ch.30 Environmental Emergiencies

Which of the following statements regarding drowning is correct?

Laryngospasm following submersion in water makes rescue breathing difficult.

Which of the following statements regarding lightning strikes is correct

Lighting often results in a brief period of asystole that resolves spontaneously.

Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when:

-a swimmer hyperventilates prior to entering the water

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

90°F (32°C).

Which of the following MOST accurately describes hyperthermia?

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

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 black widow spider bite

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

a relatively small surface area.

Signs of late heatstroke include:

a weak, rapid pulse.

To assess a patient's general 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

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

A dysbarism injury refers to the signs and symptoms related to changes in

barometric pressure

Hypothermia can worsen internal bleeding secondary to:

blood clotting abnormalities.

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.

The venom of a brown recluse spider is cytotoxic, meaning that it:

causes severe local tissue damage.

Geriatric patients are at a higher risk for heatstroke because:

circulation to the skin is reduced.

The transfer of heat to circulating air, such as when cool air moves across the body's surface, is called:

convection.

All of the following snakes are pit vipers, EXCEPT for the:

coral snake.

Drowning is MOST accurately defined as:

death from suffocation after submersion in water.

When the body loses sweat, it also loses:

electrolytes.

High humidity reduces 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

High humidity reduces the body's ability to lose heat through:

evaporation.

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.

Which of the following conditions would be the LEAST likely to increase a person's risk of hypothermia?

hyperglycemia

Shivering is a mechanism in which the body generates heat by:

increasing the metabolic rate

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.

A 48-year-old male was stung on the leg by a jellyfish while swimming in the ocean. He is conscious and alert, but complains of intense pain at the wound site. Specific treatment for this patient includes:

irrigating the wound with vinegar and immersing his leg in hot water.

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. In addition to administering 100% oxygen, you should:

load him into the ambulance and begin rapid cooling interventions.

Which of the following is an early sign of pit viper envenomation?

local swelling and ecchymosis

A frostbitten foot can be identified by the presence of:

mottling and blisters.

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:

move him into the cooled ambulance.

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

A patient with a core body temperature of 95°F (35°C) will MOST likely experience:

rapid breathing.

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′. 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, position him on his left side with his head down, and contact medical control regarding transport to a recompression facility.

While drinking beer with his friends near a creek, 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 venom of a black widow spider is toxic to the:

the nervous system

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.

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. In addition to monitoring her ABCs, administering oxygen, and turning up the heat in the back of the ambulance, you should:

place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.

A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:

provide rescue breathing, remove wet clothing, immobilize his spine, keep him warm, and transport carefully.

Burns associated with lightning strikes are typically:

superficial.

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

sweating and dilation of skin blood vessels

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

sweating and dilation of skin blood vessels.

Heatstroke occurs when:

the body's heat-eliminating mechanisms are overwhelmed.

Rough handling of a hypothermic patient with a pulse may cause:

ventricular fibrillation.

Heat loss from the body through respiration occurs when:

warm air is exhaled into the atmosphere

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 unconscious, pale, and apneic. You should:

assess for a carotid pulse for up to 45 seconds.