EMT Chapter 20:Immunologic Emergencies

Your assessment of the patient experiencing an allergic reaction should include evaluations of all the following EXCEPT the:

reproductive system

Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction?

The environment where the patient was found

Anaphylaxis caused by stinging insects is typically an allergic reaction to ____________ rather than the bite or sting itself.

injected poison, irritating toxin, or deadly venom

Urticaria is the medical term for:

hives

You have been called to a park where a local church is holding a potluck dinner. As you exit your ambulance, a woman approaches you holding her 7-year-old son who is wheezing and having difficulty breathing. She informs you that he inadvertently ate a brownie with nuts, and he is allergic to nuts. The child's mother has an EpiPen that contains the appropriate dose of epinephrine for a child. What dose would that be?

0.15 mg

The dosage of epinephrine in an adult EpiPen is:

0.30 mg

The effects of epinephrine are typically observed within _________ following administration.

1 minute

When assisting with an auto-injector, how long should you hold the pen against the thigh?

10 seconds

Because the stinger of the honeybee is barbed and remains in the wound, it can continue to inject venom for up to:

20 minutes

Which of the following patients would MOST likely have a delayed onset of an allergic reaction?

A 45-year-old male who ingested penicillin

A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?

Administer oxygen, transport at once, and request a paramedic intercept.

Care for a victim of an immunologic emergency who is severely hypotensive should include which of the following?

Apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient's body temperature.

Why do patients wheeze?

Bronchioles are constricting

Which of the following medications blocks the release of histamines?

Diphenhydramine (Benadryl)

Which of the following is NOT one of the five common allergen categories?

Environments

Patients may experience allergic reactions to which of the following substances?

Plant material, Food and medications, Insect or animal bites and stings

Which of the following sounds indicates swelling of the upper airway?

Stridor

Leukotriene

Substance made by the body that is released in anaphylaxis

Which of the following statements regarding epinephrine administration via the intramuscular (IM) route is correct?

The 1:1000 concentration should be used.

Which of the following signs/symptoms are indicative of respiratory involvement of an allergic reaction?

Tightness in the chest or throat

Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately?

Upper airway swelling

What are small, raised areas that itch?

Urticaria

Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?

Vasoconstriction and bronchodilation

At the site of the injury, signs and symptoms of an animal or insect bite or sting may include pain, localized heat, and a wheal, which appears as __________.

a raised, well-defined area of the skin

A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:

a wheal

Questions to ask when obtaining a history from a patient appearing to have an allergic reaction include:

how the patient was exposed

A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should:

administer oxygen and transport her to the hospital.

In dealing with allergy-related emergencies, you must be aware of the possibility of acute______ and cardiovascular collapse

airway obstruction

The foreign substance responsible for causing an allergic reaction is called a(n):

allergen

Speed is essential because in severe cases of anaphylaxis, ____ can occur rapidly.

death

Common side effects of epinephrine include all of the following, EXCEPT:

drowsiness

Signs of symptoms of insect stings or bites include all of the following EXCEPT:

ecchymosis

Anaphylaxis is MOST accurately defined as a(n):

extreme allergic reaction that may affect multiple body systems.

Wheezing occurs because excessive ____ and mucus are secreted into the bronchial passages

fluid

After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and resolution of her hives. However, she is still anxious and tachycardic. You should:

monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.

After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old woman with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should:

monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.

Anaphylaxis is not always life threatening, but it typically involves:

multiple organ systems

After removing the auto-injector from the patient's thigh, you should do all of the following EXCEPT:

place ice on the injection site.

Immediately after giving an epinephrine injection, you should:

properly dispose of the syringe

When a foreign substance invades the body, the body will __________.

protect itself, go on alert, and attempt to inactivate the foreign substance

When an allergic reaction proceeds to life-threatening anaphylaxis, it will usually do so __________.

quickly, within 30 minutes.

Epinephrine, whether made by the body or by a drug manufacturer, works rapidly to:

raise the pulse rate and blood pressure, inhibit an allergic reaction, and relieve bronchospasm

You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should:

request permission from medical control to give another dose of epinephrine.

The stinger from a honeybee should be:

scraped away from the skin

Eating certain foods, such as shellfish or nuts, may result in a relatively ___ reaction that can still be quite severe

slow

You should not use tweezers to remove an embedded stinger because:

squeezing may cause the stinger to inject more venom in the wound

Epinephrine stimulates the ________ response, increasing blood pressure and relieving bronchospasm.

sympathetic

Prolonged respiratory difficulty can cause______, shock, and even death.

tachycardia

Steps for assisting a patient with administration of an EpiPen include:

taking body substance isolation precautions

The goal of invaders such as bacteria and viruses is to __________.

use a human body as a home

Epinephrine is indicated for patients with an allergic reaction when:

wheezing and hypotension are present