EMS Basic Chapter 24

Which one of the following best describes a patient suffering an environmental emergency?
Intoxicated male patient who collapsed in the snow and is complaining that he feels cold

You are assessing a conscious but confused hunter who became lost in the woods on a cold day. Your assessment shows him to have an open airway, adequate breathing, and a weak radial pulse. His skin is cold to the touch and he is shivering. The EMT should recognize that the:
shivering is a protective means by which the body is attempting to warm itself.

A person is in a hot environment and his body is successfully compensating to off-load excess heat. Which one of the following assessment findings best illustrates this process?
Warm and diaphoretic skin, elevated heart rate, increased respirations

You are treating a male patient who is hypothermic. What should you do to decrease heat loss caused by radiation?
Wrap a towel around the patient’s head.

A patient who is conscious and breathing has been pulled from a stream of cold water. To decrease her loss of heat via the mechanism of conduction, the EMT should immediately:
remove her wet clothing

You have been called to a residence for a patient who is sick. On scene the family tells you that the patient is being treated for the “stomach flu” and has had a fever of 102°F for the past two days. She has been taking all of the medications prescribed by her doctor but this evening became very “sweaty.” Assessment shows her to be stable with a pulse of 88, respirations 18, adequate blood pressure of 128/68 mmHg, and an oral temperature of 100.2°F. Based on this, the EMT should recognize the:
patient’s body is cooling itself by transferring heat into the sweat, which is then evaporated into the air.

You have been chosen by the medical director to give a 15-minute presentation on cold-related emergencies to a local volunteer fire department. In preparing the talk, which one of the following points should you emphasize?
Emergency responders play a critical role in caring for the hypothermic patient since the most important phase of care occurs during the first 30 minutes.

Which one of the following statements about immersion hypothermia is false
“Immersion hypothermia typically does not occur until the water temperature is below 35°F”

A young boy complains of pain to his fingers after spending several hours outside riding a sled in cold winter temperatures. After ensuring he has no life-threatening conditions, you turn your attention to his hands and note that the fingers are cold to the touch. Suspecting that he is suffering from early or superficial cold injury, which one of the following signs or symptoms would help confirm this suspicion?
Skin on the fingers that is soft but numb

You are called for an elderly woman who has slipped on the ice. On arrival you find her supine on an icy sidewalk and responsive to painful stimuli with decorticate posturing (flexion). She has blood coming from a laceration on the back of her head and is breathing agonally at 4 times a minute. Which one of the following should you do immediately?
Perform the jaw-thrust airway maneuver.

When moving a patient with severe generalized hypothermia, which one of the following instructions is most appropriate?
“I want everyone to take extra care in moving her very gently to the stretcher. We do not want her to go into cardiac arrest.”

Which one of the following signs or symptoms best indicates that the patient with cold skin is suffering from generalized hypothermia?
Heart rate of 48 beats per minute

A core temperature is most accurately assessed on a patient who has been exposed to cold temperatures by placing a:
medical-grade thermometer in the patient’s rectum.

When providing oxygen to a patient with a core temperature of 95 degrees and adequate breathing, which one of the following is best?
Oxygen that is warmed and humidified via non-rebreather mask

You have been called for an alert and oriented male patient whose friends state he spent several hours locked out of his house in the cold temperatures. Since the primary and secondary assessments have ruled out immediate life-threatening conditions, you have decided to rewarm the patient. Which one of the following would be most appropriate for this patient?
Hot packs to the patient’s chest, groin, and armpits

Which statement made by an EMT shows that he understands the care of a patient with a localized cold injury to the foot?
“While it is best to remove wet clothing from the patient, it is best to leave clothing that is frozen to the skin in place.”

