Volume 3 Chapter 8
Over half of all poisonings that occur to children occur in what age bracket?
1 year to 5 years
Your patient in cardiac arrest overdosed by ingesting a full bottle of tricyclic antidepressant pills. His rhythm is PEA with a QRS width of 0.18 seconds. Which of the following is a proper treatment?
1 mEq/kg of sodium bicarbonate IV
What time frames do regional poison control centers provide for callers from health care providers?
24 hours a day, 7 days a week
How many poisonings occur annually in the United States, according to the American Association of Poison Control Centers?
3 million
Individuals engaged in agricultural and food handling industries are most likely to have what type of mechanism behind a toxic exposure?
Absorption
You are preparing to call the poison control center for a child who has ingested all of his parent's Inderal and Procardia. What other information may the PCC want in order to provide you the most relevantinformation?
Age of the victim, amount of medications and time ingested, and current physical condition
Which of the following is appropriate management for a patient bitten on a limb by a pit viper?
Apply a splint to the limb and immobilize in a neutral position
Your patient has overdosed on his prescribed lithium. What is the medical problem this patient has that would require this medication?
Bipolar disorder
What is the underlying pathophysiology that creates the clinical findings consistent with toxic exposure to a caustic substance?
Burn injuries at site of contact
Your patient was burned by hydrofluoric acid and is complaining of dyspnea and palpitations. Which of the following medications is most appropriate for treating him?
Calcium chloride
It is the middle of winter and you are called to a scene for a "sick family." As you arrive, the husband meets you at the road and states he has a headache but also that he returned home this morning and found his wife and two children lying on the couch all complaining of nausea/vomiting, headaches, and inability to stand. What would be an appropriate action at this time?
Call the fire department and have them retrieve the family with breathing equipment on.
You have a patient that was rescued from a burning, smoke-filled home and shows a SpCO reading of 28 percent. He is unconscious and you have to make a transport decision. Which of the following facilities is the most appropriate?
Closest hospital with a hyperbaric chamber
You are called for a "possible overdose." Examination reveals that the patient has a pulse of 112 per minute. Of the following, which is most likely to have caused the tachycardia?
Cocaine
Your patient took a large overdose of citalopram. Which of the following treatment choices is best for her?
Consider benzodiazepines for seizures and external cooling for increased body temperature
Your patient has ingested a large amount of iron supplement chewable tablets. Which of the following is the chelating agent that could be given in the hospital to bind the iron and not allow it to be absorbed?
Deferoxamine
What is the most severe form of ethanol withdrawal manifested by altered mental status and sympatheticoverdrive, which can lead to mortality?
Delirium tremens
Attempted suicides by individuals often involve what type of mechanism?
Drug overdose
Symptoms that include protruding tongue, twisted neck, deviated gaze, and abdominal rigidity should suggest which diagnosis?
Dystonic reaction
What should be the primary action when dealing with a patient sprayed with a pesticide that contains anorganophosphate?
Have the patient remove all clothing; then use copious amounts of water to flush the patient clear of any more toxin before attempting to touch the patient
Skin exposure to which of the following toxins may be decontaminated by use of water immersion mixed with magnesium sulfate, calcium salts, or benzethonium chloride?
Hydrofluoric acid
What is the most common route of toxin exposure in the pediatric population?
Ingestion
Which of the following routes of toxic exposure is most common?
Ingestion
You are called to a remote campsite for a patient who is unresponsive. According to family members, the patient came back to the camp from walking through the woods looking for some wild onions to cook with, and was complaining of severe abdominal pain. The patient then vomited, and went in his tent to lie down. Later he was found unresponsive. Given the presentation, what would be the type of toxicexposure?
Ingestion of wild mushrooms
Although toxic exposures can have immediate and delayed effects, what type of exposure mechanism would likely start out with pulmonary findings such as tachypnea, wheezing, or inspiratory crackles?
Inhalation
Which of the following is a route of toxic exposure that results in rapid absorption of a toxic agent across the alveolar-capillary membrane?
Inhalation
Toxic overdoses of acetaminophen can cause damage and necrosis to what organ of the body?
Liver
You arrive on scene for a patient who has purposely overdosed via ingestion. The empty prescription pill bottle reads "ibuprofen, 800 mg/tab." What drug class would this be?
NSAID
When a patient tries to commit suicide by ingesting something, why could the signs and symptoms be inconsistent with a single diagnosis?
Patients will have ingested more than one toxin to try to kill themselves.
Which of the following statements about the epidemiology of toxic exposures is true?
Poisonings have been constantly increasing in incidence and severity over the past several years.
You have a patient who was exposed to cyanide. During your management of this patient, which of the following drugs would not be part of the cyanide antidote kit?
Pralidoxime
What is the first priority when dealing with a patient suffering from a toxic inhalation?
Remove the patient from the source as soon as it is safe to do so
You are managing a patient with suspected CO poisoning from using a kerosene heater in his home during a cold winter night. What is the lowest SpCO reading considered to be objective for initiating treatment for the exposure?
SpCO >10 percent
For the paramedic, regardless of the mechanism by which a patient is exposed to a toxin, what should be the most important focus?
Supporting any lost vital function secondary to the poisoning
Which of the following is the definition of decontamination?
The process of reducing the amount of toxin absorbed into the body
Which of the following statements is most accurate about poison control centers and the types of health care providers who staff them?
They employ physicians, nurses, paramedics, and toxicologists.
What is the basic purpose of poison control centers (PCC)?
To provide information about poisonings and treatment recommendations for health care providers
What is a group of signs and symptoms and/or characteristic effects associated with exposure to a particular substance or class of substance called?
Toxidrome
After being bitten by an unknown spider, the patient is now in acute pain with severe muscle contraction, hypotension, and labored breathing. How should the paramedic categorize the patient's stability in order to make a transport priority determination?
Unstable
The majority of adult poisonings and overdoses are:
intentional.
The need for an increased amount of a drug to obtain effects previously attained from a lower dose of the same drug is called:
tolerance.
The study of toxins (drugs and poisons) and antidotes and their effects on living organisms is:
toxicology.
