the first step in assessing a patient with a behavioral emergency is to
ensure your safety

common causes of acute psychotic behavior include all of the following EXCEPT
Alzheimer’s disease

the term behavioral crisis is MOST accurately defined as
any reaction that interferes with activities of daily living or is deemed unacceptable by others

A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to this forearms that are actively bleeding. The MOST appropriate wat to manage this situation is to
restrain the patient with appropriate force in order to treat his injuries

in addition to ensuring his or her own safety, the EMT’s responsibility when caring for a patient with a behavioral emergency is to
diffuse and control the situation and safely transport the patient

the single most significant factor that contributes to suicide is
depression

signs of agitated delirium include
diaphoresis, tachycardia, hallucinations

Law enforcement personnel request you assistance for a 30-year-old man who they pulled for erratic driving. the patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should
limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you

which of the following is an example of a functional behavioral disorder?
schizophrenia

which of the following conditions or factors would be the LEAST likely to result in a change in behavior?
antihypertensive medication

which of the following is NOT typically linked to a psychological or behavioral crisis?
history of smoking

which of the following is a normal reaction to a crisis situation?
feeling “blue” after the break up of a long term relationship

which of the following statements is false?
most people with a mental illness are dangerous

learning to adapt to a variety of situations in daily life, including stresses and strains, is called
adjustment

if the interruption of a daily routine tends to recur on a regular basis, the behavior is also considered a _____ crisis
behavioral

if an abnormal or disturbing pattern of behavior lasts for at least ____, it is regarded as a matter of concern from a mental health standpoint
1 month

patients may show agitation, violence, or become a threat to themselves or others when they experience a _________ emergency
psychiatric

which of the following is NOT considered a possible cause of a psychiatric disorder?
emotional disturbance

an altered mental status may arise from
an inadequate blood flow to the brain

organic brain syndrome may be caused by
seizure disorder

all of the following are examples of a functional disorder EXCEPT
organic brain syndrome

when documenting abnormal behavior, it is important to
document everything that happened on the call

safety guidelines for behavioral emergencies include the following except
determining the underlying psychiatric disorder

in evaluating a situation that is considered a behavioral emergency, the first things to consider are
scene safety and patient response

_______ is a behavior that is characterized by restlessness and irregular physical activity
agitation

which of the following is NOT considered a risk factor for suicide?
recent marriage

which of the following is NOT a risk factor to consider when assessing a suicidal patient?
does the patient appear to be well groomed?

signs and symptoms of agitated delirium include all of the following EXCEPT
hyperventilation

you should request the assistance of a ______ when a mentally impaired patient refuses to go to the hospital
law enforcement officer

when restraining a patient without an appropriate order, legal actions may involve charges of
battery

when restraining a patient on a stretcher, it is necessary to constantly reassess the patient’s
respiration and circulation

depression lasting 8 months after being fired from a job is a normal mental health response
false

low blood glucose or lack of oxygen to the brain may cause behavioral changes to the degree that a psychiatric emergency could exist
true

from a mental health standpoint, a pattern of abnormal behavior must last at least 3 months to be a matter of concern
false

a disturbed patient should always be transported with restraints
false

it is sometimes helpful to allow a patient with a behavioral emergency some time alone to calm down and collect his or her thoughts
false

it is important to maintain eye contact with the patient when dealing with a behavioral crisis
true

a patient should never be asked if he or she is considering suicide
false

UTIs can cause behavioral changes in elderly patients
true

all individuals with mental health disorders are dangerous, violent, or otherwise unmanageable
false

when completing the documentation, it is important to record the reasons why you restrained a patient
true

when restraining a patient, at least four people should be present to carry out the restraint
true

a patient should be placed face down when being restrained to a litter
false

reassessment of restrained patients should take place every 5 minutes
true

tears, sweating, and blushing may be significant indicators of state of mind such as sadness, nervousness, or embarrassment
true

almost every situation, medical or trauma, will have some sort of behavioral component
true

_______ is what you can see of a person’s response to the environment; his or her actions
behavior

A __________ _______ or emergency is any reaction to events that interferes with the activities of daily living has become unacceptable to the patient, family, or community
behavioral crisis

chronic _____, or a persistent feeling of sadness or despair, may be a symptom of a mental or physical disorder
depression

