EMT - Chapter 22 - Toxicologic Emergencies

You are on scene in a remote part of a local​ park, where an unresponsive female patient was found by a passing security guard. The female​ patient, who looks to be in her​ 20s, has needle tracks on her​ arms; an empty syringe was found nearby. You have initiated spine motion restriction​ precautions, inserted a nasal​ airway, and alerted dispatch for ALS backup. The patient is currently breathing adequately and has a blood pressure of​ 102/78 mmHg, a heart rate of 68​ beats/min, and respirations of 12​ breaths/min. While awaiting arrival of the ALS​ unit, which of these steps is most​ appropriate? A. Administer 1 mg of Narcan either intramuscularly or subcutaneously B. Repeat the reassessment and vital signs every 15 minutes C. Lay the patient on her side and administer one tube of oral glucose D. Administer oxygen so as to maintain a pulse oximeter reading of​ 94% or greater

Administer oxygen so as to maintain a pulse oximeter reading of​ 94% or greater

You have been called to a dilapidated residence for a​ 26-year-old female patient complaining of generalized weakness. After applying​ gloves, you enter the home and find the patient on a couch in minimal distress. Your assessment reveals no life​ threats, but you do note track marks to both hands and arms. When asked about the​ marks, she states that she is an IV drug user and has hepatitis C. Given this​ information, you​ would: A. Place a HEPA mask on yourself B. Apply goggles and a gown C. Apply goggles D. Continue care with gloves

Continue care with gloves

You have been called for a young female patient who overdosed on several drugs. What is the most essential step for the EMT to perform while caring for this​ patient? A. Identify and correct the loss of vital​ function(s) B. Identify the​ drug(s) and​ amount(s) taken C. Identify medical conditions that may be worsened by the​ drug(s) D. Determine whether the patient has a history of drug abuse

Identify and correct the loss of vital​ function(s)

Which of these correctly identifies the routes by which a poison can enter the human​ body? A. ​Exposure, ingestion,​ inhalation, injection B. ​Ingestion, inhalation,​ injection, absorption C. ​Inhalation, injection,​ nasal-oral, visual D. ​Topical, inhalation,​ nasal-oral, absorption

Ingestion, inhalation,​ injection, absorption

A​ 44-year-old patient was found unresponsive at home. Based on his mental status and the fact that he was burning a kerosene heater in an enclosed​ room, you suspect carbon monoxide poisoning. Based on this​ information, which route of exposure would you recognize as responsible for the​ poisoning? A. Absorption B. ​Nasal-oral C. Inhalation D. Ingestion

Inhalation

A​ 19-year-old female patient with diabetes is unresponsive after drinking a large amount of alcohol and trying some​ "pills" that her friend provided. She has snoring respirations and an intact radial pulse. Emergency Medical Responders are maintaining her airway with a​ head-tilt, chin-lift​ maneuver, which has eliminated the snoring respirations. Vital signs are​ pulse, 116;​ respirations, 14​ breaths/min; minimal chest wall motion with absent breath sounds in the​ bases; and​ SpO2, 92%. Advanced life support has been contacted for assistance. Your next action would be​ to: A. Determine the​ patient's blood glucose level B. Identify the pills that the patient took C. Attempt to contact the parents for permission to treat D. Administer oxygen through positive pressure ventilation

Administer oxygen through positive pressure ventilation

A​ 44-year-old male patient was using an industrial drain cleaning solvent to clean the drains in his house. The solvent corroded through the pipes on the second​ floor, spilling into the walls and filling the house with fumes. The patient was in the house for several minutes prior to getting himself out. The primary assessment reveals him to be alert and oriented with a patent airway. He is complaining of dizziness and has rapid respirations. His radial pulse is fast and​ strong, and his skin is warm and pink. Which action should the EMT take​ first? A. Start positive pressure ventilation B. Insert a nasopharyngeal airway C. Administer supplemental oxygen D. Provide rapid transport with the patient in​ semi-Fowler's position

Administer supplemental oxygen

You have been called for a​ 41-year-old female patient who is confused. According to her​ husband, she is an alcoholic who has been in and out of rehabilitation programs for the past five years. Assessment reveals her airway to be open and her breathing adequate. Her pulse is regular and strong. Which finding would cause the EMT to classify and treat this patient as a high​ priority? A. Irritable and uncooperative with your effort to treat her B. Complaint of nausea and a temperature of 103.6degrees°F C. Smell of alcohol on the breath and complaint of headache D. Blood pressure of​ 108/72 mmHg and complaint of nausea

Complaint of nausea and a temperature of 103.6degrees°F

You have been called to a railroad yard for an unknown emergency. When you arrive on​ scene, you are directed to a tanker​ car, where two men are lying on the ground next to the railcar. The men are mechanics for the railroad company and were performing some type of repair work on the valves for the tanker car. The only other person around is a security​ guard, who saw the men suddenly collapse on a surveillance video camera and called 911 immediately. He has an automated external defibrillator​ (AED) at his side. Your initial action would be​ to: A. Remain at a safe distance and call for fire department assistance B. Take manual spine motion restriction of the head and neck and assess the ABCs for each patient C. Quickly retrieve the patients and move them to safety D. Determine which chemical the tanker contains and assess the leaks

Remain at a safe distance and call for fire department assistance

Which of these statements about poisonings is​ correct? A. All toxins are poisonous when in contact with the human body B. The majority of poisonings are intentional and result in homicide or suicide C. A poison is any substance that impairs a​ person's health by its chemical action D. The number one cause of poisoning in the United States is medications

A poison is any substance that impairs a​ person's health by its chemical action

A frantic mother called 911 because she found her​ 18-month-old daughter playing with a bottle of drain cleaner. When assessing this​ patient, what would provide the strongest evidence that the child ingested some of the​ liquid? A. Elevated heart rate B. Garbled speech C. Burns to her mouth D. Persistent crying

