Chapter 33 - Environmental Emergencies

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: A. elevating the lower extremities and giving antivenin. B, applying ice to the wound and transporting quickly. C. supine positioning, splinting the leg, and transporting. D. transporting only with close, continuous monitoring.

C

A frostbitten foot can be identified by the presence of: A. gross deformity. B. blanching of the skin. C. soft, smooth skin. D. mottling and blisters.

D

All of the following snakes are pit vipers, except for the: A. rattlesnake. B. cottonmouth, C. copperhead. D. coral snake.

D

Heat loss from the body through respiration occurs when: A. warm air is exhaled into the atmosphere. B. the core body temperature is greater than 98°F (37°C). C air temperature is greater than body temperature. D cool air is inhaled and displaces warm air.

A

Signs and symptoms of an air embolism include all of the following, except. A. dizziness. B, pale skin. C dysphasia. D joint pain

B

The EMT must assume that any unwitnessed water-related incident is accompanied by: A. possible spinal injury. B. cold-water immersion. C. an air embolism. D. alcohol intoxication.

A

Most of the serious injuries associated with scuba diving are caused by: A. too rapid of a descent. B. alcohol consumption. C. too rapid of an ascent. D. cold water temperature.

C

Signs and symptoms of an air embolism include all of the following, except. A. joint pain. B dizziness. c. pale skin. dysphasia.

C

Your assessment of a 23-year-old female reveals a core body temperature of 93.4°F (34°C). She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale, her muscles appear rigid, and her respirations are rapid. You should: A.sit her up and give her small sips of warm water to drink, place heat packs to her axillae and groin, and cover her with blankets. B.apply the automated external defibrillator in case she develops cardiopulmonary arrest, cover her with layers of blankets, and transport carefully. C.place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling. D.cover her with warm blankets and let her move about on the stretcher to generate body heat and increase her temperature.

C

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)? A. Finger motion ceases B. Shivering stops C. Mental status decreases D. Muscle activity increases

D

When the body loses sweat, it also loses: A. electrolytes. B, nutrients. C erythrocytes. D. plasma.

A

After being stung on the leg by a jellyfish, a man complains of severe pain to his leg, dizziness, and difficulty breathing. He has a red rash covering his trunk, and his blood pressure is 90/50 mm Hg. The EMT should: A. administer oxygen and epinephrine and prepare for rapid transport. B. begin transport and immerse his leg in hot water to help reduce pain. C. remove the stingers from his leg by scraping them with a stiff object. D. apply warmth to the sting area and cover it with a dry sterile dressing.

A

Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when: A. a swimmer hyperventilates prior to entering the water. B. a diver holds his or her breath during a staged ascent. C. a diver holds his or her breath for a long period of time. D. a swimmer breathes shallowly before entering the water.

A

Burns associated with lightning strikes are typically: A. superficial. B. third-degree. C. partial-thickness. D. full-thickness.

A

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, except: A. a relatively small surface area. B. a decreased ability to shiver. C. a smaller overall muscle mass. D. a smaller amount of body fat.

A

Covering a patient's _________ will significantly minimize radiation heat loss. A. head B. extremities C. abdomen D. chest

A

For sweating to be an effective cooling mechanism: A. it must evaporate from the body. B. several layers of clothing must be worn. C. the body must produce at least 1 L per hour. D. the relative humidity must be above 90%.

A

In contrast to the brown recluse spider, the black widow spider: A. is large and has a red-orange hourglass mark on its abdomen. B. has a bite that is typically painless until a blister develops. C. has a bite that usually produces local pain but no systemic signs or symptoms. D. is very small and has a violin-shaped marking on its back.

A

Patients with generalized hypothermia are at an increased risk of a local cold injury because: A. blood is shunted away from the extremities to the body's core. B. the patient is usually unable to escape the cold ambient temperature. C. the major muscles of the body become rigid during hypothermia. D. peripheral vasodilation brings warm blood to the skin's surface.

A

The body's natural protective mechanisms against heat loss are: A. constriction of blood vessels in the skin and shivering. B. respiration and constriction of blood vessels in the skin. C. shivering and vasodilation. D. vasodilation and respiration.

A

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: A. conduction. B evaporation. C. convection. D radiation

A

A patient with a core body temperature of 95°F (35°C) will most likely experience: A. a slow pulse. B. rapid breathing. C. loss of consciousness. D. muscle stiffness.

B

Signs of late heatstroke include: A. hot, moist skin. B. a weak, rapid pulse. C. nausea and vomiting. D. a change in behavior.

B

The diving reflex might allow a person to survive extended periods of submersion in cold water secondary to: A. tachycardia and a lowering of the blood pressure. B. bradycardia and a slowing of the metabolic rate. C. laryngospasm that protects the lungs from water. D. increases in the metabolic rate and oxygen demand.

