Chapter 32 Environmental Emergencies

All of the following terms are used to describe a cold body part that is not frozen, EXCEPT

frostbite

A 48-year-old male was stung on the leg by a jellyfish while swimming in the ocean. He is conscious and alert, but complains of intense pain at the wound site. Specific treatment for this patient includes

irrigating the wound with vinegar and immersing his leg in hot water.

A person’s ability to shiver is lost when his or her body temperature falls below

90°

An air embolism associated with diving occurs when

the diver holds his or her breath during a rapid ascent.

Which of the following statements regarding lightning strikes is MOST correct

Lighting often results in a brief period of asystole that resolves spontaneously

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

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

abdomen

A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform an initial assessment and determine that the patient is apneic and has a slow, weak pulse. You should

provide rescue breathing, remove wet clothing, immobilize his spine, keep him warm, and transport carefully

Heat cramps are MOST likely the result of

a loss of water and electrolytes

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.

Geriatric patients, newborns, and infants are especially prone to hyperthermia because they

exhibit poor thermoregulation

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT

a relatively small surface area

While drinking beer with his friends near a creek, 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

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

Head

In order for sweating to be an effective cooling mechanism

it must be able to evaporate from the body

Which of the following conditions would be the LEAST likely to increase a person’s risk of hypothermia? (Needs options)

Hyperglycemia

Approximately 12 hours after scuba diving with her friends, a 29-year-old female presents with pain in her elbows and knees. She is conscious and alert and is breathing with adequate tidal volume. When asked, she states that she may have ascended too rapidly during her dive, but didn’t experience any symptoms until now. When treating this patient, you should

place her in a left lateral recumbent position with her head down

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

evaporation

The venom of a brown recluse spider is cytotoxic, meaning that it

causes severe local tissue damage

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

Which of the following statements regarding drowning is MOST correct?

Laryngospasm following submersion in water makes rescue breathing difficult.

Most of the serious injuries associated with scuba diving are caused by

too rapid of an ascent

Which of the following is an early sign of pit viper envenomation?

Local swelling and ecchymosis

Burns associated with lightning strikes are typically

superficial

Heatstroke occurs when

the body’s heat-eliminating mechanisms are overwhelmed.

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

A frostbitten foot can be identified by the presence of

mottling and blisters

Hyperthermia is MOST accurately defined as a condition in which

the body is exposed to more heat than it can lose.

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 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

Geriatric patients are at a higher risk for heatstroke because

circulation to the skin is reduced

In contrast to the brown recluse spider, the black widow spider

is large and has a red-orange hourglass mark on its abdomen

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 BP is 90/50 mm Hg. In addition to administering 100% oxygen, you should

load him into the ambulance and begin rapid cooling interventions.

Shivering is a mechanism in which the body generates heat by

increasing the metabolic rate.

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

Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when

a swimmer hyperventilates prior to entering the water

A patient with a core body temperature of 92°F will MOST likely experience

rapid breathing

The MOST prominent symptom of decompression sickness is

abdominal or joint pain

The two MOST efficient ways for the body to eliminate excess heat are

sweating and vessel dilation

The body’s natural protective mechanisms against heat loss are

vasoconstriction and shivering

Rough handling of a hypothermic patient with a pulse may cause

ventricular fibrillation

The EMT-B must assume that any unwitnessed water-related incident is accompanied by

possible spine injury

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

evaporation

Signs and symptoms of an air embolism include all of the following, EXCEPT (Needs options)

pale skin

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.

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F. He is immediately placed in the warmed ambulance, where you perform an initial assessment. He is unconscious, pale, and apneic. After initiating artificial ventilations, you should

assess for a carotid pulse for up to 45 seconds

When a warm hand is immersed in water that is 70°F, heat is transferred from the hand to the water through a process called

conduction

When assessing a hypothermic patient, you should palpate for a carotid pulse for approximately __________ seconds before determining that he or she is pulseless.

30 to 45

The venom of a black widow spider is toxic to the

nervous sytem

Hypothermia occurs when the core body temperature falls below

95°F

The transfer of heat to circulating air, such as when cool air moves across the body’s surface, is called:

convection

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

evaporation

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

conduction

All of the following snakes are pit vipers, EXCEPT for the:

coral snake(which is the Elapidae family)