You have been called to a hunting camp for a patient with a severe localized cold injury to his hand and fingers. The patient is suffering no life-threatening conditions and you elect to rewarm the affected areas. Which one of the following would be appropriate for this patient?
Thaw and rewarm the tissue as quickly as possible

You have initiated the rewarming of a local cold injury to a patient’s hand and fingers. On scene the patient had no sensation in his hand or fingers. Which one of the following statements is a cause of concern when made by the patient?
“There is no pain when I rub my fingers with my other hand.”

At an in-service, your medical director asks if anyone can tell her the cause of heat cramps. What response would be most appropriate?
“They are caused when the patient’s electrolytes such as salt and calcium are lost and become too low in the body.”

Which one of the following patients would be the highest priority for transport?
19-year-old responsive to verbal stimuli with hot dry skin and tachycardia

You have been called to a park for a teenage boy who is “sick.” On scene you find a 16-year-old male who knows his name but is confused about place and time. Friends state that they have been playing basketball most of the morning and afternoon. The temperature is in the 90s and the humidity is high. His airway is patent and his breathing is fast but adequate. His pulse is weak and rapid. Observation of his skin reveals it to be pale, cool, and moist. Oxygen is being administered via nonrebreather face mask. Which one of the following would be appropriate care for this patient?
Place him supine on the stretcher with feet elevated.

When cooling a patient with possible heat stroke, which one of the following would be of most concern to the EMT?
Determining that the patient is shivering after having cold packs applied to the neck

A landscaper who has been working in 105 degree weather is responsive to painful stimuli and has an open airway. His breathing is shallow and his radial pulse is weak. His skin is hot and dry and appears to be sunburned. The EMT should immediately:
start positive pressure ventilation

A young female was weeding her garden when she was bitten on her left hand by an unidentified snake. The primary assessment does not reveal any life threats and vital signs are stable. In caring for this patient, it is critical that the EMT:
have the patient remove her wedding ring from her left hand.

You are transporting a patient who was bitten on her hand by a spider about 20 minutes ago. On scene the primary assessment revealed no life threats and vital signs were stable. While conducting your reassessment, which one of the following would be of most concern to the EMT?
Hives to the chest and abdomen

A 44-year-old female was hiking in a state park when she was bitten by a snake in her left calf. To get help, she had to hike 4 miles to the first-aid station where you are located. The hike took her 1½ hours. Your assessment reveals a red and swollen area to her leg, and she complains of discomfort to that area. Closer inspection reveals two puncture wounds in the center of the affected area. She asks you if she is going to die from the snake bite. Which one of the following is the best reply?
“You need to get checked out, but if venom was injected, the signs and symptoms of a generalized reaction typically appear very quickly.”

You have been called to a residence for a spider bite. On scene the homeowner states that he was moving some boxes in his garage when he accidentally grabbed a spider and it bit him. He killed the spider and shows you a brown-colored spider with a “violin shape” on its back. He then states that the bite does not hurt and he sees no need to go to the hospital. As a knowledgeable EMT, you should state:
“You really need to go because the bite of that spider does not heal very well and will put you at risk for infection.”

You have been asked by your medical director to put together an emergency kit specifically for patients who have been stung or bitten by small marine life animals. Which one of the following should you place in that kit?

A patient has been struck by lightning at a picnic. A doctor on scene states that the patient was in cardiac arrest after the strike, but with 1 minute of CPR, has a heartbeat and weak respirations. The patient remains unresponsive. Which one of the following should you do immediately?
Perform the jaw-thrust maneuver.

A 31-year-old groundskeeper has been stung by wasps three times in his right arm and left ankle. After performing the primary and secondary assessments, what should you do next?
Attempt removal of any embedded stingers.

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LIST 5 VITAL SIGNS THAT MUST BE MONITORED. (1) Temperature (2) Pulse (3) Respirations (4) Blood pressure (5) Level of pain WHAT ARE THE MAIN SITES FOR TAKING THE BODY’S TEMPERATURE? (1) Mouth (Oral) (2) Rectum (Rectal) (3) Armpit (Axillary) …

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