ch 37-39

treating a 6 y/o pt who is in cardiac arrest. The most common cause of pediatric cardiac arrest is

respiratory failure

You and a new EMT are volunteering at a county fair, demonstrating proper use of child safety seats. He asks, "Why is this so important?" How should you best respond

"Children are needlessly injured in motor vehicle accidents every year. Because trauma is the leading cause of death in children and infants it's important that we teach parents how to properly use the safety seats."

Which statements made by the EMT is most appropriate regarding dealing with caregivers and children during a medical emergency

"I try to include the caregiver in all that I do with his or her child so that the child and caregiver are more comfortable."

attempting to assess pediatric pt who fell off a jungle gym. Which would be best statement to obtain cooperation of your pt

"Katie, this is my stethoscope. i can use it to hear what you're breathing sounds like. would you like to look at for a minute?"

transporting a 3 y/o in cardiac arrest. most appropriate when communicating with a parent or caregiver

"We are going to perform CPR the entire way to the hospital."

Which pts is at the highest risk of developing hypothermia

84 y/o male in his home in February

narrow temperature range at which the body functions best is between

97.7-99.5

ventilating a 23mo. who suddenly stopped breathing. strong pulse of 72. How should you properly care

Using an appropriately sized bag-mask device, deliver each breath over 1 second

Special consideration should be taken when selecting a facility to which to transport a pt suffering from decompression sickness. patient should be transported to

a facility equipped with a decompression chamber

dispatched to a private residence for a pt with back pain. Upon arrival, wife leads you into the family room where her husband is sitting in a chair. complaining of severe back pain. he was watching TV when he got up to get a drink. On his way to the kitchen, he felt a "tearing" pain in his abdomen. pain then moved to his back. pt is most likely experiencing

a nabdominal aortic aneurysm

treating pt who was found out in the cold. best assess skin temperature, place the back of your hand against the pt's

abdomen

treating hypothermic pt, you apply chemical hot packs to the patient's neck, armpits, and groin areas. This is an example of

active rewarming

called to a skilled nursing home to transport pt with fever and pneumonia to the hospital for further care and treatment. As such, you realize that the primary focus of your care will be

administering a bronchodilator

assessing a pt with a history of cardiac problems. While checking his pulse, you note it is irregular without any pattern. This finding would be considered

an irregular pulse

called to a beach, where pt is in excruciating pain after coming into contact with a jellyfish. The nematocysts are still attached to your patient's lower leg. begin to treat your patient by

apply baking-soda slurry, then scrape off nematocysts

treating a hiker who was bitten on the leg by a snake. Which is acceptable treatment for this pt

apply pressure immobilization bandage the entire length of the extremity

obtaining a history on a 94 y/o male pt, he states he was one of the first humans to land on the moon. elderly patients may make up imaginary experiences to help replace lost memories. While assessing this pt, you should NOT

assume he has dimentia

assessing an 81 y/o female patient. She appears to have a diminished mental status. further evaluate her mental status you should do all of the following EXCEPT

assume the diminished mental status is normal

dispatched to private residence for a child having severe breathing difficulty. Upon your arrival, you find a 3 y/o child in severe respiratory distress. skin is cyanotic and she responds only to painful stimuli. pt's grandmother states she was complaining this morning about a sore throat and was running a fever. most appropriate treatment -

begin gentle ventilations with a bag-mask device and supplemental oxygen

farm where pt is complaining of abdominal pain, cramping in her thighs, and nausea. During questioning you learn that she was cleaning doesn't recall being bit by anything. spot a mark on her left ankle that is red and swollen. What might she be suffering from

black widow bite

When cells freeze,

blood flow to the infected area is impeded

#1 cause of death in infants and children is

blunt force trauma

While relaxing on the dock you notice a swimmer in distress. swimmer is 25 ft from shore, there is a rowboat with throwable flotation cushions tied to the dock. no lifeguard on duty. Which should you do first

call for help and try to throw the cushion to the swimmer

most serious event associated with lightning strike is

cardiac arrest

very cool night and you are dispatched to a city alley, where you find unresponsive man holding a bottle of alcohol. skin is cold to the touch. After opening the airway and ensuring that the patient is breathing, you should

checking patients pulse

dispatched to a private residence for a child who fell down some steps. Upon arrival, you find the child crying in her mother's arms. physical exam reveals several contusions in various stages of healing and some red band-like marks on the patient's buttock and lower back. You should be suspicious that the

child may have been abused

sitting on a cold metal bleacher while watching a high school football game. which methods would you lose body heat to the bleachers

conduction

The process of developing hypothermia includes

constriction of blood vessels

pt had been hiking all day and became lost early in the evening. It is now early the following morning. found about half a mile from the trail head, shivering and disoriented. How did he lose body heat