Burns to her mouth

What is the greatest risk related to the ingestion of​ cyanide? A. Widespread hypoxia B. High fever C. Lung damage D. Gastrointestinal damage

Widespread hypoxia

A patient who is agitated and hyperactive with dilated pupils and tachypnea has most likely​ ingested: A. Heroin B. Methadone C. Hallucinogens D. Crack cocaine

Crack cocaine

You have been called for a​ 13-year-old boy who was caught sniffing glue by his parents. The boy is lethargic and​ confused, complains of​ "burning" in his mouth and​ nose, and has nausea and vomiting. Based on the clinical presentation and mechanism of​ illness, how has this poison affected the​ patient's brain? A. Crossing from the lungs into the bloodstream and then circulating to the brain B. Being absorbed through the small intestine into the bloodstream and then going to the brain C. Absorbing fumes through the​ skin, nose, and eyes and then going on to the brain D. Directly contacting the brain by crossing the mucous membranes of the mouth and nose

Crossing from the lungs into the bloodstream and then circulating to the brain

Which of these actions should you and your partner take when you arrive on the scene at a large factory where an unresponsive patient was subjected to a powdered chemical that contacted large portions of his unprotected​ skin? A. Allow your partner to enter the scene while you remain behind so as to offer​ "buddy-rescue" should he become overwhelmed by the toxic powder B. Ensure that you are properly protected with gloves and protective gear to prevent the powder from contacting your skin C. Do not enter the scene until all buildings that make up the factory complex have been evacuated D. Wrap the patient up in a large sheet of plastic to minimize the risk of the powder contaminating other surfaces

Ensure that you are properly protected with gloves and protective gear to prevent the powder from contacting your skin

You have been called for a​ "drunk" male patient at a halfway house known to provide living quarters to persons with drug and alcohol problems. Residents tell you that the patient is a heavy drinker and must have had too much last night. This morning he was found​ "passed out" with alcohol on his breath. Quick assessment of the scene reveals the patient to be prone on a dirty bed in a room littered with liquor containers. Aside from the​ alcohol, which of these observations would be most significant to the​ EMT? A. Smell of urine in the room B. An empty​ fast-food bag on the bedside table C. Dried vomit on the floor D. Glucometer on the table

Glucometer on the table

You have been called for a​ 46-year-old male patient who just smoked crack cocaine. In reviewing his past medical​ history, which of these conditions would be most of most​ concern? A. Heart disease B. Migraine headaches C. Diabetes D. Alcoholism

Heart disease

You have been called to an alcoholism rehabilitation center. On​ scene, one of the counselors tells you that the patient is a​ 44-year-old woman who just came to the center this morning. She has not had any alcohol for 24 hours and is now sweating profusely and has an elevated heart rate and blood pressure. Based on this​ information, the EMT would recognize that the patient​ is: A. Experiencing delirium tremens B. Psychologically dependent on alcohol C. Physically dependent on alcohol D. Experiencing alcohol tolerance

Physically dependent on alcohol

On the scene of a​ drug-related emergency, the​ 22-year-old patient tells you that he has been taking amphetamines because he likes the way that they make him feel. Over the past two​ days, he has been taking more and​ more, and today he feels as though his heart is racing. He also tells you that he recognizes he has a problem and wants to get help. When you are assessing the​ patient, which sign or symptom would provide further evidence that the patient has been abusing​ amphetamines? A. Constricted pupils B. Fatigue and prolonged sleep C. Auditory hallucinations D. Increased blood pressure

Increased blood pressure

What is the most common route by which a poison enters the​ body? A. Ingestion B. Topical C. Inhalation D. Exposure

Ingestion

While he was changing the battery on a​ truck, acid from the battery splashed into a​ 66-year-old man's right eye. The patient now complains of burning pain to his right eye and is having a hard time keeping it open. He is alert and oriented and has no problems with his​ airway, breathing, or circulation. Your next action would be​ to: A. Place a cold pack to the eye and immediately transport the patient to the hospital B. Rinse the eye with a mixture of sterile water and sodium bicarbonate C. Irrigate the eye with water for a minimum of 20 minutes D. Cover both eyes and provide immediate and rapid transport

Irrigate the eye with water for a minimum of 20 minutes

A​ 56-year-old male patient has been exposed to fumes containing cyanide. Why should the EMT call for advanced life support​ assistance? A. Paramedics can induce​ vomiting, so as to rid the body of the cyanide B. Paramedics may be able to administer a cyanide antidote C. Oxygen will make this patient worse if given by the EMT D. IV fluids are needed to flush the cyanide from the​ patient's body

Paramedics may be able to administer a cyanide antidote

You are respond to an​ "unknown/unresponsive" emergency called in by a bystander. On​ scene, you find the female patient to be conscious but confused and extremely​ nauseated; she has vomited twice. Examination of the vomitus reveals fragments of different pills. Her past medical history includes diabetes and alcoholism. En route to the​ hospital, the patient vomits again and suddenly becomes unresponsive. Your first action would be​ to: A. Get another set of vital signs B. Check the​ patient's blood sugar C. Contact medical command D. Position the patient on her side

Position the patient on her side

An​ 18-year-old female patient has eaten a poisonous mushroom. Medical direction has ordered you to administer activated charcoal. Immediately following​ administration, the patient vomits the medication. She remains alert and oriented with no current life threats to the​ airway, breathing, or circulation. Your next action would be​ to: A. Readminister the activated charcoal B. Reassess and continue transport C. Place the patient supine D. Administer a glass of milk

Readminister the activated charcoal

A worker at a chemical plant was working on a​ high-pressure tank containing chlorine gas when the valve​ broke, filling the room with chlorine gas and throwing the patient forcefully against the wall. He was unresponsive and trapped in the room for 10​ minutes, until being pulled out by firefighters. When the patient is brought to your​ location, he appears unresponsive. Your first action in caring for this patient would be​ to: A. Determine the presence or absence of a pulse B. Take manual spine motion restriction of the head and neck and perform the​ jaw-thrust maneuver C. Assess breathing and auscultate breath sounds D. Open the airway using the​ head-tilt, chin-lift maneuver