______ _______ _____ is a temporary or permanent dysfunction of the brain caused by a disturbance in the physical or physiologic functioning of the brain
organic brain syndrome

any time you encounter an emotionally depressed patient, you must consider the possibility of
suicide

people with ______ may experience symptoms including delusions, hallucinations, a lack of interest in pleasure, and erratic speech
schizophrenia

violent or dangerous people should be managed by _____ ______ before emergency care is rendered
law enforcement

when a patient is not mentally competent to grant consent, the law assumes that there is _______ _________
implied consent

the most common cause of dementia is primary progressive dementia, also known as
Alzheimer dementia

in subduing a disturbed patient, use the ____ force necessary
minimum

abnormal operation of an organ that cannot be traced to an obvious change in structure or physiology of the organ
functional disorder

a symptom or illness caused by mental factors as opposed to physical ones
psychogenic

an illness with psychological or behavioral symptoms that may result in impaired functioning
psychiatric disorder

the patient may show agitation or violence or become a threat to self or others
psychiatric emergency

a state of delusion in which the person is out of touch with reality
psychosis

condition of impairment in cognitive function that can present with disorientation, hallucinations, or delusions
delirium

you are preparing to transport an unresponsive stroke patient to the emergency department. which of the following would be the BEST position to place this patient in for transport?
recovery position

the recovery position offers the most protection against potential aspiration of vomitus or secretions

you are treating a patient experiencing a stroke who is aphasic. he is unable to move his right arm and legs. after applying oxygen and assuring his airway is clear, which treatment will most likely benefit this patient?
continue talking and reassuring the patient

what is the MOST important aspect to consider when dealing with inhaled poisons?
high concentrations of oxygen

which of the following would suggest to you that a patient is at an increased risk of suicide?
recent emotional trauma, sudden improvement in depression, alcohol and drug abuse

identify the signs and symptoms of a narcotic overdose
bradypnea, shallow respirations, pinpoint pupils

which of the following phases of a generalized seizure is characterized by rhythmic jerking movements of the extremities?
clonic

your diabetic is unresponsive, pale, cool, and diaphoretic. which of the following would you suspect is occurring with this patient?
hypoglycemia

polydipsia, polyphagia, and polyuria are all symptoms of which of the following?
hyperglycemia

which of the following assessments would be less critical in a medical assessment?
skeletal integrity

your young female patient suggests she might be pregnant. she complains of severe abdominal pain under the left diaphragm. your most appropriate action is to
administer high-concentration oxygen

in the case of a behavioral emergency, which of the following would be a physiological cause?
low blood sugar

you are interviewing the family of a seizure patient. which of the following answers to your questions should give you the greatest concern?
“he has stopped and started seizing three times in a row now”

the stopping and starting of the seizure three times in a row indicates status epilepticus, which is serious

which of the following is the MOST common route of entry of toxic substances into the body?
inhalation

the cartilaginous projection just in front of the ear’s outer opening is known as which of the following?
tragus

what is the name given for a relatively rapid onset of widespread disorganized thought?
delirium

you are assessing a 1 yo you suspect has a fever. which of the following is the MOST appropriate method of checking the temperature?
using a rectal thermometer

a common cause of vaginal discomfort, odorous discharge and vaginal itching is
bacterial vaginosis

what care should you provide a patient who is adequately breathing but unresponsive?
continue assessment without any intervention

identify the signs and symptoms connected to carbon monoxide poisonings
headache, nausea, vertigo, and weakness

a child has just stopped seizing from a high fever. a rescuer should immediately perform which action?
call ALS and request assistance

your patient is an 85 yo male with long cardiac history. he has called the ambulance today because he has had episodes of chest pain. the chest pain and associated symptoms are classic for angina or an impending MI. the patient’s vitals are P 82, BP 138/86, and R 16. when the pain starts, you note that the patient’s pulse falls to 48. what would you expect to find as a result of this slowing of the pulse?
reduced cardiac output

you arrive on scene of an unresponsive female who is barely breathing. witnesses state she just stopped seizing before you arrived. which information will be most useful to the providers if available?
locating a medic alert bracelet on the patient’s wrist

when a patient is having a generalized seizure, the phase where the muscle tension is continuous is called
tonic

which type of pain would a patient describe as localized and intense?
somatic/parietal

which of the following anatomical structures within the pulmonary system is primarily responsible for the trapped air that an asthmatic experiences?
bronchi

