MOD6 - Chapter 33 - Environmental Emergencies

Created by Jeff_Yulo 

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emt

In which of the following ways does the body produce heat in response to being cold?

Excreting more urine
Burning fewer calories
Shivering
Increasing the respiratory rate

Shivering

In which of the following situations would a person lose heat by conduction?

Sitting on cold metal bleachers at a football game
Wearing wet clothing in windy weather
Breathing
Going outside without a coat during a cold but calm day

Sitting on cold metal bleachers at a football game

When the body is in water, how many times faster does it lose heat than when it is in still air?

2
100
10
25

25

A patient who is lying on cold ground is losing the most amount of heat by what mechanism?

Radiation
Convection
Conduction
Shivering

Conduction

Which of the following is the process in which heat is lost from the body as wind passes over it?

Convection
Hydrodynamic cooling
Exposure
Condensation

Convection

Which of the following is the most significant way in which the body cools itself?

Respiration
Perspiration
Radiation
Vasoconstriction

Perspiration

Why is it important to keep patients at rest when they are hypothermic?

Since the blood is warmest in the extremities, exercise or unnecessary movement could quickly circulate the warm blood and raises the core body temperature.
Since the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and drop the blood pressure.
Since the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and lower the core body temperature.
None of the above

Since the blood is warmest in the extremities, exercise or unnecessary movement could quickly circulate the warm blood and raises the core body temperature.

Which of the following does NOT make infants and children more prone to hypothermia?

Inefficient metabolism
Large body surface area
Small muscle mass
Little body fat

Inefficient metabolism

Which of the following terms describes the temperature of the surrounding air?

Wind chill index
Shell temperature
Core temperature
Ambient temperature

Ambient temperature

In cases of extreme hypothermia, you will find the patient unconscious, with no discernible vital signs, and skin cold to your touch with stiff joints as if they appear dead. What is the emergency care for these patients?

Contact medical control for input into the best treatment for this patient.
Call the coroner as indications are the patient is cold and deceased, which is a definitive sign of death.
Check distal CSM, apply warming packs to the extremities, and transport the patient.
Assess the carotid pulse for 30 to 45 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.

Assess the carotid pulse for 30 to 45 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.

To assess skin temperature for a possibly hypothermic patient, the EMT should place the back of his hand against which part of the patient's body?

Forehead
Cheek
Abdomen
Inner wrist

Abdomen

Allowing a patient's body temperature to increase by preventing further heat loss is referred to as which of the following?

Core rewarming
Passive rewarming
Active rewarming
Natural rewarming

Passive rewarming

Applying an external source of heat to the patient's body to rewarm him is called ________ rewarming.

central
active
endogenous
peripheral

active

The technique for central rewarming requires the application of heat to which of the following areas of the patient's body?

Chest, back, neck, and armpits
Lateral chest, neck, armpits, and groin
Head, neck, chest, and back
Head, neck, chest, and groin

Lateral chest, neck, armpits, and groin

Which of the following is acceptable when actively rewarming a hypothermic patient?

Encouraging the patient to exercise
Giving coffee or brandy to drink
Warming the patient as quickly as possible
Applying humidified oxygen

Applying humidified oxygen

In a hypothermic patient the coldest blood is found in what part of the patient's body?

Intestines
Heart and lungs
Head
Extremities

Extremities

You arrive on the scene and find an unresponsive homeless man lying in the alleyway clutching a wine bottle. He is wearing a long-sleeved shirt, but does not have pants on. His skin feels cold to the touch. The week's temperatures have not been above 50°F. Which of the following should you do immediately after ensuring the patient has an adequate airway?

Apply the AED.
Provide manual stabilization of the cervical spine.
Begin passive rewarming.
Check the pulse.

Check the pulse.

Rough handling of a patient with severe hypothermia may result in which of the following?

Ventricular fibrillation
Seizures
Heart attack
Rewarming shock

Ventricular fibrillation

When resuscitating a hypothermic patient in cardiac arrest, resuscitation attempts must continue until the patient has:

been ventilated for at least 30 minutes with an oropharyngeal airway in place.
developed rigor mortis.
been defibrillated a total of nine times.
been rewarmed.

been rewarmed.

