EMS Chapter 32 Environmental Emergencies
You are assessing a 30-year-old woman with a heat-related emergency. Her skin is flushed, hot, and moist, and her level of consciousness is decreased. After moving her to a cool environment, managing her airway, and administering oxygen, you should:
Check the blood glucose level if the patient has altered mental status.
You respond to a female jogger who was jogging in the park. The ambient temperature is 100F. She is complaining of dizziness, dry tongue, rapid pulse, and thirst. Which heat emergency is she MOST likely suffering from?
Heat exhaustion
What is the definitive treatment for a patient suffering from air embolism or decompression sickness?
Hyperbaric chamber
Which of the following is NOT a basic rule of water rescue?
If you must swim to the person, turn around so your back is to them.
Heat emergencies commonly occur at athletic events and practices. If the patient is in a cold-water immersion bath upon your arrival, do NOT remove the patient unless the temperature has normalized to between:
101 F and 102 F
At what age does an infant have the ability to generate heat when needed?
12 to 18 months
In a cold emergency, if you cannot feel a radial pulse, gently palpate for a carotid pulse and wait for up to____ before you decide whether the patient is pulseless.
60 seconds
During the coldest month of the winter, you are called to the home of an elderly woman. When you arrive, you immediately note that the house is extremely cold. The patient is lethargic. Her blood pressure is 90/60 mm Hg, her pulse is 48 beats/min, and her respirations are 8 breaths/min and shallow. Suspecting hypothermia, what would you estimate her core body temperature to be?
89 F to 92 F
Which of the following might be difficult to palpate with a patient who experienced a water emergency?
Blood pressure
Which of the following is NOT a predisposing factor in hypothermia?
Sex of the patient
Gently pinching the skin on the patient's forehead or the back of the hand will test the skin's?
Turgor
A lightning injury characterized by dysrhythmias that spontaneously resolve and superficial burns would be classified as being:
Moderate
What would a 25-year-old, relatively healthy patient who received a bite from a black widow spider mostly likely receive as treatment?
Pain relief
Regardless of the severity of the exposure, management of hypothermia in the field consists of stabilizing ABC's and:
Preventing further heat loss
Soaking the affected extremity in hot water for 30 minutes would work for injuries from all of the following marine animals, EXCEPT:
Sea anemones.
Should you commence CPR on a patient with hypothermia who has no pulse?
Yes, there is evidence that CPR, when correctly done, will increase blood flow to critical parts of the body.
The venom of a brown recluse spider is cytotoxic, meaning that it:
causes severe local tissue damage.
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
A patient with a core body temperature of 95°F (35°C) will MOST likely experience:
rapid breathing.
Which of the following is an example of altitude sickness?
All of these answers are correct
Consider a rendezvous with ALS for more aggressive treatment if:
All of these answers are correct.
If there is a possibility that you are assigned to cold weather search-and-rescue, you should receive survival training and:
All of these answers are correct.
Shortly after ascending rapidly to the surface of the water while holding his breath, a 29-year-old diver begins coughing up pink, frothy sputum and complains of dyspnea and chest pain. You should suspect and treat this patient for:
An air embolism
Most of the serious injuries associated with diving are related to which of the following emergencies?
Ascent emergencies.
A swimmer who breathes in and out rapidly and deeply before entering the water in an effort to expand their capacity to stay underwater may experience which of the following problems?
Breath-holding syncope
How could alcohol place a patient at greater risk for temperature-related emergencies?
By increasing fluid loss
What is the term that encompasses the fire coral, sea wasp, and sea anemones?
Coelenterates
When a warm hand touches metal or ice, the heat transfer is called:
Conduction
When a person is exposed to cold temperatures and strong winds for an extended period of time, he or she will lose heat mostly by:
Convection
Three ambulances respond to a golf course where six golfers were struck by lightning. Two of the golfers are conscious and alert with superficial skin burns (group 1). The next two golfers have minor fractures and appear confused (group 2). The last two golfers are in cardiac arrest (group 3). According to reverse triage, which group of golfers should be treated FIRST?
Group 3
Which of the following should you NOT do when treating a patient who has a cold emergency?
Have the patient walk, if possible
You respond to a male patient who has been exercising in a very hot environment. As you check his vital signs, his pulse is becoming weaker. You are perspiring, but your patient is not. From what could your patient be suffering?
Heat stroke
What is the most common problem surrounding drowning deaths by young children in residential pools?
Lack of adult supervision.
Which of the following statements regarding drowning is correct?
Laryngospasm following submersion in water makes rescue breathing difficult.
Which of the following statements regarding lightning strikes is correct?
Lightning strikes may cause cardiac dysrhythmias that spontaneously resolve.
You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient's vital signs, she states that she and her family returned from a camping trip 2 days ago. On the basis of this patient's presentation, you should suspect:
Lyme disease.
Which of the following conditions shows symptoms of headache, loss of appetite, difficultly sleeping, shortness of breath during physical exertion, and a swollen face?
Mountain sickness
What is the MOST obvious way to decrease way to decrease heat loss from radiation and convection?
Move the patient out of a cold environment
Patients with decompression sickness and air embolism must be treated in a
Recompression chamber
A woman has frostbite in both feet after walking several miles in a frozen field. Her feet are white, hard, and cold to the touch, Treatment at the scene should include:
Removing her wet clothing and covering her feet with dry, sterile dressings.
You are called to a well-kept home for an 8year-old girl. She presents with vomiting, headaches, and partial paralysis. During the history-taking stage, her mother reports that about 8 days ago they were hiking in the mountains and when they arrived home, the child found a tick on her leg, which the mother removed. What could be affecting this patient?
Rocky Mountain spotted fever
A 13-year-old girl is found floating face down in a swimming pool. Witnesses tell you that the girl had been practicing diving. After you and your partner safely enter the water, you should:
Rotate the entire upper half of her body as a unit, supporting her head and neck.
As an EMT working in a cold environment, your_______ must also be properly maintained and equipped for a cold environment.
Vehicle
Your body needs calories for your metabolism to function. What is the catalyst for much of this metabolism?
Water
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.
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 heat stroke include:
a weak, rapid pulse.
After being stung on the leg by a jellyfish, a man complains of severe pain to his leg, dizziness, and difficulty breathing. He has a red rash covering his trunk and his blood pressure is 90/50 mm Hg. The EMT should:
administer oxygen and epinephrine and prepare for rapid transport.
A dysbarism injury refers to the signs and symptoms related to changes in:
barometric pressure.
The diving reflex may allow a person to survive extended periods of submersion in cold water secondary to:
bradycardia and a slowing of the metabolic rate.
Geriatric patients, newborns, and infants are especially prone to hyperthermia because they:
exhibit poor thermoregulation.
Shivering is a mechanism in which the body generates heat by:
increasing the metabolic rate.
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.
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. You should:
place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.
