) the patient is anxious and tachycardic. b) a paramedic is present at the scene. c) wheezing and hypotension are present. d) the reaction produces severe urticaria.
wheezing and hypotension are present.
The two MOST common signs of anaphylaxis are:
wheezing and widespread urticaria.
The two MOST common signs of anaphylaxis are: a) wheezing and widespread urticaria. b) expiratory stridor and tachycardia. c) hypertension and swollen hands. d) watery eyes and localized itching.
wheezing and widespread urticaria.