Take manual spine motion restriction of the head and neck and perform the​ jaw-thrust maneuver

A drug addict informs you that he has been taking OxyContin and now requires more and more of the drug to take his chronic back pain away. The EMT would recognize this patient as​ experiencing: A. Tolerance B. Adverse reaction C. Dependence D. Overdose

Tolerance

You are caring for a patient who intentionally drank a compound containing a high percentage of methanol. He is confused and​ lethargic, but has no obvious deficits to his​ airway, breathing, or circulation. En route to the​ hospital, the patient states that he is very nauseated and thinks that he is going to vomit. Your immediate action would be​ to: A. Turn the patient on his side B. Prepare the suction C. Check the​ patient's breath sounds D. Assess the​ patient's abdomen

Turn the patient on his side

Which action indicates that the EMT is correctly administering activated charcoal to a patient who has ingested a toxic​ substance? A. The charcoal is squirted into the mouth B. The charcoal is mixed with milk C. Sugar is added to make the charcoal taste better D. The patient drinks the charcoal through a straw

The patient drinks the charcoal through a straw

You have assessed a​ 25-year-old female who states that she took a large number of antidepressants and other medications in an effort to end her life. The primary assessment reveals no​ life-threatening conditions. Why is it important to get the​ patient's medical history at this​ time, rather than later on in the assessment or during​ transport? A. The police on scene will need the information prior to transport from the scene B. Patients are generally scared early on and more truthful with information C. The patient may become confused and be unable to provide information D. Further assessment may not be needed if there is no past medical history

The patient may become confused and be unable to provide information

When assessing a patient who has been exposed to a poisonous​ substance, it is essential to​ understand: A. The signs and symptoms of toxic exposure will vary depending on the specific poison B. Absorption into the body has not occurred if the signs of illness are not apparent within 15 minutes C. Vomiting indicates that the poison has not yet been absorbed into the body D. The route of entry into the body will determine the signs and symptoms

The signs and symptoms of toxic exposure will vary depending on the specific poison

Generally​ speaking, which technique should the EMT use first when confronted with a patient in a drug or alcohol abuse situation who is experiencing a​ "bad trip" and expressing some potentially violent​ tendencies? A. The​ "patient restraint" technique B. The​ "talk down" technique C. The​ "take down" technique D. The​ "assessment down" technique

The​ "talk down" technique

A confused female patient states that she was intoxicated and accidentally drank a glass of household bleach. When transporting this​ patient, which complication would you continually assess​ for? A. Chest pain B. Headache C. Diaphoresis D. Vomiting

Vomiting

Which of these statements indicates that the EMT understands the condition of​ withdrawal? A. ​"Withdrawal is a term that is applied to the cessation of street drugs to which the patient is​ addicted, not prescription​ drugs." B. ​"Withdrawal indicates that a patient is addicted to a drug and is presently overdosed on that​ drug." C. ​"Withdrawal is typically not a​ life-threatening situation and is easily managed by​ EMS." D. ​"Withdrawal from drugs or alcohol can be just as serious a medical emergency as an​ overdose."

​"Withdrawal from drugs or alcohol can be just as serious a medical emergency as an​ overdose."

The EMT accurately understands alcoholism when he​ states: A. ​"Aside from the excessive amounts of​ alcohol, much of the health deterioration that accompanies alcoholism comes from​ malnutrition." B. ​"The diagnosis of alcoholism is applied to a person who drinks hard​ liquor, not beer or​ wine." C. ​"Surprisingly, in the late stages of their​ condition, persons with alcoholism are very functional and able to hold down a job and maintain good family​ relations." D. ​"Alcohol is classified as a drug on which the addict becomes psychologically​ dependent, not physically​ dependent."

"Aside from the excessive amounts of​ alcohol, much of the health deterioration that accompanies alcoholism comes from​ malnutrition."

Firefighters have pulled a​ 62-year-old male patient from a bedroom that was on fire. According to the​ firefighters, the patient was smoking in bed and fell asleep. They found him supine on the floor. Assessment reveals him to be responsive to painful​ stimuli, with soot in his airway. He is breathing​ rapidly, but has no evidence of burns to his body. His pulse is 124​ beats/min, respirations are 24​ breaths/min, blood pressure is​ 146/90 mmHg, and SpO2 is​ 95%. After providing the appropriate​ care, which of these questions would be the most important to ask the firefighters prior to​ transport? A. ​"Which materials were burning in the​ room?" B. ​"How did the fire​ start?" C. ​"How fast was the patient breathing when you found​ him?" D. ​"How long was the patient trapped in the​ room?"

"How long was the patient trapped in the​ room?"

After determining that a patient intentionally overdosed on blood pressure​ medications, which of these questions would be most​ appropriate? A. ​"Why did you take so many​ pills?" B. ​"How many pills did you​ take?" C. ​"Were you confused about the proper​ dose?" D. ​"Are you on other​ medications?"

"How many pills did you​ take?"

A​ 17-year-old male patient was stung by an unidentified insect. On​ scene, the sting site to his right forearm showed some redness and mild swelling. During the​ reassessment, which statement made by the patient would indicate that venom from the sting is being absorbed into the​ bloodstream? A. ​"The area around the bite feels​ numb." B. ​"The bite seems to be hurting worse​ now." C. ​"I think that my arm is more​ swollen." D. ​"I feel sick to my stomach and​ dizzy."

"I feel sick to my stomach and​ dizzy."

Which of these complaints would the EMT expect from a person who has just used crack cocaine for the first​ time? A. ​"My nose feels​ raw." B. ​"I see​ spiders." C. ​"My heart feels​ slow." D. ​"I have chest​ pain."

