EMT Assessment of Patient with Possible Head Trauma
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Questions and Answers

What is your immediate priority in caring for a patient in a room filled with gas?

  • Loosen all tight-fitting clothing
  • Remove the patient from the immediate environment (correct)
  • Start positive pressure ventilation
  • Assess the airway, breathing, and circulation

    • What should be the EMT's next action when dealing with a 14-year-old male who intentionally took medication to kill himself?

    Check the radial pulse and skin characteristics

    Which observation is most significant for the EMT at a halfway house where a 'drunk' male patient was found 'passed out'?

  • An empty fast-food bag on the bedside table
  • Glucometer on the table (correct)
  • Smell of urine in the room
  • Dried vomit on the floor

    • What must the EMT do prior to administering activated charcoal to an adult patient who has overdosed on several medications?

    <p>Shake the medication thoroughly to mix it</p> Signup and view all the answers

    What is the greatest risk related to the ingestion of cyanide?

    <p>Widespread hypoxia</p> Signup and view all the answers

    What should the EMT inform the patient about the additive in the activated charcoal?

    <p>You may experience diarrhea after taking the charcoal.</p> Signup and view all the answers

    What is a sign of withdrawal in a patient who wants help to rid herself of an addiction to pain medications?

    <p>She starts to become agitated</p> Signup and view all the answers

    Which finding would cause the EMT to classify and treat this patient as a high priority?

    <p>Complaint of nausea and a temperature of 103.6 degrees°F</p> Signup and view all the answers

    A patient who is agitated and hyperactive with dilated pupils and tachypnea has most likely ingested:

    <p>Crack cocaine</p> Signup and view all the answers

    A 44-year-old patient was found unresponsive at home. Based on his mental status and the fact that he was burning a kerosene heater in an enclosed room, you suspect carbon monoxide poisoning. Based on this information, which route of exposure would you recognize as responsible for the poisoning?

    <p>Inhalation</p> Signup and view all the answers

    For which of these patients would activated charcoal be indicated given the type of poisoning?

    <p>A 27-year-old who intentionally took a large amount of Tylenol 45 minutes ago</p> Signup and view all the answers

    You have been called to an alcoholism rehabilitation center. On scene, one of the counselors tells you that the patient is a 44-year-old woman who just came to the center this morning. She has not had any alcohol for 24 hours and is now sweating profusely and has an elevated heart rate and blood pressure. Based on this information, the EMT would recognize that the patient is:

    <p>Physically dependent on alcohol</p> Signup and view all the answers

    Generally speaking, which technique should the EMT use first when confronted with a patient in a drug or alcohol abuse situation who is experiencing a 'bad trip' and expressing some potentially violent tendencies?

    <p>The 'talk down' technique</p> Signup and view all the answers

    You have been called for a patient with alcoholism who is experiencing a medical emergency. On scene, a home health nurse informs you that the patient is experiencing delirium tremens. As an EMT, you recognize that:

    <p>This is a life-threatening condition requiring rapid transport</p> Signup and view all the answers

    Following a large wedding that occurred the previous night, health authorities announce that some of the food was contaminated with Salmonella. Consequently, your EMS service receives notice that it may receive a significant number of calls involving food poisoning. A new EMT asks you how to treat patients with food poisoning. What is your best response?

    <p>You should treat the patient based on his signs and symptoms, just like a patient who ingested any other poison.</p> Signup and view all the answers

    What is the typical dosage for intranasal administration of naloxone?

    <p>1 mg in each nostril</p> Signup and view all the answers

    You are assessing a young male patient who was found in an alley by sanitation workers. Assessment reveals the patient responds to painful stimuli by opening his eyes, but then closes them once you stop pinching the muscles on his neck. His airway is open and his breathing is shallow. His skin is cool and diaphoretic, and his pupils are constricted and do not react to light. Based on these assessment findings, the EMT would be suspicious of:

    <p>Narcotic overdose</p> Signup and view all the answers

    You suspect food poisoning in a 51-year-old male patient with nausea, vomiting, diarrhea, and fever. He is alert and oriented with no life threats to his airway, breathing, or circulation. His vital signs are pulse, 124; respirations, 20 breaths/min; blood pressure, 198/98 mmHg; and SpO2, 93% on room air. The patient has a history of COPD and hypertension, for which he did...

    <p>e manual spine motion restriction precautions</p> Signup and view all the answers

    A patient has been found unresponsive on her bedroom floor. When assessing her, the EMT would have the highest index of suspicion for a narcotic overdose when he notes:

    <p>Shallow and slow respirations</p> Signup and view all the answers

    You are en route for a possible heroin overdose. As an EMT, you would recognize heroin fits best into which drug category based on its effects?