convection

assessing infant you suspect is suffering from hypoperfusion (shock). Which would you recognize as a sign of shock in an infant

cool, clammy skin

dispatched to a fraternity house, where a party has been going on most of the night. You find an intoxicated 22 y/o male pt who went out walking in the snow without socks or shoes. pt has deep cold injuries to both feet. treatment for this patient should include

covering the injury to preserve heat

If diver ascends too quickly, the changing pressures can cause

decompression sickness

Cardiovascular changes that may result from aging include

decreased cardiac output

As we age, changes in the brain can lead to

decreased reaction times

While in a study session, you and your classmates are discussing the role the thyroid gland plays in body processes. A decrease in the function of the thyroid gland is likely to produce which of the following in an elderly patient

decreased tolerance of heat and cold

begun to transport a patient from a skilled nursing facility. Your partner tells you that he believes that the pt is dehydrated. What sign or symptom best reinforces his suspicion

dry mouth and tongue

Although other age groups are as likely to attempt suicide, which of the following groups is most likely to be successful

elderly men

dispatched to a private residence for a child having difficulty breathing. When you arrive, you find a 2 y/o male pt in obvious respiratory distress. possible causes of respiratory distress in this patient EXCEPT

emphysema

You have just arrived at the side of an elderly pt who took excessive amounts of several medications after becoming confused. Which one of the following is the immediate priority in caring for this pt

evaluate and support the its airway and breathing

You are doing a clinical rotation in the geriatric unit. After assessing several pts, you sit down and discuss your findings with your preceptor. After this you realize that you must keep a high index of suspicion for serious conditions in elderly pts

even if symptoms are seemingly mild or vague

called to the side of a confused geriatric pt complaining of abdominal pain. Prior to palpating the pt's abdomen, the EMT must first

explain the family members why you are palpating the its abdomen

It is a hot summer day, dispatched to a construction site for a worker who is extremely ill. Co-workers moved pt into the shade. responsive, but disoriented. skin is flushed and hot to the touch. Although it is a hot day, your pt has very little sweat on his skin. your pt is suffering a heat-related emergency that you recall is a result of

failure of body temp regulation mechanisms

transporting an ill 8 y/o to the hospital for evaluation when he suddenly starts having a seizure. most common cause of seizures in pediatric pts is

fever

2 y/o pt with abdominal pain and chest pain. mother tells you that he hasn't had a bowel movement in several days. What condition might you suspect

gastroesophageal reflux disease

pt presents with flushed skin and is sweating profusely. complains of severe pain in his legs. may be suffering from

heat cramps

pt has been hiking for several hours in the heat and has not been drinking water. sweating, BP is 90/60, pulse 100, and he says that he is light-headed. he may be suffering from

heat exhaustion

You are assessing an elderly resident of an extended care facility. To help distinguish between normal and abnormal complaints you might ask

how is the way you feel today different from how you felt last week?

While assessing the mental status in your 73 y/o male patient you discover that although he is alert, he is not oriented to place or time. Common causes of altered mental status in the elderly include all of the following EXCEPT

hyperglycemia

busy shopping center, found an infant left alone in a car. It is 95°F outside and no one has been able to locate the child's parent to determine how long the infant has been left alone. The infant is likely suffering from

hyperthermia

pt has been playing indoor soccer for several hours. particularly humid day, pt appears to be sweating profusely. he may be suffering from

hyperthermia

In many ways a localized cold injury is similar to

hypothermia

cold December morning, dispatched to the scene of a motor vehicle collision. one pt who appears to have struck his head on the dashboard. management of this pt should include treatment for

hypothermia

C-spine immobilization in drowning victims is

indicated only when clear MOI exists

pt was struck by lightning while golfing. unresponsive on the eighth hole with no pulse or breathing. What should you do first

initiate AED use

After a particularly cold December night, pt was found unresponsive behind a dumpster. How do you begin to treat pt

insert appropriate airway to assist ventilations

treating a maintenance worker who has been shoveling snow. If he is experiencing severe hypothermia, what might you expect to see

irrational behavior

When transporting pt who you suspect may be suffering from decompression sickness and doesn't appear to have sustained any spinal injury, it is best to transport him in the ___ position

lateral recumbant

Most states categorize the EMT as a mandatory reporter of child abuse. This means that you must report suspected abuse to which of the following parties

law enforcement

In addition to convection, radiation, and conduction, how does the body gain heat

metabolic output

conducting a safety presentation at the local senior citizen center, you explain that in the elderly population, EMS is frequently called for all of the following EXCEPT

