EMT Chapter 32: Environmental Emergencies

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should:
assess for a carotid pulse for up to 60 seconds.

A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:
supine positioning, splinting the leg, and transporting.

All of the following terms refer to a body part that is cold but not frozen, EXCEPT:
frostbite

Burns associated with lightning strikes are typically:
superficial.

Common signs and symptoms of heat exhaustion include all of the following, EXCEPT:
hot, dry skin

Drowning is MOST accurately defined as:
death from suffocation after submersion in water.

Hypothermia occurs when the core body temperature falls below:
95°F (35°C).

In contrast to Lyme disease, Rocky Mountain spotted fever:
can cause paralysis and cardiorespiratory collapse.

Most of the serious injuries associated with scuba diving are caused by:
too rapid of an ascent

The body’s natural cooling mechanism, in which sweat is converted to a gas, is called:
evaporation

The EMT must assume that any unwitnessed water-related incident is accompanied by:
possible spinal injury

The MOST prominent symptom of decompression sickness is:
abdominal or joint pain.

The venom of a black widow spider is toxic to the:
nervous system

When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:
conduction

Which of the following is an early sign of pit viper envenomation?
local swelling and ecchymosis

Which of the following MOST accurately describes hyperthermia?
The body is exposed to more heat than it can lose.

You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should:
assess the unresponsive patient’s pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.

You are transporting a 28-year-old man with a frostbitten foot. The patient’s vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should:
protect the affected part from further injury.

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. You should:
load him into the ambulance and begin rapid cooling interventions.

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should:
suction his mouth and nose, apply high-flow oxygen, monitor the patient’s breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.

Signs and symptoms of heat exhaustion and associated hypovolemia include all of the following, EXCEPT:
normal thirst

Signs and symptoms of severe systemic hypothermia include all of the following, EXCEPT:
shivering

The organs most severely affected by air embolism are the:
brain and spinal cord

The rate and amount of heat loss by the body can be modified by all of the following, EXCEPT:
increasing fluid intake

Treatment of drowning or near drowning begins with:
rescue and removal from the water

Which of the following statements regarding the brown recluse spider is NOT true?
It is larger than the black widow spider

Most heat stroke cases occur when the temperature is around _____°F and the humidity is 80%.
80

_____ is the least common but most serious illness caused by heat exposure, occurring when the body is subjected to more heat than it can handle and normal mechanisms for getting rid of the excess heat are overwhelmed.
Heat stroke

In the United States, the most common form of pit viper is the _______
rattlesnake

Never assume that a(n) ______, pulseless patient is dead.
cold

A person’s ability to shiver is lost when his or her body temperature falls below:
90°F (32°C)

An air embolism associated with diving occurs when:
the diver holds his or her breath during a rapid ascent.

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT:
relatively small surface area

Covering a patient’s _________ will significantly minimize radiation heat loss.
head

Heat loss from the body through respiration occurs when:
warm air is exhaled into the atmosphere.

Heat stroke occurs when:
the body’s heat-eliminating mechanisms are overwhelmed.

High air temperature reduces the body’s ability to lose heat by:
radiation

High humidity reduces the body’s ability to lose heat through:
evaporation

Hypothermia can worsen internal bleeding secondary to:
blood-clotting abnormalities.

In contrast to the brown recluse spider, the black widow spider:
is large and has a red-orange hourglass mark on its abdomen.

In order for sweating to be an effective cooling mechanism:
it must be able to evaporate from the body

Patients with generalized hypothermia are at an increased risk of a local cold injury because:
blood is shunted away from the extremities to the body’s core.

The body’s natural protective mechanisms against heat loss are:
vasoconstriction and shivering

The two MOST efficient ways for the body to eliminate excess heat are:
sweating and vasodilation

To assess a patient’s general body temperature, pull back on your glove and place the back of your hand on his or her skin at the:
abdomen

To obtain the MOST accurate reading of a patient’s core body temperature, you should place a special hypothermia thermometer:
into the patient’s rectum

When the body loses sweat, it also loses:
electrolytes

Which of the following conditions would be the LEAST likely to increase a person’s risk of hypothermia?
Hyperglycemia

Which of the following medications increases a person’s risk of a heat-related emergency?
Diuretics

Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?
Tachycardia

You are assessing a man with suspected hypothermia. The patient is conscious and alert, and is actively shivering. His respiratory rate is increased, but his breathing is unlabored, and the pulse oximeter reads 72%. The pulse oximetry reading is MOST likely:
secondary to decreased perfusion in the extremities.

The characteristic appearance of blue lips and/or fingertips seen in hypothermia is the result of:
blood vessels constricting

Hypothermia is more common among all of the following EXCEPT:
long-distance athletes

Management of hypothermia in the field consists of all of the following EXCEPT:
massaging the cold extremities

When the heat gain exceeds heat loss, ___ results
hyperthermia

Contributing factors to the development of heat illnesses include all of the following EXCEPT:
increased fluid intake

When obtaining a SAMPLE history for a patient with a diving emergency, pay special attention to all of the following diving parameters EXCEPT:
time of day

Which of the following statements about heat cramps is FALSE?
They only occur when it is hot outdoors

Sings and symptoms of heat exhaustion and associated hypovolemia include all of the following EXCEPT:
normal thirst

Most spinal injuries in diving incidents affect the:
cervical spine

Often, the first sign of heat stroke is:
a change in behavior

____ is the body’s reaction to inhaling very small amounts of water.
Laryngospasm

In a diving emergency, _____ occurs when bubbles of gas, especially nitrogen, obstruct the blood vessels.
decompression sickness

Young children can drown in as little as ___ of water if left unattended
1 inch

You should never give up on resuscitating a cold-water drowning victim because:
the resulting hypothermia can protect vital organs from the lack of oxygen.

The three phases of a dive, in the order they occur, are:
descent, bottom, and ascent

Areas usually affected by descent problems include:
the lungs

Potential problems associated with rupture of the lungs include all of the following EXCEPT:
hemopneumothorax

Black widow spiders may be found in all of the following EXCEPT:
Alaska

Coral snake venom is a powerful toxin that causes ___ of the nervous system
paralysis

Rocky Mountain spotted fever Lyme disease are both spread through the tick’s:
saliva

Signs of envenomation by a pit viper include all of the following EXCEPT:
chest pain

Removal of a tick should be accomplished by:
using fine tweezers to pull it straight out of the skin

Treatment for a snake bite from a pit viper includes all of the following EXCEPT:
providing water to drink

As you assess a patient, he has cold, clammy skin and a dry tongue. You suspect that:
he has suffered heat exhaustion

The direct transfer of heat from his body to the cold ground is called:
conduction

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Which one of the following signs or symptoms best indicates that the patient with cold skin is suffering from generalized hypothermia? Heart rate of 52 beats per minute You have been called to a park for a teenage boy who …

Which of the following descriptions BEST characterizes deep​ frostbite? The tissue becomes frozen. Which of the following combinations of findings makes a patient with a potential​ with a related emergency the HIGHEST priority for​ transport? Hot skin and altered mental …

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 …

Acute toxicity immediate and early effects of a single or short term exposure to the substance in question – usually easily identified – can replicate toxicity – usually no long-term residual effects Chronic toxicity long-term repeated exposure to a substance, …

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