Which of the following is NOT a classification of localized cold injury?

Hypothermia
Frostbite
Frostnip
All of the above are localized cold injuries.

Hypothermia

The term gangrene means tissue:

damage.
discoloration.
infection.
death.

death

Localized cold injury occurs due to vasoconstriction and:

chemical imbalance in the tissues.
blood clots.
ice crystal formation in the tissues.
loss of calcium.

ice crystal formation in the tissues.

Which of the following BEST describes a localized cold injury with a clear line of demarcation of its limits?

Early frostnip
Late frostbite
Immersion foot
Deep frostnip

Early frostnip

The term blanching, used to describe localized cold injury, means the tissue has turned to which of the following colors?

White or lighter
Blue or purple
Red
Black

White or lighter

Which of the following should the EMT do during the treatment of localized cold injury?

Encourage the patient to use the affected part.
Rub the affected area with snow.
Massage the affected area.
Gradually warm the affected area.

Gradually warm the affected area.

When actively rewarming a frostbitten extremity in warm water, you should change the water when the temperature falls below ________ °F.

115-120
100-105
85-95
80-90

100-105

Which of the following describes the condition of having an abnormally high body temperature?

Hyperthermia
Septic shock
Hyperdynamic state
Heat shock

Hyperthermia

For which of the following reasons are newborns, infants, and the elderly more readily affected by the heat than other age groups?

Faster metabolism
Increased body mass
Inadequate salt intake
Poor ability to regulate body temperature

Poor ability to regulate body temperature

Heat cramps occur due to loss of which of the following substances?

Water
Salt
Magnesium
Water and potassium

Salt

Heat stroke is caused by which of the following mechanisms?

Blockage of blood flow to the brain
Extreme dilation of all the blood vessels
Failure of temperature regulation mechanisms
Heat-induced swelling of brain tissue

Failure of temperature regulation mechanisms

When submerged in water, biological death may be delayed if the water temperature is below ________ °F.

70
98.6
50
32

70

Regarding drowning in adults, which of the following statements is true?

Colder water improves survival chances in saltwater drowning but not in freshwater drowning.
Water temperature makes no difference in the chances of survival in either saltwater or freshwater drowning.
The colder the water, the better the chances of survival in either saltwater or freshwater drowning.
The warmer the water, the better the chances of survival in saltwater drowning.

The colder the water, the better the chances of survival in either saltwater or freshwater drowning.

Which of the following spiders can cause a characteristic wound with a bite that is often painless?

Brown recluse spider
Sheet web spider
Argiope spider
Black widow spider

Brown recluse spider

Where should a constricting band be placed to reduce lymphatic flow after a venomous snake bite?

Two inches above the bite
Two inches below the bite
Two inches above and two inches below the bite
None of the above; constricting bands should not be used.

Two inches above and two inches below the bite

The purpose of a constricting band after a venomous snake bite is to impede the flow of which of the following?

Lymph
Arterial blood
Venom
Both A and C

Lymph

Of the following venomous snakes, which one usually has the highest incidence of a "dry bite"?

Coral snake
Water moccasin
Mississauga rattlesnake
Copperhead

Coral snake

Which of the following could worsen the effects of a snake bite?

Application of ice
Cutting and suctioning out the venom
Constricting bands above and below the bite
All of the above

Application of ice

Reducing the pain of a marine animal sting can be accomplished by rinsing the affected area with which of the following?

Sterile saline solution
Gasoline or kerosene
Cold water
Vinegar

Vinegar

Which of the following occurs when gases leave a damaged lung in a diving accident and enter the bloodstream?

Arterial thrombosis
Arterial blood gases
Hyperbaric arterial injury
Arterial gas embolism

Arterial gas embolism

Which of the following is caused by trapped nitrogen gas in the tissues due to a rapid ascent from a scuba dive?