    <p>Sedatives</p> Signup and view all the answers

    Which of these descriptions is most characteristic of carbon monoxide?

    <p>Carbon monoxide is an odorless gas that can kill a person by causing severe hypoxia</p> Signup and view all the answers

    A 42-year-old patient weighs 154 pounds (70 kg). How much activated charcoal would you administer to him?

    <p>70 grams</p> Signup and view all the answers

    On the scene of a drug-related emergency, the 22-year-old patient tells you that he has been taking amphetamines because he likes the way that they make him feel.

    <p>To experience a sense of euphoria</p> Signup and view all the answers

    Given these assessment findings, the EMT would be most concerned about­­­­­?

    <p>Possible brain injury</p> Signup and view all the answers

    What is the route of poisoning for this patient?

    <p>Injection</p> Signup and view all the answers

    Which of these questions would be most appropriate?

    <p>How many pills did you take?</p> Signup and view all the answers

    What complaint would the EMT expect from a person who has just used crack cocaine for the first time?

    <p>I have chest pain.</p> Signup and view all the answers

    What is the initial intervention in caring for this patient?

    <p>Perform a jaw-thrust maneuver</p> Signup and view all the answers

    Which of these conditions would be of most concern?

    <p>Heart disease</p> Signup and view all the answers

    What is the first action in caring for this patient?

    <p>Apply supplemental oxygen</p> Signup and view all the answers

    What is the immediate action?

    <p>Perform a manual airway maneuver</p> Signup and view all the answers

    Which of these interventions would most likely be included in your care?

    <p>Open the airway, provide oxygen, and give rapid transport to the hospital</p> Signup and view all the answers

    What would the EMRs do?

    <p>Irrigate the eye with water for a minimum of 20 minutes</p> Signup and view all the answers

    Which statement indicates that venom from the sting is being absorbed into the bloodstream?

    <p>I feel sick to my stomach and dizzy.</p> Signup and view all the answers

    Which of these correctly identifies the routes by which a poison can enter the human body?

    <p>Ingestion, inhalation, injection, absorption</p> Signup and view all the answers

    What is the need for?

    <p>Seizure precautions</p> Signup and view all the answers

    Which assessment finding would be most suggestive that the poison from the plant leaves has been absorbed into the patient's body?

    <p>Confusion and lethargy</p> Signup and view all the answers

    What would the Poison Control Center personnel most likely need to determine care options?

    <p>The patient's weight</p> Signup and view all the answers

    What is appropriate care for this patient?

    <p>Rinsing his face and mouth with water</p> Signup and view all the answers

    What is the immediate action?

    <p>Leave the room until it is cleared by the fire department</p> Signup and view all the answers

    This medication is primarily absorbed into the body through which structure?

    <p>Small intestine</p> Signup and view all the answers

    What does withdrawal from drugs or alcohol indicate?

    <p>Withdrawal from drugs or alcohol can be just as serious a medical emergency as an overdose.</p> Signup and view all the answers

    What is the first action?

    <p>Position the patient on her side</p> Signup and view all the answers

    What is the highest priority of care?

    <p>Managing the airway and breathing</p> Signup and view all the answers

    How has this poison affected the patient's brain?

    <p>Crossing from the lungs into the bloodstream and then circulating to the brain</p> Signup and view all the answers

    Which statement made by the patient would the EMT recognize as most important?

    <p>I just turned the furnace on last night.</p> Signup and view all the answers

    Which statement indicates proper initial care?

    <p>Let's open the airway manually first.</p> Signup and view all the answers

    Which patient would the EMT recognize as a drug abuser?

    <p>A 39-year-old female who takes pain medications even though she is not in pain</p> Signup and view all the answers

    What does the EMT accurately understand about alcoholism?

    <p>Aside from the excessive amounts of alcohol, much of the health deterioration that accompanies alcoholism comes from malnutrition.</p> Signup and view all the answers

    What is the first action?

    <p>Apply a self-contained breathing apparatus and enter the room</p> Signup and view all the answers

    How fast was the patient breathing when you found him?

    <p>Answer not provided</p> Signup and view all the answers

    How long was the patient trapped in the room?

    <p>Answer not provided</p> Signup and view all the answers

    What is the most essential step for the EMT to perform while caring for a patient who has overdosed on several drugs?

    <p>Identify and correct the loss of vital function(s)</p> Signup and view all the answers

    What would be appropriate care for a patient who took a Percocet pill at a party?

    <p>Nonemergent transport</p> Signup and view all the answers

    While awaiting arrival of the ALS unit, which of these steps is most appropriate for an unresponsive female patient with needle tracks on her arms?