while treating a homeless person at a park for chest pain and dizziness, he tells you the chest pain is the worst pain he has ever had. after checking his vital signs which are: P 88, R 16, and BP 120/80, you should
assist him with his own nitroglycerin

you are evaluating a patient who lives in a nursing home and is acting abnormally. she has a history of diabetes and you are unclear whether the patient’s sugar is low or high. what is the MOST appropriate reason for giving instant glucose?
the benefits of giving sugar outweigh the consequences of it

your patient complains of coughing up blood. he is a new resident at a homeless shelter and the staff says he has trouble sleeping as well as trouble breathing. his skin is cool and diaphoretic. what does this information tell you?
he probably has COPD

which of the following assessment findings would be the MOST consistent with a patient suffering from a transient ischemic attack?
neurological deficits that have completely resolved

which of the following is a narcotic?
codeine

you arrive on scene of an unresponsive female who is barely breathing. witnesses state she just stopped seizing before you arrived. which information will be MOST useful to the providers if available?
locating a medic alert bracelet on the patient’s wrist

you arrive at the scene of a low velocity motor vehicle crash with one reported patient. the vehicle has struck a light post but has sustained minimal damage. the emergency medical responder in the vehicle with the 16 year old patient states the patient has been unconscious since their arrival. what is your suspicion regarding this patient?
the patient fainted after the accident

what is the name for mid-cycle abdominal pain as a result of ovulation?
mittelschmerz

during the medical exam of a patient complaining of dizziness and nausea, the rescuer may modify his assessment slightly. Which will MOST likely be omitted during this particular patient assessment?
circulatory assessment

which of the following best differentiates an emergent heat illness from one that is merely urgent?
a decrease in level of consciousness

the best explanation of a bloody show during pregnancy is
a small mixture of blood and mucous that precedes delivery

what type of poisoning should you suspect when your patient presents with slow pulse, excessive salivation and sweating, nausea, vomiting, difficulty breathing, and constricted pupils?
insecticide? narcotics?

a good way to explain what sickle-cell anemia is, would be to state it is an abnormal
hemoglobin in red blood cells

you have an adult patient with an accidental petroleum poisoning. which of the following is the most expected route for this poisoning?
ingested

at the scene of a multi-vehicle collision, you are attempting to evaluate a young teen-age boy who was a belted backseat passenger. he has no obvious external injuries. the driver of this vehicle is severely injured. as you question the boy, he does not respond to your questions but continues to rock back and forth in his seat. he also avoids any eye contact. as you attempt to take vital signs he pushes you away. one issue to consider with this child is that he
has some autistic disorder

is in a state of shock

has a head injury

a 16-year-old female has collapsed on a city street. as you begin your assessment she tells you she is “bleeding down there” and then admits to having an abortion earlier today. your immediate response is
finish your assessment, lay the patient in a position of comfort, and apply oxygen

you are on the scene of a 23-year-old patient complaining of excruciating pain in the left flank. he has vomited and his skin is pale and cool to the touch. which of the following would you suspect?
acute renal failure?

chronic renal failure

renal calculi

your neurological emergency patient opens his eyes to voice command, utters incomprehensible sounds, and can localize pain. GCS?
10

when the blood serum insulin level falls, the patient’s
pancreas releases glucagon to increase glucose levels

you are called to a private residence to care for pregnant female that is bleeding vaginally. you estimate that she has lost about 750 ml of blood from what you see at the scene. she claims she has no pain. based on this information, you believe the cause to be
placenta previa

You respond to a call for a 33-year-old female who had initially complained of abdominal pain on a very hot and humid day. The patient is now unconscious and breathing shallow with minimum chest movement. Friends tell you that the patient was healthy before she complained of abdominal pain. How would you expect to find her skin?
sweaty

patients normally respond to heat-related problems by sweating to cool themselves down. this is a compensation mechanism. pale and clammy indicates shock, cyanosis demonstrates cold/hypoxia.