"Squeeze" injuries of the ear and sinuses
Pulmonary embolism
Decompression sickness
Nitrogen narcosis

Decompression sickness

Which of the following increases a scuba diver's risk of decompression sickness?

Taking cold or sinus medications before a dive
Flying within several hours after a dive
Diving on a full stomach
Breathing 100 percent oxygen before a dive

Flying within several hours after a dive

You arrive on the scene to find a scuba diver on board a boat slumped over in the captain's chair with frothy blood in his mouth. The captain states that the diver was down no more than 15 feet when he ascended rapidly and called for help. Which of the following is most likely?

Decompression sickness
The bends
Air embolism
Caisson's disease

Air embolism

Which of the following types of snake is NOT a pit viper?

Water moccasin
Rattlesnake
Coral snake
Copperhead

Coral snake

You are enjoying some time at the beach on your day off when you hear a swimmer crying for help. As you spot the swimmer about 30 feet from shore, she cries out again but appears to be getting weaker. Although there is no lifeguard on duty, there is a rowboat and a ring buoy available. Assuming you do NOT know how to swim or consider yourself a poor swimmer, which of the following should you do first?

Row the boat out to the swimmer.
Use the buoy to float out to the swimmer.
Find someone who can swim to try to swim out and save the swimmer.
Call for help and try to throw the buoy to the swimmer.

Call for help and try to throw the buoy to the swimmer.

To rescue someone who has fallen through the ice, which of the following is the safest device to use?

A jet-ski
A flat-bottomed aluminum boat
A ladder
A ring buoy

A flat-bottomed aluminum boat

Most radiant heat is lost through which part of the body?

The hands and feet
The head
The buttocks
The torso

The head

Which of the following signs would you NOT expect to see in a patient suffering from severe hypothermia?

Numbness
Shivering
Drowsiness
Skin cool to touch

Shivering

Why is it important to remove constricting items such as rings before thawing a frozen extremity?

Because thawed areas often swell
To prevent damage to the property such as rings and watches
Because thawing leaves clots behind in the veins
All of the above

Because thawed areas often swell

Which of the following would you expect to see in a patient with severe hypothermia?

Irrational behavior
Loss of muscle tone
Rapid respirations
Tachycardia

Irrational behavior

In a patient with extreme hypothermia who appears to be in cardiac arrest, you should assess the pulse for how long?

30 to 45 seconds
20 to 30 seconds
5 to 10 seconds
15 to 20 seconds

30 to 45 seconds

Your patient is a 24-year-old man who smoked a cigarette dipped in formaldehyde and then went outside with no shoes on and walked in the snow for about an hour. He has deep local cold injuries to both feet. Which of the following should be included in your management of this patient?

Break blisters before wrapping both feet in sterile dressings.
Have the patient sit with his feet lower than the rest of his body.
Gradually rewarm both feet.
Massage the feet briskly.

Gradually rewarm both feet.

Your patient is a 44-year-old female with a history of alcoholism. She has been walking around at an outdoor fair on a hot, sunny day. She is disoriented to time; has hot, dry skin; and appears to be generally weak. Which of the following is the appropriate sequence of treatment for this patient?

Have the patient drink an electrolyte solution or sports drink and apply cold packs to her neck, armpits, and groin.
Get as much ice as possible from the food vendors at the fair, place the patient in a large container of ice, and apply oxygen by nonrebreather mask.
Give oxygen by nonrebreather mask, have the patient sip a sports drink or electrolyte solution, remove heavy clothing, and place cold packs on her neck, armpits, and groin.
Give oxygen by nonrebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.

Give oxygen by nonrebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.

Which of the following is often associated with water-related emergencies?

Hypothermia
Cardiac arrest
Alcohol use
All of the above

All of the above

Which of the following is acceptable in the management of a patient stung by a honey bee?

Soak the affected area in warm water.
Pull the stinger out using tweezers.
Remove jewelry from any affected limbs.
Elevate the affected site above the level of the heart to reduce swelling.

Remove jewelry from any affected limbs.

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