    <p>Administer oxygen so as to maintain a pulse oximeter reading of 94% or greater</p> Signup and view all the answers

    When performing a reassessment of a patient who overdosed on medications, which of these findings would be most concerning?

    <p>Red-colored stool</p> Signup and view all the answers

    What medication would you prepare and administer to a patient who ingested a large amount of poison?

    <p>Actidose</p> Signup and view all the answers

    When directed by the Poison Control Center to administer milk to a patient who has overdosed on a medication, what should you do?

    <p>Contact medical command to confirm this treatment</p> Signup and view all the answers

    Why should the EMT call for advanced life support assistance when dealing with a patient who has been exposed to fumes containing cyanide?

    <p>Paramedics may be able to administer a cyanide antidote</p> Signup and view all the answers

    Which set of instructions given to another EMT would be most appropriate when managing a patient who ingested numerous household cleaners in an attempt to kill himself?

    <p>'Let's gather up all of the containers of the chemicals he may have taken and take them with us.'</p> Signup and view all the answers

    What would be included in the initial care for an 18-month-old girl who ingested drain cleaner?

    <p>Burns to her mouth</p> Signup and view all the answers

    What question should the EMT ask a middle-aged male who drank some 'chemicals' to kill the bugs in his body?

    <p>'Do you know exactly what it was you drank?'</p> Signup and view all the answers

    What is marijuana best described as?

    <p>A cannabis product</p> Signup and view all the answers

    What indicates an understanding of overdoses with narcotic drugs?

    <p>'When performing the primary assessment, we need to be alert for respiratory depression and have the naloxone ready.'</p> Signup and view all the answers

    What action should be taken when dealing with a hepatitis C patient who is an IV drug user?

    <p>Continue care with gloves</p> Signup and view all the answers

    What immediate action would be taken when dealing with a situation where two men are lying next to a tanker car?

    <p>Remain at a safe distance and call for fire department assistance</p> Signup and view all the answers

    Which statement regarding antidotes is correct?

    <p>An antidote will neutralize or counteract the effects of a poison or toxic substance</p> Signup and view all the answers

    What should be assumed when dealing with a 2-year-old girl who may have taken Digoxin pills?

    <p>The Digoxin pills have yet to be absorbed into the body</p> Signup and view all the answers

    Study Notes

    Toxicological Emergencies

    • A confused 41-year-old female patient, an alcoholic with a history of rehabilitation, is classified as high priority due to a complaint of nausea and a temperature of 103.6°F.

    Signs of Drug Ingestion

    • Agitated and hyperactive patient with dilated pupils and tachypnea likely ingested crack cocaine.
    • Patient who is irritable and uncooperative, with a smell of alcohol on their breath and complaint of headache may be experiencing symptoms of alcohol intoxication.

    Poisoning

    • Carbon monoxide poisoning can occur through inhalation, such as in an enclosed room with a kerosene heater.
    • Activated charcoal is indicated for a 27-year-old who intentionally took a large amount of Tylenol 45 minutes prior.

    Withdrawal Symptoms

    • A 44-year-old woman who has not had alcohol for 24 hours and is sweating profusely, with an elevated heart rate and blood pressure, is physically dependent on alcohol.
    • Delirium tremens is a life-threatening condition requiring rapid transport, characterized by symptoms such as hallucinations, fever, and dilated pupils.

    Patient Assessment

    • A patient with signs of opioid overdose, such as constricted pupils, shallow breathing, and cool, diaphoretic skin, is suspected to have ingested a narcotic.
    • A patient with signs of food poisoning, such as nausea, vomiting, diarrhea, and fever, should be encouraged to drink water for rehydration and may require oxygen administration.

    Medication Administration

    • Naloxone
    • Activated charcoal

    Patient Care

    • The "talk down" technique is used to calm a patient experiencing a "bad trip" due to drug ingestion.
    • Manual spine motion restriction precautions should be taken when assessing a patient who has overdosed and is lying at the bottom of some stairs.

    Routes of Exposure

    • Ingestion is the most common route by which a poison enters the body.
    • Inhalation is a route of exposure, such as in the case of chlorine gas.
    • Absorption is a route of exposure, such as in the case of pesticide splashed into the eyes.
    • Topical is a route of exposure, such as in the case of a powdered chemical contacting large portions of the skin.

    Substance Abuse

    • A patient who has taken an excessive amount of Tylenol with codeine may have a history of behavioral problems.
    • A patient who has overdosed on heroin may present with signs of opioid overdose.
    • A patient who is physically dependent on alcohol may experience withdrawal symptoms such as delirium tremens.