which of the following signs or symptoms would you least expect to find in a patient suffering from an upper GI bleed?
hematochezia

you are called to a local factory for a patient who has passed out. the patient was in an overheated room and your assessment findings reveal a 28-year-old male with cool, diaphoretic skin. the patient has a pulse of 124 and a BP of 88/40. which of the following would you suspect based on the above assessment findings?
heat exhaustion

which of the following would be the best educational advice you could give to a patient who has a severe food allergy?
recognize and avoid that food

which of the following respiratory patterns is associated with an attempt to compensate for diabetic ketoacidosis?
Kussmaul respirations

which of the following methods of entry of allergens into a patient will more likely result in anaphylaxis than the other methods of entry?
injection

you are treating an adult patient who is experiencing an anaphylactic reaction. the patient is unresponsive, has a weak carotid pulse, and has a blood pressure of 64/40. the paramedics are 4 minutes away from the scene. you have called medical direction and they have denied your request to administer an auto-injector. which of the following reasons best explains why medical direction denied your request?
the auto-injector will not be effective?

which of the following signs would you most likely expect to see as you assess a patient with a low GI bleed?
hematochezia

you have completed treatment of a patient with confirmed TB. how should you disinfect your stethoscope?
sterilization

pain associated with peritoneal irritation will typically be described by the patient as which of the following?
somatic/parietal–sharp, easily localized pain

what would be the most expected finding with a patient that has suffered a ruptured appendix with toxins that have spread throughout the abdomen?
severe somatic pain (easily localized) throughout the abdomen

what is the function of the pancreas?
to produce insulin

what is the normal BGL range?
80-120 mg/dL

type 1 diabetes
childhood
patient does not produce insulin
beta cells of pancreatic islets are destroyed by person’s own immune system, genetic, or environmental factors

type 2 diabetes
later onset
patient produces inadequate amounts of insulin
glucose unable to enter body effectively due to resistance of insulin’s effective use

glucagon
released by pancreas to wake up the liver and make it start changing glycogen into glucose

glycogen
where we store extra sugar in the muscles and liver

diabetic shock/ insulin shock
< 40 mg/dL rapid or normal respirations, pale and moist skin, sweating, dizziness and headache, rapid pulse, low BP, hunger, AMS, aggressive/confused

ketoacidosis
400-800 mg/dL
no insulin so body turns to fat for fuel which creates a ton of waste bi-products (ketones)
s/s: vomiting, abd pain, unconsciousness, Kussmaul (deep rapid) breathing, breath smells like juicy fruit gum
needs hydration, insulin electrolyte replacement

diabetic coma
800 mg/dL
Kussmaul respirations
dehydration, fruity breath odor, rapid weak pulse, low BP, unresponsive, usually takes several hours to develop

how does insulin work?
hormone produced by the pancreas which enables glucose to enter the cells to feed them and provide body with energy

oral glucose
1 tube=15 g
ability to swallow
AMS
caution with head injury and increased ICP

common allergens
substance invades your body, which then sends out a team to investigate new substance, and they take a chemical picture of the intruder, then body develops sensitivity to recognize invader next time, and creates antibodies (wanted posters)

histamine
closes off the roads and airports, all cells are suspect
when released, makes vessels leaky to remove allergen, reduce perfusion to prevent allergen from circulating, close the airway so nothing else gets into the lungs

epi-pen
0.3 mg adults/0.15 mg pediatric
effects < 1 min indicated for ANAPHYLAXIS increased CNS effects, stimulant effects, HTN, anxiety

anaphylaxis
vasodilation
permeable/leaky vessel walls=fluid escape in the tissues (angioedema)
low BP
pruritus
urticaria
pale or cyanotic
bronchoconstriction (wheezing and stridor)
DISTRIBUTIVE SHOCK because of vasodilation

allergic reaction
exaggerated immune response to any substance
s/s: malaise, anxiety, cough, chest tightness, hoarse, scratchy throat
basophils: histamines, leukotrienes
massive release of histamine

anaphylactoid
does not require sensitization

substance abuse
the knowing misuse of any substance to produce a desired effect

inhalation

absorption

ingestion

injection

what is important info to get from poisonings and overdose patients?
substance, route of exposure time of exposure, local or systemic effects

stimulants/sympathomimetic
dilated pupils (MYDRASIS), paranoia, seizures, agitation, cardiac arrhythmias, stroke, HTN, tachycardia

hallucinogens
delusions agitation, inability to feel pain (PCP), erratic behavior, seizures with heavy use, high temperature

sedative-hypnotics
CNS depressants, used to relieve anxiety and induce sleep, alcohol

opioids
CNS depressants, severe respiratory depression, appear sedated, pinpoint pupils (MIOSIS), cyanosis

cholinergic
overstimulate parasympathetic functions
s/s DUMBELS SLUDGE, seizures, inadequate respirations, patient suffocates

anticholinergic
opposite of cholinergic reaction; block parasympathetic nerves, can lead to cardiac dysrhythmias, patient may go from normal to death to death in 30 min

