Chapter 32 Environmental Emergencies

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

80

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

90°F (32°C)

Hypothermia occurs when the core body temperature falls below:

95°F (35°C).

Heat loss from sitting on snow:

Conduction

Heat loss that occurs from helicopter rotor blade down wash:

Convection

Temperature of the central part of the body:

Core temperature

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

Diuretics

Heat loss resulting from sweating:

Evaporation

___ 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 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 is an early sign of pit viper envenomation?

Local swelling and ecchymosis

Heat loss resulting from standing in a cold room:

Radiation

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

Which of the following MOST accurately describes hyperthermia?

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

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

a relatively small surface area.

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.

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.

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.

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

cold

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

When the body loses sweat, it also loses:

electrolytes.

High humidity reduced 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.

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

head

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

hot, dry skin.

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 perform rapid cooling interventions.

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.

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

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 water.

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.

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.

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

sweating and vasodilation.

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.

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.

Heat loss from the body through respiration occurs when:

warm air is exhaled into the atmosphere.