Chapter 21: Toxicology

Which of the following is NOT considered a sign or symptom of alcohol withdrawal?

Chest pain.

A 4-year-old, 15-kg male ingested an unknown quantity of acetaminophen (Tylenol). The child's mother states that she does not know when the ingestion occurred. The child is conscious and alert and in no apparent distress. The EMT should:

Administer 15 g of activated charcoal.

Treatment for ingestion of poisonous plants includes all of the following, EXCEPT:

Administering activated charcoal.

In general, injected poisons are impossible to dilute or remove because they:

Are usually absorbed quickly into the body.

Activated charcoal may be indicated for a patient who ingested:

Aspirin.

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).

You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient's dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes:

Attempting to calm him and giving him oxygen if tolerated.

Your priority in caring for a patient with a surface contact poisoning is to:

Avoid contaminating yourself

The MOST important consideration in caring for a patient who has been exposed to an organophosphate insecticide or some other cholinergic agent is to:

Avoid exposure yourself.

Which of the following sets of vital signs would the EMT MOST likely encounter in a patient with acute cocaine overdose?

BP, 200/100 mm Hg; pulse, 150 beats/min.

As you enter the residence of a patient who has possibly overdosed, you should:

Be alert for personal hazards.

After administering activated charcoal to a patient, it is MOST important to:

Be alert for vomiting.

Activated charcoal is given to patients who have ingested certain substances because it:

Binds to the substance and prevents absorption.

The major side effect associated with administration of activated charcoal is:

Black stools.

How do poisons typically act to harm the body?

By changing the normal metabolism of cells or by destroying them.

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.

Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which of the following side effects would you expect the patient to experience?

Dry mucous membranes.

Common names for activated charcoal include all of the following, EXCEPT:

Fructose.

You have responded to the home of a 26-year-old woman who has reportedly taken a large number of pills in an attempt to commit suicide. As you enter the living room, you see her sleeping in her chair, and several empty alcohol containers are present. She is breathing heavily. You are able to arouse her consciousness for a short period of time. Which course of action takes priority?

Have her take activated charcoal while she is conscious.

"Nerve gases" overstimulate normal body functions that are controlled by parasympathetic nerves, causing:

Increased salivation.

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.

A 25-year-old man overdosed on heroin and is unresponsive. His breathing is slow and shallow and he is bradycardic. He has track marks on both arms. The EMT should:

Insert a nasal airway and ventilate with a BVM.

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.

The poison control center will be able to provide you with the most information regarding the appropriate treatment for a patient with a drug overdose if the center:

Is aware of the substance that is involved.

Substance abuse is MOST accurately defined as:

Knowingly misusing a substance to produce a desired effect.

An overdose of acetaminophen, the active ingredient in Tylenol, will MOST likely cause:

Liver failure.

Before giving activated charcoal, you should:

Obtain approval from medical control.

Heroin is an example of a(n):

Opioid.

Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of:

Oxycodone (Percocet).

Airborne substances should be diluted with:

Oxygen.

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.

Medical problems that may cause the patient to present as intoxicated include all of the following, EXCEPT:

Syncope.

Signs and symptoms of a sympathomimetic drug overdose include:

Tachycardia.

Which of the following statements regarding the Salmonella bacterium is correct?

The Salmonella bacterium itself causes food poisoning.

Which of the following statements regarding injected poisons is FALSE?

They are easily diluted once in the bloodstream.

You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Immediate management for this patient should include:

Thoroughly suctioning her oropharynx.

A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing:

Tolerance.

Victims of inhaled poisoning will require which of the following?

Transport to an emergency department for evaluation.

If the victim of a toxicologic emergency vomits, an EMT should _________.

Use appropriate personal protective equipment 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 beats/min, 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.

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?