OTC meds
aspirin, acetaminophen
n/v, liver failure, hyperventilation, confusion, ringing in ears

activated charcoal
for ingested poisons, dilute airborne exposures with oxygen, remove contact exposures with water unless contraindicated

emetic
vomiting

cathartic
diarrhea

tolerance
need for increased amount of drug to have same desired effect

addiction
overwhelming desire or need to continue using an agent

delirium tremens
episode can last 1-3 days
confusion, tremors, n/v/d, high fever, severe hallucinations, sweating, HTN, tachycardia, insomnia
stage 4 of alcohol withdrawal

pancreatitis
alcohol abuse, gallstones, infection
s/s: severe pain in LUQ and RUQ radiating to back, n/v, fever, tachycardia, abdominal distention and tenderness, can lead to sepsis, hemorrhage, low or high BGL

cholecystitis
30-50 yo
more common to have pain at night or after a fatty meal
s/s: n/v, gas, indigestion, constant severe RUQ pain, refers to right upper back, flank, shoulder, can lead to tissue death, perforation, or pancreatitis

peritonitis
caused by substances leaking into peritoneal cavity, blood/pus/digestive fluids, other infection that spreads (PID, gastroenteritis, nephritis)

PID
infection of upper organs of reproduction which can result in ectopic pregnancy or sterility, most common sign is generalized lower abdominal pain, begins during or after menstruation, may be made worse by walking, dyspareunia

ulcers
erosion of stomach lining that leads to bleeding, perforation, leakage of contents into abdomen, from chronic use of NSAIDs, alcohol use and smoking, H. pylori,
s/s: n/v, belching, heartburn, hematemesis

UTI
lower abdominal pain, fever, pain and frequent urination, hematuria

appendicitis
more common in children or elderly
caused by blockage in intestines
s/s begins with periumbilical pain, dull generalized RLQ pain, n/v, anorexia, fever/chills, rebound tenderness, Markle heel-jar test

esophageal varices
pressure in blood vessels surrounding esophagus increases, looks like liver failure, weight loss and anorexia, jaundice, edema in the abdomen, abdominal pain, n/v, sudden onset of discomfort in throat, severe difficulty swallowing, vomiting bright red blood, hypotension, signs of shock

abdominal pain patients
transport gently, do not delay transport if life threat, signs of shock, possible internal bleeding, poor general impression
nothing PO
OPQRST pain
place patient supine with legs drawn up and flexed at knees
palpate 4 quadrants gently

conduction
direct physical touch

convection
through circulating air

evaporation
cooling of body through sweating

radiation
most significant cause of heat loss (cover hands, head, and feet)

immersion hypothermia
cold and wet is worse than cold and dry

shivering
best defense against cold

thermoregulation
respirations increase to lose more heat, body excretion urination and defecation, piloerection insulating layer

deep cold injury
cellular death from shift in electrolytes; warm-water bath; wrap as if treating burn

superficial cold injury
skin pale and cold; will remain soft; loss of feeling/sensation to injured area; rewarm with blankets

hypothermia
s/s: facial puffiness, hoarseness, sparse and dry hair, AMS, shivering, increased HR and RR, pale skin, goosebumps, poor muscle coordination, show and irregular HR (late sign), loss of muscle activity, dilated pupils, cyanosis

high risk for hypothermia
very young/very old, alcohol use, narcotics, sedatives, antidepressants, women less than men, adults less than children

mild hypothermia
<95°; shiver, difficulty speaking, ataxia, apathy, amnesia

moderate hypothermia
<90°; stupor, pupils dilate, shivering ceases, O2 need drops by 25%, pulse and CO decrease by ⅓, cardiac dysrhythmias develop

severe hypothermia
<84°; pulse and CO decrease by over 50%, O2 need decreases by 50%, hypotensive, lose reflexes, prone to develop V-FIB