"I have chest​ pain."

You have been called to a residence for a​ 31-year-old patient who is complaining of​ confusion, nausea,​ vomiting, and a headache. His symptoms started this morning and have been getting worse all day. Despite lying in bed and resting all​ day, he is more fatigued than before. Which of these statements made by the patient would the EMT recognize as most important in relation to the​ patient's present​ complaint? A. ​"I just turned the furnace on last​ night." B. ​"I tried some raw seafood last​ week." C. ​"I have not been sleeping well the past few​ nights." D. ​"My wife is taking​ penicillin, to which I am​ allergic."

"I just turned the furnace on last​ night."

You have been summoned to a residence for a child who ingested a liquid pesticide. On​ scene, the worried parents inform you that their​ 4-year-old son and some friends were playing in the garage and apparently found some​ pesticide, which their son says he tasted. Assessment indicates that he is​ alert, oriented, and crying and has some white powder around his mouth. After performing the initial assessment and finding no​ life-threatening conditions, it is imperative that the EMT make which question or​ statement: A. ​"Do you think this was an intentional​ act?" B. ​"I need to see the other​ children." C. ​"These chemicals need to be put out of​ reach." D. ​"Are all of his shots​ up-to-date?"

"I need to see the other​ children."

Which set of instructions given to another EMT would be most appropriate when managing a patient who ingested numerous household cleaners in an attempt to kill​ himself? A. ​"Before we​ leave, please call the hospital and tell them what he took so that they will​ know." B. ​"Let's gather up all of the containers of the chemicals he may have taken and take them with​ us." C. ​"We need to pour a sample of each cleaner that he may have taken into containers and take the samples with​ us." D. ​"I need you to write down all of the cleaners he may have taken so we can let the hospital​ know."

"Let's gather up all of the containers of the chemicals he may have taken and take them with​ us."

Emergency Medical Responders have removed a female patient from her​ bedroom, where she was found lying on her bed with a suicide bag over her head. The bag is removed and you note the woman to be​ unresponsive, pulseless, and apneic. Given the use of a suicide bag and the presentation of the​ patient, which of these statements indicates proper initial​ care? A. ​"Do not apply the AED since the arrest was not caused by a cardiac​ event." B. ​"Let's open the airway manually​ first." C. ​"I need someone to assess the​ patient's blood glucose​ level." D. ​"I need someone to get a pulse oximetry reading​ immediately!"

"Let's open the airway manually​ first."

Which of these statements made by an EMT indicates an accurate understanding of inhalation​ poisonings? A. ​"The onset of signs and symptoms associated with an inhalation poisoning are often​ rapid." B. ​"Inhalation poisons affect the​ lungs, but they do not circulate throughout the​ body." C. ​"Most inhalation poisonings are easily identified by residue or burns around the​ patient's mouth." D. ​"It is probably safe to enter the scene of an inhalation emergency if I do not smell​ anything."

"The onset of signs and symptoms associated with an inhalation poisoning are often​ rapid."

What is the typical dosage for intranasal administration of​ naloxone? A. 2 mg repeated every 5 minutes only if the patient responds to the initial dose B. 1 mg every 10 minutes C. 1 mg in each nostril D. 2 mg every 5 minutes until the patient regains consciousness

1 mg in each nostril

Medical direction has ordered the administration of activated charcoal to a​ 3-year-old boy. Which of these doses would be most​ appropriate? A. 0.5​ mg/kg B. 50 grams C. 1​ gram/kg D. 100 mg

1​ gram/kg

A​ 42-year-old patient weighs 154 pounds​ (70 kg). How much activated charcoal would you administer to​ him? A. 70 grams B. 500 grams C. 100 grams D. 154 grams

70 grams

A patient informs you that he smoked marijuana all night and now has great​ anxiety, hunger, and tremors to both hands. The EMT would recognize marijuana is best described​ as: A. A hallucinogen B. A sedative C. A cannabis product D. An appetite stimulant

A cannabis product

For which of these patients would you be most concerned about accidental exposure to​ cyanide? A. An auto mechanic working near exhaust fumes B. A worker who paints cars in an auto body shop C. A firefighter battling a smoky structure fire D. A coal miner working long hours in a mine

A firefighter battling a smoky structure fire

A​ 44-year-old male patient had a pesticide splashed into his eyes. Aside from local irritation and damage to the​ eyes, he developed systemic complications when the pesticide entered and circulated throughout his body. When completing the prehospital care​ report, the EMT would note the route of exposure​ as: A. Visual B. Injection C. Absorption D. Topical

Absorption

Medical direction has ordered you to administer activated charcoal to a patient who ingested a large amount of poison. When looking in your medical​ kit, which medication would you prepare and​ administer? A. Glyburide B. Ecotrin C. Nitrostat D. Actidose

Actidose

A patient who has ingested a toxic substance is to receive activated charcoal. The EMT knows that the charcoal will benefit the patient​ by: A. Coating the small​ intestine, limiting absorption of the poison B. Neutralizing the poison in the bloodstream C. Causing​ vomiting, thereby removing the poison from the body D. Adsorbing the poisonous substance in the stomach

Adsorbing the poisonous substance in the stomach

Which of these statements regarding antidotes is​ correct? A. Antidotes are beneficial because they will remove the poison from the body B. An antidote will neutralize or counteract the effects of a poison or toxic substance C. There are many antidotes for a large number of poisons and toxic substances D. An antidote can only be given in the emergency department by the physician or nurse

An antidote will neutralize or counteract the effects of a poison or toxic substance

At the scene of an industrial​ accident, you are presented with a male patient who was exposed to a powerful pesticide in powder form. The patient states that he was moving sacks of the pesticide when one broke​ open, creating a cloud of powder that surrounded​ him, and which he then inhaled. During the​ incident, his face and arms became covered with the powder. At the present​ time, he complains of difficulty breathing and burning of his skin on his face and arms. You note that some of the pesticide remains on these areas of the body. Your first action in caring for this patient would be​ to: A. Apply supplemental oxygen B. Obtain vital signs and a medical history C. Flush the pesticide with copious amounts of water D. Brush off the remaining pesticide

