EMT Ch 21 Toxicology
True or False: Opioids, sedatives, and barbiturates slow breathing, so ventilatory complications are a concern.
True
Which of the following might make it difficult for you to establish an IV access in a patient with a drug abuse problem? Tachycardia Nausea and/or vomiting Venous scarring Hypotension
Venous scarring (or track marks) makes it difficult to establish IV access.
Activated charcoal is given to patients who have ingested certain substances because it:
binds to the substance and prevents absorption
What is the most common route of poisoning? Absorption Ingestion Inhalation Injection
According to the AAPCC, approximately 80% of all poisoning is by ingestion.
Antihistamines are an example of which of the following? Anticholinergic agent Cholinergic agent Sympathomimetic Synthetic cathinone
Antihistamines are an example of anticholinergic agents that block parasympathetic nerves.
True or False: Most poisons do not have an antidote.
True
Which of the following sets of vital signs would the EMT MOST likely encounter in a patient with acute cocaine overdose?
BP 200/100 mmHg, 150 beats/min
How do poisons typically act to harm the body?
By changing the normal metabolism of cells or by destroying them
You can use the mnemonic DUMBELS to remember the signs and symptoms of which of the following? Acetaminophen poisoning Anticholinergic agents Cholinergic agents Food poisoning
DUMBELS stands for Diarrhea, Urination, Miosis/muscle weakness, Bradycardia/bronchospasm/bronchorrhea, Emesis, Lacrimation, and Seizures/salivation/sweating, which are the signs and symptoms of cholinergic drug poisoning.
You are assessing a patient who presents with slurred speech, hypoventilation, and hypotension. Which of the following might the patient have taken? Pilocarpine Albuterol Diazepam Diphenhydramine
Diazepam is a sedative-hypnotic and signs and symptoms include slurred speech, sedation or coma, hypoventilation, and hypoventilation.
True or False: When dealing with an absorbed poison, you should flush the skin of the affected area with an alcohol rinse for 15 to 20 minutes.
False, When dealing with an absorbed poison, you should flush the skin of the affected area with clean WATER (NOT alcohol) for 15 to 20 minutes.
True or False: Ingested poisoning is usually accidental in adults.
False, ingested poisoning is usually accidental in children and deliberate in adults.
You are assessing a 28-year-old patient and you notice he has pinpoint pupils. You suspect a drug overdose. What drug is the likely cause of this phenomenon? Cocaine Methamphetamine Heroin Alcohol
Heroin is an opioid, and a sign of an opioid overdose is pinpoint pupils.
What should you give a patient displaying respiratory depression and hypotension? Activated charcoal Naloxone Phenobarbital Codeine
Naloxone is an antidote that reverses the effects of opiate or opioid overdose, which is characterized by respiratory depression and hypotension.
Heroin is an example of a(n):
Opioid
Which of the following is a CNS stimulant? Alcohol Opiates Sedative-hypnotics Sympathomimetics
Sympathomimetics are CNS stimulants. Cocaine is an example of a sympathomimetic.
For which of the following would you use a DuoDote Auto-Injector? Sarin gas attack Morphine overdose Carbon monoxide poisoning Acetaminophen overdose
The DuoDote Auto-Injector is used to counteract cholinergic agents like sarin gas.
Which of the following types of food poisoning results from an organism? Botulism Datura Salmonella Staphylococcus
The Salmonella bacterium produces an infection in an individual who ingests the contaminated foods.
Victims of inhaled poisoning will require which of the following?
Transport to an emergency department for evaluation
Which of the following questions would be LEAST pertinent during the initial questioning of a patient who ingested a substance?
Why was the substance ingested?
Which of the following is true about the use of activated charcoal in treating poisoning? The usual adult dose is 15 to 30 g. Before you give a patient charcoal, you must obtain approval from medical control. If the patient has a decreased LOC and cannot protect his or her airway, do not give activated charcoal. The adverse effects of ingesting activated charcoal include diarrhea and bloody stools.
You should contact medical control and you should not give activated charcoal to patients with altered LOC.
Sympathomimetic and ________ overdoses are very similar because both may cause agitation, tachycardia, and dilated pupils. Anticholinergic Cholinergic Sedative-hypnotic Opiate
anticholinergic
You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and hydrocodone (Vicodin). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient should include:
assisted ventilation and naloxone (Narcan)
As you enter the residence of a patient who has possibly overdosed, you should:
be alert for personal hazards
A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient's wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is MOST likely experiencing:
delirium tremens (DTs)
Most poisonings occur via the __________ route.
ingestion
Of the four avenues of poisoning, generally ______________ is the most worrisome in terms of treatment to the EMS provider
injection
When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that:
internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot
An overdose of acetaminophen, the active ingredient in Tylenol, will MOST likely cause:
liver failure
Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of:
oxycodone (Percocet)
The recommended treatment for absorbed or contact poisons includes _________.
safely removing or diluting the poisonous substance
In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be MOST alert for:
seizures and cardiac arrhythmias
Which of the following statements regarding the Salmonella bacterium is correct?
the Salmonella bacterium itself causes food poisoning
A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing
tolerance
If the victim of a toxicologic emergency vomits, an EMT should _________.
use appropriate PPE and examine the vomitus for pill fragments or other clues for patient care
You receive a call to a residence where a man found his wife unresponsive on the couch. The patient's respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 bpm, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should:
ventilate her with a BVM