profound hypothermia
<70°; pulse declines by 80%, deteriorates to cardiac arrest

urban hypothermia
doesn’t have to be freezing outside, poor living conditions

hypothyroidism
deficiency in thyroid; lowers metabolism; weight gain

heat cramps
increased HR to pump blood to the skin so it can make sweat; increased respirations dump out excess heat through breathing
body cools itself by sweating (evaporation), dilation of BV (vasodilation) allows for more heat to be radiated; hyperthermia core temp > 101°F
painful muscle spasms, possibly from electrolyte imbalances (lack of Na, Ca)
usually athletes
treatment: remove from heat, rest the cramping muscle, replace fluids by mouth REHYDRATE but not gatorade, Pedialyte!, ALS can help

heat exhaustion
disturbance of blood flow mild s/s of shock, body is still compensating for temp changes; dry tongue and thirst, normal vs and temp, skin may be pale, cool, and sweaty
treatment: remove extra clothing, remove from hot environment, give O2, have pt lie down and elevate legs, if pt is alert give water slowly; apply cold compresses, have person lie down, give fluids, elevate feet, use fan to lower temp

heatstroke
cooling mechanisms are overwhelmed; hot dry flushed skin, change in behavior leading to unresponsiveness (usually first sign); pulse is rapid then slows, BP ↓
exertional heatstroke: result of activity, exercise, hot environment for long periods
nonexertional heatstroke: sedentary lifestyle, chronically ill, medications that inhibit temp regulation, areas that do not experience heat waves often
treatment: O2, AC on high, ice packs, remove clothing, cover with wet sheet and fan patient

diving reflex
on facial contact with cold water, the human HR slows 10-25%; body shunts blood to the heart & brain, away from the extremities
body vasoconstricts
diaphragm spasms

severe hypothermic state
tachycardia
tachypnea
bradycardia
bradypnea
hypotension
check core body temp (rectal) and carotid pulse

decompression sickness
flying too soon after a dive
inadequate time to ascend
diving for too long
repeated dives on same day
age/poor physical condition
heart or lung problems
dehydration
type 1- pain (shoulder), rash and pruritis
type 2- back/abd pain, dyspnea, burning sensation when breathing, rales, bladder distension, s/s of shock, ataxia

air embolism
mottling of the skin
froth at the mouth and nose (pink)
severe pain in muscle, joints, and/or abdomen
dyspnea
chest pain

diving interventions
provide prompt transport to nearest recompression facility
administer oxygen
make sure pt is warm, especially after cold-water immersion

behavioral emergency
abnormal behavior that is unacceptable to the patient, family, and/or community
s/s: hypoxia, hypoglycemia, heat/cold, seizures, mind-altering substances, withdrawal

depression
deep feeling of sadness or despair, factor in ½ of suicides, loss of appetite, restlessness, insomnia, apathy

suicide
may be violent
air of despair or hopelessness
avoid eye contact
speak slowly
project a sense of vacancy
do they have a plan?
unsafe objects nearby?
self-destructive behavior evidence?

bipolar disorder
manic highs and depressive lows
talking very fast, restlessness, impulsive behaviors, easily distracted
feeling tired or slowed down, irritability, loss of interest in activities

schizophrenia
onset early adulthood
delusions, hallucinations, erratic speech, flat affect, impaired language skills
antipsychotics for treatment (haldol, thorazine, risperdal, abilify, seroquel)

procedure for assessing and managing psychiatric patients
hx: psych problems, use of psych meds, substance abuse, suicidal thoughts
assessment: AMS, trauma, fear, anger, confusion, hostility, rule out underlying issue
interventions: be caring/careful, intervene only to safely transport, transport to appropriate facility based on condition, transport criteria
ongoing: never let your guard down, use law enforcement personnel, give advance warning to hospital; NEVER restrain the pt in a prone position, one person for each extremity, plan ahead, use reasonable force and appropriate method of restraint, document everything and secure witnesses, be wary of violence

how long does behavior pattern exist before it is a matter of concern?
1 month

predicting factors for violence
rubbing neck, posture, scene, vocal activity, physical activity, silence, past hx

your patient is complaining of an achy or colicky pain that is poorly localized and felt deep within the body. which best describes this pain?
visceral pain located in hollow structures (appendix or gallbladder)

the goal for treating ingestion of toxins is to prevent the toxin from reaching which of the following?
the small intestine

which of the following is true regarding the delivery of the placenta?
you should delay transport until the placenta has delivered

massage abdomen?