Apply supplemental oxygen

Which of these guidelines would the EMT follow when talking down a patient with a​ drug-related emergency? A. Inform the patient that restraints will be used if he does not listen to you B. Calmly explain to the patient that this is a consequence of abusing drugs C. Make frequent physical contact with the patient to establish trust D. Be authoritative and tell the patient to follow your directions

Calmly explain to the patient that this is a consequence of abusing drugs

You have been called to a residence for a​ 14-year-old male​ patient, who states that he intentionally took some medication to kill himself. Assessment indicates that he is alert and​ oriented, and has an open airway and adequate breathing. Given the​ situation, the​ EMT's next action should be​ to: A. Check the radial pulse and skin characteristics B. Ask the patient if he feels nauseated C. Inquire why the patient took the medication D. Determine what was taken

Check the radial pulse and skin characteristics

The Poison Control Center has advised you to administer milk to a patient who has overdosed on a medication. Given this​ information, you​ would: A. Contact medical command to confirm this treatment B. Transport the patient immediately instead and arrange for ALS intercept C. Administer the milk as ordered D. Contact ALS backup and wait on scene until they arrive

Contact medical command to confirm this treatment

You are called to an alcoholic crisis center to transport a patient experiencing delirium tremens. When assessing the​ patient, which signs or symptoms would you associate with this​ condition? A. High​ fever, seizure​ activity, sweating, lethargy B. Constricted​ pupils, hypothermia,​ confusion, hypotension C. Loss of​ memory, hallucinations,​ fever, dilated pupils D. Seizure​ activity, memory​ impairment, bradycardia, tremors

Loss of​ memory, hallucinations,​ fever, dilated pupils

When treating a patient for an​ overdose, the highest priority of care is placed​ on: A. Managing the airway and breathing B. Determining what and how much drug was taken C. Establishing the​ patient's risk for suicide D. Contacting law enforcement

Managing the airway and breathing

A​ 32-year-old female patient calls 911 to say that she injected herself with some heroin 15 minutes​ ago, which she just bought from​ "some guy" on the street. She has never tried heroin and is now scared about what she has done. Assessment reveals her to be conscious and well oriented. Her airway is open and she is breathing 14 times a minute. Her pulse is moderate in strength and her skin is warm and dry. What would be the appropriate care for this​ patient? A. Apply a tourniquet above the site of injection B. Administer intranasal naloxone C. Place a warm pack to the injection site D. Monitor her and initiate transport

Monitor her and initiate transport

You are assessing a young male patient who was found in an alley by sanitation workers. Assessment reveals the patient responds to painful stimuli by opening his​ eyes, but then closes them once you stop pinching the muscles on his neck. His airway is open and his breathing is shallow. His skin is cool and​ diaphoretic, and his pupils are constricted and do not react to light. Based on these assessment​ findings, the EMT would be suspicious​ of: A. Stroke or hypoglycemia B. Methamphetamine overdose C. Traumatic assault D. Narcotic overdose

Narcotic overdose

You suspect food poisoning in a​ 51-year-old male patient with​ nausea, vomiting,​ diarrhea, and fever. He is alert and oriented with no life threats to his​ airway, breathing, or circulation. His vital signs are​ pulse, 124;​ respirations, 20​ breaths/min; blood​ pressure, 198/98​ mmHg; and​ SpO2, 93% on room air. The patient has a history of COPD and​ hypertension, for which he did not take his medications today. In this​ situation, what would be the appropriate initial​ care? A. Encourage water by mouth for rehydration B. Oxygen at 2 lpm through a nasal cannula C. Take the blood pressure pill that the patient missed earlier D. Follow up with his family doctor

Oxygen at 2 lpm through a nasal cannula

You are by the side of a young female college student who is unresponsive. Friends say that she is normally not a heavy​ drinker, but tonight she drank an excessive amount of alcohol because her boyfriend broke up with her at the party. She responds to painful stimuli and has snoring respirations. Her respiratory rate is 8​ breaths/min and her radial pulse is weak. Your immediate action would be​ to: A. Apply oxygen via a nonrebreather mask B. Determine whether drugs are also involved C. Administer positive pressure ventilation D. Perform a manual airway maneuver

Perform a manual airway maneuver

Which of these is the​ EMT's highest priority when presented with a patient who has been exposed to a poisonous​ substance? A. Perform a primary assessment B. Administer activated charcoal C. Induce vomiting D. Identify the poison

Perform a primary assessment

You are transporting a patient who overdosed on medications from a community emergency department​ (ED) to a large medical center for continued care. In the​ ED, the patient received two doses of activated charcoal. When performing your reassessment of the​ patient, which of the findings would be most​ concerning? A. Diarrhea B. ​Red-colored stool C. Dark black stool D. Nausea

Red-colored stool

A patient working at an ice plant is trapped in a room filled with sulfur dioxide. You don a​ self-contained breathing apparatus and enter the​ room, finding the patient unresponsive on the floor. The room remains filled with the gas. Your immediate priority in caring for this patient is​ to: A. Assess the​ airway, breathing, and circulation B. Remove the patient from the immediate environment C. Loosen all​ tight-fitting clothing D. Start positive pressure ventilation

Remove the patient from the immediate environment

Emergency Medical Responders​ (EMRs) respond to a female patient who was found by her husband in their​ second-floor bedroom. When the responders​ arrived, she was lying on her​ bed, with a tourniquet on her arm. They also found a​ syringe, with unknown​ contents, lying on the floor next to the bed. Her husband denies that she abuses any drugs. The EMRs have removed the tourniquet and inserted a nasopharyngeal​ airway, and they are providing positive pressure ventilations at the rate of 10​ breaths/min with a​ bag-valve-mask device and supplemental oxygen. You note the woman to be​ unresponsive, with a pulse rate of​ 52, and apneic. What would your initial proper care​ include? A. Immediately move the patient to a firm surface B. Seek an order to administer naloxone C. Apply the AED D. Extricate the patient from the bedroom