B

You are assessing a man with suspected hypothermia. The patient is conscious, alert, and 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: A. a direct reflection of his increased respiratory rate B. secondary to decreased perfusion in the extremities. C. accurate because shivering affects hemoglobin binding. D accurate because he has signs of respiratory failure.

B

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 pink froth coming from his nose and mouth. You should: A place him in a semi-sitting position, suction his mouth and nose, apply a continuous positive airway pressure (CPAP) device, and transport to the closest emergency department. B. 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. C. suction his mouth and nose, keep him supine and elevate his legs to prevent air bubbles from entering his brain, administer high-flow oxygen, and transport to a hyperbaric chamber. D. position him supine with his head elevated 30°, suction his mouth and nose, hyperventilate him with a bag-valve mask, and contact medical control for further guidance.

B

Which of the following most accurately describes hyperthermia? A. The core body temperature exceeds 99.5°F (37°C). B. The body eliminates more heat than it can generate. C. The body is exposed to more heat than it can lose. D. Heat evaporates a significant amount of body water.

C

Which of the following statements regarding lightning strikes is correct? A. Victims who are struck by lightning often experience severe full-thickness burns. B. Cervical spine fractures are the most common cause of lightning-related deaths. C. Lightning strikes might cause cardiac dysrhythmias that spontaneously resolve. D. The tissue damage pathway caused by lightning usually occurs through the skin.

C

You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient's vital signs, she states that she and her family returned from a camping trip two days ago. On the basis of this patient's presentation, you should suspect: A. Rocky Mountain spotted fever. B. an allergic reaction. C. Lyme disease. D. exposure to poison ivy.

C

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: A. administer oxygen via a nonrebreathing mask. B, cover his foot with chemical heat compresses. C. protect the affected part from further injury. D. rewarm his foot in 102°F to 104°F (38.9°C to 40°C) water.

C

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: A apply chemical heat packs to his groin and axillae. B open his airway and give two rescue breaths. C apply an automated external defibrillator and assess his cardiac rhythm. D. assess for a carotid pulse for up to 60 seconds.

D

Shivering is a mechanism in which the body generates heat by: A. decreasing the use of oxygen. B. retaining excess carbon dioxide. C. decreasing the metabolic rate. D. increasing the metabolic rate.

D

The venom of a brown recluse spider is cytotoxic, meaning that it: A. weakens the structure of the bones. B. suppresses the respiratory drive. C. destroys the body's red blood cells. D. causes severe local tissue damage.

D

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: A. forehead. B. neck. C. chest. D. abdomen.

D

To obtain the most accurate reading of a patient's core body temperature, you should place a special hypothermia thermometer: A. behind the patient's knee. B. under the patient's armpit. C. under the patient's tongue. D. into the patient's rectum.

D

Which of the following conditions would be the least likely to increase a person's risk of hypothermia? A. Head injury B. Severe infection C. Spinal cord injury D. Hyperglycemia

D

Which of the following is an early sign of pit viper envenomation? A. General weakness and diaphoresis B. Signs and symptoms of hypoperfusion C. Syncope and bleeding at distal sites D. Local swelling and ecchymosis

D

Which of the following is an early sign of pit viper envenomation? A. Syncope and bleeding at distal sites B. Signs and symptoms of hypoperfusion C. General weakness and diaphoresis D. Local swelling and ecchymosis

D

Which of the following most accurately describes hyperthermia? A. The body eliminates more heat than it can generate. B. The core body temperature exceeds 99.5°F (37°C). C. Heat evaporates a significant amount of body water. D. The body is exposed to more heat than it can lose.

D

Which of the following statements regarding drowning is correct? A. Artificial ventilations can easily be performed in patients with a laryngospasm. B. Large amounts of water enter the lungs in a small number of drowning victims. C. Hypoxia in the drowning victim initially occurs due to water in the lungs D. Patients with a submersion injury might deteriorate rapidly because of pulmonary injury and cerebral hypoxia.

D

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: A.immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after five minutes of treatment. B.focus your initial treatment efforts on the patients who are conscious because the unresponsive patient is likely in irreversible cardiac arrest. C.recognize that the patients who are conscious are at high risk for developing cardiac arrest and quickly assess them for potentially life-threatening injuries. D.assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the automated external defibrillator as soon as possible.

D

You are assessing a 33-year-old male who complains of severe abdominal pain, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Your assessment reveals that the patient's abdomen is rigid and painful to palpation. You should suspect: A. envenomation from a pit viper. B. Rocky Mountain spotted fever. C. a brown recluse spider bite. D. a black widow spider bite.

D

You are dispatched to a local high school track and field event for a 16-year-old male who fainted. The outside temperature is approximately 95°F (35°C) with high humidity. Upon your arrival, the patient is conscious, alert, and complains of nausea and a headache. His skin is cool, clammy, and pale. You should: A give him a liquid salt solution to drink. B apply chemical ice packs to his axillae. C administer 100% supplemental oxygen. D. move him into the cooled ambulance.

D