motor vehicle collision

pt suffering from heat exhaustion, first thing you should do

move him to a cooler enviornment

You are dispatched to a private residence for a 2 y/o with a high fever. You find the patient lying in his crib in possible respiratory distress. Which one of the following signs is normal in a child that is not prominent in adults

movement of abdomen with respiratory effort

assessment tool you might use to help assess circulation in the pediatric pt is capillary refill. which age groups is this tool most appropriate

o-6 years of age

6 y/o male pt has a decreased level of consciousness. mother states that they do not have health insurance so they did not take him to the hospital last week when he started vomiting and had massive diarrhea. he has not had anything to eat or drink since then. snoring respirations that are rapid and inadequate. radial pulse cannot be located, carotid pulse is rapid and weak. capillary refill is five seconds and skin is cool to the touch. first intervention in caring for this child

open airway using head tilt/chin lift

called to a community pool where a 5 y/o male pt slipped and fell down several stairs. unresponsive and is not breathing. begin to manage this pt

open airway with modified jaw-thrust maneuver

It is a sunny, called to a shopping center parking lot for a child left in a car. Upon arrival, infant who was left unattended in a car for an unknown time. infant is unresponsive to all stimuli. Which should you do next

open airway, insert OPA, assist venilations with BVM

To rewarm a local cold injury

place the affected part in water slightly warmer than body temperature

Airway management of a 4 y/o may be made easier by

placing a small towel under its shoulders

Which lung conditions is very common the elderly

pneumonia

In addition to making sure the scene is safe for you and your partner, what should you also look for when performing a scene size-up in the home of an elderly pt

potential fall hazards

4 y/o pt in this age group is considered

preschooler

It is a hot, middle-aged female pt has been walking around at a county fair. disoriented and complaining of extreme weakness. skin is hot and dry. Management of this pt

providing oral rehydration

called to the marina for a patient who fell off a jet ski. arriving, lake patrol is bringing in the pt. consider all of the following EXCEPT

pt is suffering from hyperthermia

apartment complex for an elderly patient who is not acting right. Upon arrival, elderly male patient sitting in a living room chair. apartment feels very cold. You recall that newborns, infants, and the elderly are more vulnerable to temperature extremes than other age groups because these age groups

regulate body temperature poorly

treating pt who was stung in the forearm by a bee. Which of the following is acceptable treatment for this pt

remove jewelry from affected limb

private residence assessing a 1 y/o pt. mother states she called an ambulance because her daughter was having a seizure. child has been ill for the past two days. pt is very warm to the touch and is not responding appropriately for her age. treatment should include

removing warm clothing down to underpants or diaper

assessing pt who is homeless and was found lying in an alley during a severe snowstorm. pt has apparently been exposed to the cold for several hours. Early signs of hypothermia include

shivering

assessing an elderly pt and obtaining a history from her family, you become suspicious of possible elder abuse. Which of these is NOT a form of elder abuse

social abuse

treating a victim of lightning strike who has a pulse and is breathing adequately, be sure to

take c-spine immobilization options

An 87 y/o male pt got out of bed, became dizzy, and fell onto the floor, hitting the right side of his face. find him sitting on the floor with his wife next to him. wife states that he did not lose consciousness and that this has happened several times over the past few days, ever since the doctor put him on a new blood pressure medication. pt is currently alert and oriented and complaining of dizziness and a headache. history of coronary artery disease, emphysema, and hypertension. Which one of the following should you do first

take manual in-line stabilization

assessing a 74 y/o female patient who was recently diagnosed with a thoracic aortic aneurysm. If this aneurysm dissects, your pt most likely will describe the pain as a

tearing

Which of the following statements is TRUE regarding adult drowning pts

the colder the water, the better chances of survival in salt water and freshwater drowning

Children may be more susceptible to bruising a lung because

their ribs are more pliable

attempting to obtain a history on your 78 y/o male pt who has a hearing impairment from years of factory work. While communicating with this pt you should remember

to make sure the pt can see you when you are speaking

called to care for a 20mo. female pt, given the pt's age, you would appropriately classify the pt as

toddler

beginning your assessment on an elderly pt who says she is having a heart attack. Which of the following should raise your index of suspicion

trouble breathing

One of the divers in the marina is complaining of general aches and pains in his joints, appears to have a rash on his neck. symptoms are generally associated with

type I decompression sickness

When nitrogen bubbles affect blood flow to the lungs and a pt presents in respiratory distress with acute chest pain after a dive, he may be suffering from

type II decompression sickness

You should perform CPR on child pts

unless pt presents with lividity

helping with a presentation to a Boy Scout troop on environmental emergencies. Which of the following do you tell them is a symptom of a snake bite

vision problems

4 y/o presenting with altered mental status and no other obvious underlying cause should be treated

with supplemental oxygen and rapid transport