Seek an order to administer naloxone

You have been called for a​ 28-year-old male patient with a history of behavioral problems. He responds to painful stimuli with garbled speech. His airway is​ patent, but breathing is inadequate. His radial pulse is rapid and his skin cool and moist. He has crackles at the bases of both lungs and the following vital​ signs: pulse,​ 108; respirations, 6​ breaths/min and​ shallow; blood​ pressure, 98/64​ mmHg; and​ SpO2, 92%. A friend informs you that the patient may have drunk a considerable amount of​ antifreeze, possibly up to 12 hours​ ago, in a suicide attempt. The first thing you should do​ is: A. Look for confirmation that the antifreeze was ingested B. Call poison control C. Provide​ low-flow oxygen to increase the pulse oximeter reading to​ 94% D. Start positive pressure ventilation

Start positive pressure ventilation

A​ 14-year-old female patient has taken an excessive amount of Tylenol with codeine. Family members were asleep when they heard a crash and found her at the bottom of the stairs. When they asked the adolescent if she was​ okay, she replied that her boyfriend broke up with her and she saw no point in going on with her​ life, so she took an overdose. When you arrive by the​ patient's side, you note that she is responsive to verbal stimuli with eye opening and is​ breathing, has an intact​ airway, and is breathing somewhat shallow but still adequately. Your first action would be​ to: A. Determine exactly how much medication she took B. Start positive pressure ventilation with oxygen C. Take manual spine motion restriction precautions D. Open the airway with the​ head-tilt, chin-lift maneuver

Take manual spine motion restriction precautions

When the EMT contacts the Poison Control Center for a female patient who accidentally overdosed on her blood pressure medications when she misread the​ label, which additional information would the center personnel most likely need to determine care options for the​ patient? A. The​ patient's weight B. The type of container in which the medication was found C. The most recent​ bowel/bladder characteristics D. The​ patient's birthday

The​ patient's weight

You are preparing to administer activated charcoal to a patient who has ingested a poison. The activated charcoal authorized by your medical director also contains a cathartic. Which of these statements would you make to the patient regarding this​ additive? A. ​"This charcoal will most likely give you a slight​ headache." B. ​"The additive in the charcoal may cause you to​ vomit." C. ​"You may experience diarrhea after taking the​ charcoal." D. ​"If you have a heart​ condition, I cannot give you this​ medication."

"You may experience diarrhea after taking the​ charcoal."

Following a large wedding that occurred the previous​ night, health authorities announce that some of the food was contaminated with Salmonella.​ Consequently, your EMS service receives notice that it may receive a significant number of calls involving food poisoning. A new EMT asks you how to treat patients with food poisoning. What is your best​ response? A. ​"If the patient has a​ fever, we can administer a medication to make him vomit so as to get the food out of his​ system." B. ​"The primary role of EMS in this situation is just to transport the patient to the​ hospital." C. ​"You should treat the patient based on his signs and​ symptoms, just like a patient who ingested any other​ poison." D. ​"After assessing the​ patient, the administration of activated charcoal can be effective if there are no obvious​ contraindications."

"You should treat the patient based on his signs and​ symptoms, just like a patient who ingested any other​ poison."

The EMT is transporting a patient with the diagnosis of​ Wernicke-Korsakoff syndrome. The EMT recognizes that this patient has a past medical history​ of: A. Drug abuse B. Pancreatic failure C. Alcoholism D. Liver failure

Alcoholism

A​ 53-year-old female patient has intentionally ingested a large amount of Valium. This medication is primarily absorbed into the body through which​ structure? A. Small intestine B. Large intestine C. Stomach D. Esophagus

Small intestine

You are transporting a patient who wants help to rid herself of an addiction to pain medications. She says she has not taken any pain medications since​ yesterday, and needs help. Which of these findings would you recognize as a sign of​ withdrawal? A. Her body temperature falls B. She begins to cry uncontrollably C. Her mental status decreases D. She starts to become agitated

She starts to become agitated

A​ middle-aged male with behavioral problems states that he drank some​ "chemicals" to kill the bugs in his body. The patient is alert and oriented and shows no​ life-threatening conditions to the​ airway, breathing, or circulation. At this​ point, which of these questions should the EMT​ ask? A. ​"Are you taking other​ medications?" B. ​"Do you know exactly what it was you​ drank?" C. ​"When did you drink​ it?" D. ​"Have you thrown​ up?"

"Do you know exactly what it was you​ drank?"

For which of these patients is a​ "talk down" technique​ indicated? A. A​ 59-year-old whose heart is racing after trying cocaine B. An​ 18-year-old who is having a​ "bad trip" after taking his​ parent's antihypertensive medication to get​ "high" C. A​ 47-year-old who has chronic alcoholism and is demanding help D. A​ 26-year-old who took LSD and is panicked because spiders are after him

A​ 26-year-old who took LSD and is panicked because spiders are after him

For which of these patients would activated charcoal be indicated given the type of​ poisoning? A. A​ 24-year-old female who was sniffing glue and now complains of a headache B. A​ 17-year-old male who drank bleach 30 minutes ago C. A​ 53-year-old female who took an overdose of antidepressants earlier in the day D. A​ 27-year-old who intentionally took a large amount of Tylenol 45 minutes ago