    EMS Response

    • The first action in caring for a patient with a chemical exposure is to take manual spine motion restriction precautions and perform the jaw-thrust maneuver.
    • In the case of a drug overdose, monitor the patient and initiate transport promptly.
    • When responding to a call for a patient with a suspected poisoning, ensure proper protection with gloves and gear to prevent contamination.### Poisoning and Overdose Scenarios

    Patient Assessment

    • A patient is breathing adequately with a blood pressure of 102/78 mmHg, a heart rate of 68 beats/min, and respirations of 12 breaths/min.
    • Administer oxygen to maintain a pulse oximeter reading of 94% or greater.

    Activated Charcoal Administration

    • Medical direction has ordered the administration of activated charcoal to a patient who ingested a large amount of poison.
    • Actidose is the medication to prepare and administer.

    Cyanide Exposure

    • A patient exposed to fumes containing cyanide requires advanced life support assistance because paramedics may be able to administer a cyanide antidote.

    Household Cleaners Ingestion

    • When managing a patient who ingested numerous household cleaners, gather all containers of the chemicals and take them with you to the hospital.
    • Insert a nasal airway in an unconscious patient who ingested a household cleaner and is having difficulty breathing due to swelling from burns in the mouth.

    Inhalation Poisoning

    • The onset of signs and symptoms associated with an inhalation poisoning are often rapid.
    • Administer supplemental oxygen to a patient who was using an industrial drain cleaning solvent and was exposed to fumes.

    Pediatric Ingestion

    • When a child ingests a toxic substance, continually assess for respiratory depression and have naloxone ready.
    • In a child who ingested drain cleaner, burns to the mouth provide strong evidence of ingestion.

    Accidental Exposure

    • Accidental exposure to cyanide is a concern for a firefighter battling a smoky structure fire.

    Antidotes

    • An antidote will neutralize or counteract the effects of a poison or toxic substance.

    Methanol Poisoning

    • When caring for a patient who intentionally drank a compound containing a high percentage of methanol, turn the patient on their side if they are nauseated and think they are going to vomit.

    Airway Management

    • When presented with an unresponsive patient who may have taken an unspecified poison, manually open the airway and perform suction.

    Petroleum Refining Plant Exposure

    • A patient who inhaled hydrocarbon fumes at a petroleum-refining plant requires continuous high-concentration oxygen.

    Priority of Care

    • The EMT's highest priority when presented with a patient who has been exposed to a poisonous substance is to perform a primary assessment.

    Anaphylactic Reaction

    • A patient who was stung by a hornet while golfing and is confused with stridorous respirations, warm and flushed skin, and hives, has an injection route of poisoning.

    Overdose

    • When determining that a patient intentionally overdosed on blood pressure medications, ask how many pills they took.
    • A person who has just used crack cocaine for the first time may complain of chest pain.

    Industrial Accident

    • When caring for a patient exposed to a powerful pesticide in powder form, apply supplemental oxygen as the first action.

    Airway Management

    • Respiratory rate of 8 breaths/min indicates need for immediate oxygenation via nonrebreather mask
    • Radial pulse being weak is a concern for airway management
    • Importance of determining if drugs are involved in the situation

    Seizure Emergencies

    • Seizures in a patient who has been partying all night, with a history of diabetes and drug abuse
    • Importance of checking blood glucose levels and providing oxygen
    • Administering oral glucose is not a recommended intervention

    Drug Abuse

    • Importance of understanding the signs and symptoms of toxic exposure, which vary depending on the specific poison
    • Vomiting does not necessarily indicate that the poison has not been absorbed into the body
    • Routes of poison entry into the body include ingestion, inhalation, injection, and absorption

    Poisoning Emergencies

    • Importance of irrigating the eye with water for at least 20 minutes in cases of acid splashes
    • Recognition of symptoms of poisoning, such as numbness, redness, swelling, and abdominal pain
    • Importance of seeking medical direction in cases of poisoning

    Patient Assessment

    • Importance of assessing the patient's airway, breathing, and circulation (ABCs) in cases of poisoning or overdose
    • Recognition of signs of withdrawal, such as agitation, nausea, and vomiting
    • Importance of determining the patient's weight in cases of poisoning or overdose

    Suicide Attempts

    • Importance of recognizing the warning signs of suicide, such as a patient's statement of intent to die
    • Immediate action required in cases of suicide attempts, including removal of the patient from the immediate environment
    • Importance of maintaining a calm and authoritative tone when talking to a patient who has attempted suicide

    Chemical Exposure

    • Importance of removing the patient from the immediate environment in cases of chemical exposure
    • Recognition of symptoms of chemical exposure, such as lethargy, confusion, and nausea
    • Importance of irrigating the skin and eyes with water in cases of chemical exposure

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    Description

    A patient presents with confused and slurred speech, the smell of alcohol on his breath, and a hematoma on the left side of his head after a fall. The EMT must assess the situation and decide on a course of action.

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