chapter 30

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.

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:

Lyme disease.

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).

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.

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

a swimmer hyperventilates prior to entering the water.

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

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.

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.

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 diving reflex may allow a person to survive extended periods of submersion in cold water secondary to:

bradycardia and a slowing of the metabolic rate.

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.

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

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.

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

diuretics

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.

All of the following terms are used to describe a cold body part that is 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.

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

You and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should:

move him as a unit to a supine position.

The venom of a black widow spider is toxic to the:

nervous system.

Signs and symptoms of an air embolism include all of the following, EXCEPT:

pale skin.

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.

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 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.

High air temperature reduces the body's ability to lose heat by:

radiation

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.

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

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.

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

ventricular fibrillation.

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.

Heatstroke 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.

Heat loss from the body through respiration occurs when:

warm air is exhaled into the atmosphere.

The MOST prominent symptom of decompression sickness is:

abdominal or joint pain.