A​ 27-year-old who intentionally took a large amount of Tylenol 45 minutes ago

You are a new EMT in a very busy urban EMS system. Before joining this​ agency, you worked as a volunteer in a rural EMS​ system, where you did not experience many EMS calls. You are working with a seasoned EMT when you are requested to respond to a residential home for an unresponsive​ 13-year-old male patient. Upon your​ arrival, the family escorts you into the​ garage, where the boy is being cradled by his crying mother. The boy is unresponsive. As you draw nearer to the​ boy, your partner says to​ you, "Hey, you smell that moth ball​ smell? I know what might be going​ on." Given your​ partner's statement, how might the odor be related to the​ patient's condition? A. Camphor overdose B. Organophosphate overdose C. Chloral hydrate overdose D. Acetone overdose

Camphor overdose

An​ 11-year-old boy with a history of mild developmental delays has possibly ingested parts of a household​ plant; his mother states that she found him eating the​ plant, then immediately called 911. You note that the plant has been overturned and is missing a considerable number of leaves. Assessment reveals the boy to be lethargic and​ confused; he complains of abdominal​ pain, accompanied by nausea and vomiting. His airway is patent and his respirations are adequate. Which of these assessment findings would be most suggestive that the poison from the plant leaves has been absorbed into the​ patient's body? A. Leaves missing from the plant B. Nausea and vomiting C. Abdominal pain D. Confusion and lethargy

Confusion and lethargy

A​ 31-year-old female patient was stung by a hornet while golfing. Your assessment reveals her to be confused with stridorous respirations. Her skin is warm and flushed and covered with hives. A stinger is located on the back of her neck. Based on this​ information, you would recognize that the route of poisoning for this patient​ is: A. Topical B. Injection C. Anaphylactic D. Absorption

Injection

You have been called to a residence for a cognitively challenged​ 32-year-old female patient who drank from a bottle of floor cleaner. She is​ unconscious, exhibits snoring​ respirations, and is having a difficult time breathing due to swelling from burns in her mouth. Which of these steps should be included in the initial care for this​ patient? A. Apply​ high-flow oxygen via nonrebreather B. Insert a nasal airway C. Suction the airway D. Contact poison control

Insert a nasal airway

You have been called for an unresponsive patient. When you arrive at the​ scene, hysterical family members direct you to an unresponsive​ 32-year-old woman who is lying on the bedroom floor. Her husband says that she left a note saying that she wanted to kill herself and took an unspecified poison. Assessment reveals a​ green-colored liquid in her mouth and respirations that are​ rapid, shallow, and gurgling. The​ patient's pulse is​ weak, and her skin is cool and dry with cyanosis to her fingertips. Your immediate action would be​ to: A. Extricate the patient and provide care en route to the hospital B. Start positive pressure ventilation C. Read the note for clues to what the patient took D. Manually open the​ patient's airway and perform suction

Manually open the​ patient's airway and perform suction

A​ 17-year-old female patient was at a party where she tried a Percocet pill​ (narcotic pain​ reliever). After taking the​ pill, she became scared that she was going to die and is now crying. At the present​ time, she feels slightly​ nauseated, but has no other complaints. There are no life threats and her vital signs are​ pulse, 88;​ respirations, 14​ breaths/min; blood​ pressure, 108/68​ mmHg; and​ SpO2, 98% on room air. The patient has no medical history but is allergic to​ peanuts, for which she has a prescribed epinephrine​ auto-injector. Appropriate care for this patient would​ include: A. Nonemergent transport B. Asking if she has an epinephrine​ auto-injector with her C. ​Talk-down technique D. Supplemental oxygen via a nasal cannula at 2 lpm

Nonemergent transport

A​ 49-year-old patient with alcoholism has fallen down a flight of stairs after consuming​ two-fifths of whiskey. He presents with confused and slurred speech and the smell of alcohol on his breath. Family states that he is​ "hopeless" and has been drinking more and more every night. They also say that he must be more drunk than usual because he usually does not slur his speech. Assessment reveals his airway to be​ open, breathing​ adequate, and circulation intact. He has a hematoma from the fall to the left side of his head and complains of pain to his left wrist. Given these assessment​ findings, the EMT would be most concerned about​ the: A. Possible brain injury B. Amount of alcohol consumed C. Possible wrist fracture D. Lack of family support

Possible brain injury

On arrival at a tailgate party in a parking lot near a​ college, you observe a crowd around a young man who is seizing. As you get equipment from the ambulance and make your way to the​ patient, his friends tell you that the patient has been up all night​ "partying" by drinking alcohol and smoking crack cocaine. At the​ patient's side, you note that he is no longer​ seizing, but is unresponsive and has snoring respirations. His respirations are labored at 16​ breaths/min and his radial pulse is strong. His skin is cool and diaphoretic. Friends also inform you that he has​ diabetes; about an hour​ ago, they heard him say that he thought his blood sugar was becoming low. Which of these interventions would most likely be included in your​ care? A. Open the​ airway, check the blood glucose​ level, and administer oral glucose B. Open the​ airway, provide​ oxygen, and administer oral glucose C. Insert an oral​ airway, provide positive pressure​ ventilation, and administer oral glucose D. Open the​ airway, provide​ oxygen, and give rapid transport to the hospital

Open the​ airway, provide​ oxygen, and give rapid transport to the hospital

The family of a​ 31-year-old female patient reports that she has taken an overdose of her​ father's diabetes medication. Assessment reveals her to be​ unresponsive, lying on the​ floor, with snoring respirations. Her pulse is rapid and her skin is cool to the touch. The patient has no history of diabetes but is allergic to penicillin. It is believed that she took the medication within the past hour. Your initial intervention in caring for this patient would be​ to: A. Administer activated charcoal B. Induce vomiting C. Perform a​ jaw-thrust maneuver D. Administer glycogen or intranasal naloxone

Perform a​ jaw-thrust maneuver

Medical direction has ordered the administration of activated charcoal to an adult patient who has overdosed on several unspecified medications. Prior to administering the​ medication, the EMT​ must: A. Determine whether the patient has a prescription for the medication B. Shake the medication thoroughly to mix it C. Determine whether the patient has a history of diabetes D. Ask the patient if he has had diarrhea over the past two weeks

