Emt chapter 24
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
When the body loses sweat, it also loses:
electrolytes
The body's natural cooling mechanism, in which sweat is converted to a gas, is called:
evaporation
Geriatric patients, newborns, and infants are especially prone to hyperthermia because they:
exhibit poor thermal regulation
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
Which of the following conditions would be the LEAST likely to increase a person's risk of hypothermia?
hyperthermia
What are other conditions you should consider as potential causes of the patient's AMS?
hypoglycemia give oral glucose. look for occult head injury. look for ams from trauma.
Shivering is a mechanism in which the body generates heat by:
increasing metabolic rate
To obtain the MOST accurate reading of a patient's core body temperature, you should place a special hypothermia thermometer:
into the patients 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 perform rapid cooling interventions
Which of the following is an early sign of pit viper envenomation?
local swelling and ecchymosis
Heat cramps are MOST likely the result of
loss of water and electrolytes
A frostbitten foot can be identified by the presence of:
mottling and blisters
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.
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
What specific treatment is required for this patient?
move patient to cool environment + give oxygen. remove patient clothing because heat can be trapped. place cold packs @ groins, axillae (arm pits), behind neck.
The venom of a black widow spider is toxic to the:
nervous system
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:
open the unresponsive patient's airway with the jaw-thrust maneuver, assess his ABCs, and begin CPR and attach the AED as soon as possible.
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
Approximately 12 hours after scuba diving with her friends, a 29-year-old female presents with pain in her elbows and knees. She is conscious and alert and is breathing with adequate tidal volume. When asked, she states that she may have ascended too rapidly during her dive, but didn't experience any symptoms until now. When treating this patient, you should
place her in a left lateral recumbent position with her head down
What risk factors does this patient have that predispose him to heat illness?
prolonged exertion in hot sun. not drinking water so not producing sweat. Medical History - diabetes hypertension using diuretics promoting urination contributing to dehydration.
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
A patient with a core body temperature of 92°F 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.
Burns associated with lightning strikes are typically
superficial
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 two MOST efficient ways for the body to eliminate excess heat are:
sweating and dilation of skin blood vessels
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
What is the most likely explanation for this patient's vital signs?
tachypnea, tachycardia hypotension signs of shock. needs IV, additional help ALS. elevate patient's legs, continue high flow oxygen, monitor patient.
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.
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
Heat loss from the body through respiration occurs when
warm air is exhaled into the atmosphere
When assessing a hypothermic patient, you should palpate for a carotid pulse for approximately __________ seconds before determining that he or she is pulseless.
30-45 seconds
A person's ability to shiver is lost when his or her body temperature falls below
90 degrees
Hypothermia occurs when the core body temperature falls below:
95 degrees fareinheit or 35 degrees celsius
What factors can decrease the body's ability to eliminate excess heat?
High air temperature vigorous exercise = sweat 1 L of sweat per hour loss of fluids = dehydration Chronic Disease - obstructive pulmonary disease, diabetes, dehydration, obesity medications
Which of the following statements regarding drowning is MOST correct?
Laryngospasm following submersion in water makes rescue breathing difficult.
Which of the following statements regarding lightning strikes is MOST correct?
Lighting often results in a brief period of asystole that resolves spontaneously
What type of heat illness should you suspect that he is experiencing? Why?
Patient has heat stroke. When body is exposed to more heat than it can handle +normal compensatory mechanisms that eliminate excess heat are overwhelmed. AMS confusion or coma/flushed hot skin
How should you adjust your treatment for this patient?
Patient with inadequate breathing needs bag mask device with ventilation. keep patient cool. insert airway adjunct.
How does the body normally balance heat production + elimination?
Sweating + dilation of blood vessels brings warm blood to surface of skin releases heat via radiation. remove patient's clothing. put patient in cooler environment.
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
The EMT must assume that any unwitnessed water-related incident is accompanied by
a possible spinal injury
Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT:
a relatively small surface area
The EMT must assume that any unwitnessed water-related incident is accompanied by:
a spinal injury
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
The MOST prominent symptom of decompression sickness is:
abdominal or joint pain.
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. After initiating artificial ventilations, you should:
assess for a carotid pulse up to 45 seconds
A dysbarism injury refers to the signs and symptoms related to changes in
barometric pressure
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 the slowing of a 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
eriatric 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
How will you know when you have adequately cooled the patient?
core body temperature is assessed via rectal thermometer. Don't overcool patient result is shivering. Shiver generates more heat.