20 min to deliver?

the major advantage of having liquid oxygen for home use is
it allows the patient to store a lot more oxygen in the home

you are preparing to transport a 30 year old female who is semi-responsive, confused, and talking. you suspect she is having some type of diabetic reaction. what would be the first step in treating the patient properly?
administer oxygen

the visible indication of a patient’s mood is termed
affect

which of the following would be the best way to receive directions regarding the proper treatment for a poisoning?
call the poison control center

during your initial assessment, you discover your patient is bleeding from an obvious stab wound. which of the following statements is true regarding proper care?
OSHA recommends you take strict BSI precaution when dressing an open wound

which of the following is the least useful examination component of an abdominal assessment in the pre-hospital setting?
auscultation

you are called to the scene of a patient with a head injury who has a temperature of 104° F. Other than head injury, what other condition should be a part of your field diagnosis?
pyrexia- high body temperature

a sharp type of pain from the abdomen that travels along neural routes is known as which of the following?
somatic pain

your patient has an inflammation of the gallbladder resulting in abdominal pain. which of the following descriptions of the pain should you most likely expect the patient to report?
visceral (hollow organ)–poorly localized

pain associated with peritoneal irritation will typically be described by the patient as which of the following?
somatic–localized easily

the patient experiencing a severe headache should be re-evaluated frequently since they are prone to experience
vomiting

EMS responds to a daycare center for a child with AMS. caretakers describe a 9 year old female “acting like she is on drugs”. there is very little to indicate a toxicological emergency. what symptom would confirm a suspicion of hypoglycemia instead of drugs?
headache

why should we contact medical direction early in the pre-hospital management of a poisoning or overdose patient, even prior to transporting?
so the hospital can acquire the antidote in a timely fashion so that it is available when you arrive

so the hospital can give you info regarding the expected effects of the poison

you are called to a patient who has urticaria, itching, coughing, and tachycardia after eating shellfish. the patient states he is having difficulty breathing. which of the following is an expected finding in an anaphylaxis case?
angioedema

you are evaluating a patient you suspect was bitten by a venomous snake. which skill would most likely be done after contacting medical control?
immobilizing the injured extremity?

which of the following would be abnormal for a pregnant female in her last trimester of pregnancy?
an elevated BP?

blood loss of 30% with no signs of shock

following assessment of an unresponsive patient, you have determined the patient is a high priority. after you have addressed the life-threatening problems, what do you do next?
a rapid secondary assessment (rapid physical survey)

visceral pain
earliest manifestation of an abdominal condition; originates from stimulation of nerve fibers within the organ itself

POORLY LOCALIZED
dull, aching, crampy

hollow organs (gallbladder, appendix) feel crampy, colicky, dull, intermittent

solid organs- kidney, liver, visceral peritoneum feel like dull and constant pain

associated n/v, diaphoresis, tachycardia

somatic pain
indicates progression of condition

sharp, intense, constant type of pain that travels along definite neural routes produced when parietal peritoneum nerve fibers are activated
pain is LOCALIZED EASILY

patients lie still in fetal position to relax the peritoneal cavity, breathing is shallow and fast to reduce diaphragm movement

sometimes caused by chemical irritants

referred pain
type of visceral pain that is felt away from the actual affected organ site; usually WELL LOCALIZED in the skin of deeper tissue

diverticulitis
the pouches in the colon become infected

According to the National Institutes of Health, what percentage of the U.S. population suffers from diabetes? A) 5% B) 8% C) 10% D) 7% D When blood calcium levels are high, the thyroid gland releases ___________, which causes the reabsorption …

The term “behavioral crisis” is MOST accurately defined as: any reaction that interferes with activities of daily living or is deemed unacceptable by others. General guidelines for managing a patient with a behavioral emergency include: being prepared to spend extra …

The term eugenics refers to: a political policy of preventing those who suffer from mental illness from reproducing. The treatment mechanism associated with touching a troubled area of patient’s body with a special rod was: mesmerism WE WILL WRITE A …

A 33-year-old woman who is 36 weeks pregnant is experiencing vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. You should: Select one: A. position her supine and elevate her legs 12 inches. B. ventilate …

At a workshop about multiple personality disorder, a therapist says, “In my experience, once integration begins, the need for therapy is practically over, and later dissociations just don’t happen.” This therapist’s experience is: Very unusual; most successful therapies last well …

Which of the following is NOT typically linked to a psychological or behavioral crisis? Mind-altering substances An underlying medical problem History of smoking Stress History of smoking Which of the following is a normal reaction to a crisis situation? Monday …

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