Shake the medication thoroughly to mix it

A patient has been found unresponsive on her bedroom floor. When assessing​ her, the EMT would have the highest index of suspicion for a narcotic overdose when he​ notes: A. A glass pipe with a sticky residue in it B. Bottle of Valium next to her C. Shallow and slow respirations D. Dilated pupils

Shallow and slow respirations

An alert and oriented​ 5-year-old child drank some ammonia that was placed in a cup in the garage. He is very scared and complains of abdominal​ pain, but states that he has not vomited. Assessment shows ammonia in and around his mouth as well as on his breath. He has an open airway and is breathing adequately. His pulse and skin show no abnormalities. Appropriate care for this patient would​ include: A. Administering activated charcoal B. Inducing vomiting C. Initiating positive pressure ventilation D. Rinsing his face and mouth with water

Rinsing his face and mouth with water

You are en route for a possible heroin overdose. As an​ EMT, you would recognize heroin fits best into which drug category based on its​ effects? A. Sedatives B. Psychedelics C. Hallucinogens D. Stimulants

Sedatives

This is the third day that a patient is in withdrawal from alcohol. If called to care for this​ patient, the EMT would recognize the need​ for: A. Warm blankets B. Restraints C. Positive pressure ventilation D. Seizure precautions

Seizure precautions

The grandfather of an alert and oriented​ 2-year-old girl found her on the floor playing with pills from his open bottle of Digoxin​ (a heart medication that slows the heart​ rate). He cannot remember how many pills were in the​ bottle, but he thinks that some are missing and suspects that his granddaughter may have eaten them thinking that they were candy. Assessment reveals the​ patient's airway to be open and breathing adequate. Her pulse is appropriate for a child her age and her skin warm and dry. Her grandfather is not sure of how long ago she may have taken the pills. Given the assessment​ findings, the EMT would​ assume: A. The Digoxin pills have yet to be absorbed into the body B. The child must have spit the pills out before swallowing them C. The child apparently did not take any Digoxin D. Not enough Digoxin was taken to harm the child

The Digoxin pills have yet to be absorbed into the body

You have been called for a patient with alcoholism who is experiencing a medical emergency. On​ scene, a home health nurse informs you that the patient is experiencing delirium tremens. As an​ EMT, you recognize​ that: A. The patient will require the administration of glucose B. This is a​ life-threatening condition requiring rapid transport C. The patient is in the early stages of alcohol withdrawal D. The patient is extremely intoxicated and in danger of dying

This is a​ life-threatening condition requiring rapid transport

Which of these patients would the EMT recognize as a drug​ abuser? A. A​ 41-year-old male who tried marijuana for the first time B. A​ 56-year-old male who accidentally took an additional dose of blood pressure medication C. A​ 46-year-old female who used cocaine for 10 years but has not used it in 5 years D. A​ 39-year-old female who takes pain medications even though she is not in pain

A​ 39-year-old female who takes pain medications even though she is not in pain

A​ 44-year-old male patient who works at a​ petroleum-refining plant inhaled a significant amount of hydrocarbon fumes and now complains of a headache with associated dizziness and​ nausea, as well as mild shortness of breath. He is alert and​ oriented, and there are no life threats to his​ airway, breathing, or circulation. Which of these steps should be included in his assessment and​ care? A. Continuous​ high-concentration oxygen B. ​Head-to-toe decontamination C. Aspirin for the headache D. Intranasal naloxone

Continuous​ high-concentration oxygen

You are responding to a​ drug-related emergency. While you are en route to the​ scene, the dispatcher informs you that the patient has overdosed on an unspecified narcotic. Which of these statements made by your partner indicates an understanding of overdoses with narcotic​ drugs? A. ​"We will have to be careful because narcotic overdoses can cause​ hallucinations, and the patient may be​ violent." B. ​"If the patient is​ conscious, we will have to ask about chest pain since narcotics can increase the​ heart's workload." C. ​"We need to look at the pupils. If they are​ constricted, the patient has most likely taken a narcotic and we will have to administer naloxone​ intravenously." D. ​"When performing the primary​ assessment, we need to be alert for respiratory depression and have the naloxone​ ready."

"When performing the primary​ assessment, we need to be alert for respiratory depression and have the naloxone​ ready."

Which of these descriptions is most characteristic of carbon​ monoxide? A. Carbon monoxide is a tasteless gas that is produced by household appliances such as electric furnaces B. Carbon monoxide is an odorless gas that can kill a person by causing severe hypoxia C. Carbon monoxide poisoning symptoms mimic the​ flu, but it tends to cause a higher fever than the flu D. It generally takes several days for a toxic level of carbon monoxide to accumulate in the body

Carbon monoxide is an odorless gas that can kill a person by causing severe hypoxia

After a 911 call​ hang-up, you are dispatched to the​ caller's residence. When you enter the room with a police​ escort, you find an unresponsive female patient with a bag over her head. A person in the neighboring apartment tells you that the patient has depression and warned that​ "there is going to be a death​ today." Your immediate action would be​ to: A. Remove the bag and assess for airway occlusion B. Move the patient out to the ambulance before initiating care C. Provide manual spine motion restriction precautions D. Leave the room until it is cleared by the fire department

Leave the room until it is cleared by the fire department

A female patient in her forties has overdosed and is lying at the bottom of some stairs. Her husband reluctantly informs you that she is addicted to pain medications and was chewing a fentanyl​ (narcotic pain​ reliever) patch this evening. She was having difficulty standing up and fell down the stairs. The husband is so frustrated with her that he immediately leaves the scene. The patient has snoring respiration and is incontinent of urine. You first step in caring for this patient would be​ to: A. Check her pupils for signs of a narcotic overdose B. Take manual spine motion restriction precautions C. Apply supplemental oxygen D. Open the airway with a​ head-tilt, chin-lift maneuver

Take manual spine motion restriction precautions