The emt should assess for hypoglycemia in small

DIABETIC EMERGENCIES QUIZ

Write the letter of the best answer in the space provided.

1. Insulin can best be described as a(n)

A. amino acid. C. blood sugar.

B. hormone. D. platelet.

2. The organ(s) responsible for the production of insulin is (are) the

A. liver. C. pancreas.

B. kidneys. D. spleen.

3. All of the following are signs or symptoms commonly associated with a diabetic emergency except

A. an elevated heart rate. C. seizure activity.

B. combativeness. D. hot, dry skin.

4. The simple form of sugar that is the body’s main source of energy is

A. insulin. C. adrenalin.

B. glucose. D. diabanese.

5. Glucose is administered in the form of a

A. tablet. C. suspension.

B. liquid for injection. D. gel.

6. Which memory aid should be used to gather a history from a patient with an altered mental status?

A. SAMPLE C. START

B. AVPU D. DCAP-BTLS

7. The type of diabetes that requires a patient to inject insulin daily is

A. Type 1. C. “maturity-onset diabetes.”

B. Type 2. D. diabetic ketoacidosis.

8. If a patient has excessive thirst, breath with a fruity odor, and warm, dry skin, you would suspect

A. hypoglycemia. C. hyperglycemia.

B. epilepsy. D. cerebral edema.

9. All of the following are medications often taken by diabetics except

A. Glynase®. C. nitroglycerin.

B. Humalog®. D. Orinase®.

10. For the EMT to administer oral glucose, the patient must meet all of the following criteria except

A. an altered mental status.

B. a baseline blood pressure that is greater than 90 mmHg systolic.

C. a history of diabetes controlled by medication.

D. the ability to swallow.

11. Proper administration of oral glucose usually produces

A. headache. C. diaphoresis.

B. bradycardia. D. no side effects.

12. What action does oral glucose take in the bloodstream?

A. decreases blood sugar C. decreases insulin level

B. increases blood sugar D. increases insulin level

13. If you are in doubt as to whether the patient is suffering from an emergency related to hypoglycemia or hyperglycemia, err to benefit the patient and

A. allow the patient to drink. C. administer oral glucose.

B. withhold liquids from the patient. D. withhold oral glucose.

14. Which of the following is a contraindication to the administration of oral glucose?

A. history of diabetes C. trauma

B. altered mental status D. unresponsiveness

15. Patients with an altered mental status and without suspected spinal injury should be transported in what position?

A. shock C. prone

B. lateral recumbent D. supine

IN THE FIELD

Review the following real-life situation. Then answer the questions that follow.

You and your partner are dispatched at 1015 to the Riverside Apartments on Montgomery Drive, Apartment 323, for an unconscious male. Upon your arrival, the patient’s excited wife meets you at the door. As she leads you to the kitchen, she explains that her husband, who is diabetic, has not been feeling well and stayed home from work today due to nausea and vomiting. While they were sitting at the kitchen table, he suddenly passed out and she immediately called 911. As you enter the kitchen, you see a male patient in his late 50s slumped in a kitchen chair. Your primary assessment reveals that the patient is unresponsive and bradypneic (10 breaths per minute), with a weak and rapid radial pulse and pale, cool, and clammy skin.

1. What condition do these signs and symptoms suggest?

2. In addition to a SAMPLE history, what additional questions would you ask the patient’s wife?

3. Is oral glucose indicated for this patient? Why or why not?

4. What additional emergency medical care would you provide to this patient?

Write the word or words that best complete each sentence in the space provided.

1. The body’s main source of energy is .

2. The hormone secreted by the pancreas that is needed to promote the movement of glucose from the blood into the cells is known as .

3. When there is a(n) of insulin, glucose cannot enter the cells; instead, it remains in the bloodstream, causing a high level of glucose in the blood, a condition known as .

4. When a diabetic’s insulin level is too high, too much sugar enters the cells and not enough sugar remains in the blood, a condition called .

5. is the medication of choice in the emergency medical care of the diabetic patient with an altered mental status.

6. Assess and document the mental status of a diabetic patient using the scale.

7. As an alternative to squeezing small portions of the tube of oral glucose into the patient’s mouth, the EMT could use a(n) .

8. Type diabetes typically develops in adulthood and is controlled by diet, exercise, oral medications, and, in severe cases, with insulin.

9. is a disease characterized by an altered relationship between glucose and insulin.

10. If no mechanism of injury is apparent, you would suspect that a patient’s altered mental status is a result of a(n) .

11. Never administer oral glucose to a patient who cannot swallow or who is .

12. For a patient with an altered mental status, repeat the ongoing assessment every

.

13. The most common sign of hypoglycemia is a(n)

__________________.

14. An altered mental status from hypoglycemia will typically have a(n)

onset.

15. A patient may take as long as minutes before showing improvement from receiving oral glucose.

ACUTE DIABETIC EMERGENCIES: LISTING

1. List five medications often taken by diabetics.

2. List nine signs and symptoms associated with a diabetic emergency.

3. List the three indications for administering glucose to a diabetic patient.

​

4. List the four steps in the administration of glucose.

ORAL GLUCOSE

Write in the missing information on the medication flash card below and save the completed card for future reference.

Medication Names:

1. Generic:

2. Trade:

Indications:

1.

2.

3.

Contraindications:

1.

2.

Medication Form: Dosage: Actions:

1.

2.

Side Effects:

SEIZURES & SYNACOPE QUIZ

Write the letter of the best answer in the space provided.

1. A sudden and temporary alteration in brain function caused by massive electrical discharge in a group of nerve cells in the brain is called

A. a convulsion. C. postictal activity.

B. a seizure. D. dysrhythmias.

2. The chronic brain disorder that is characterized by recurrent seizures is called

A. the aura. C. epilepsy.

B. CVA. D. postictal activity.

3. All of the following are common causes of seizures except

A. shock. C. infection.

B. hypoxia. D. hypoglycemia.

4. The period following a seizure in which the patient may be unresponsive, extremely sleepy, weak, and disoriented is called the

A. grand mal state. C. tonic phase.

B. postictal state. D. clonic phase.

5. Many patients will tell the EMT that they knew they were going to seize because of the

A. tonic phase. C. clonic phase.

B. postictal state. D. aura.

6. The period of a seizure when the patient’s muscles become contracted and tense with arching of the back is called the

A. tonic phase. C. clonic phase.

B. postictal state. D. aura.

7. The period of a seizure when muscles spasm and then relax, producing violent and jerky activity, is called the

A. clonic phase. C. aura.

B. tonic phase. D. postictal state.

8. A life-threatening condition characterized by a patient’s seizing for more than 5 minutes or consecutive seizures without an intermittent period of consciousness is called

A. a grand mal seizure. C. status epilepticus.

B. a convulsion. D. epilepsy.

9. A sudden and temporary loss of consciousness is called

A. epilepsy. C. syncope.

B. a convulsion. D. seizure.

10. The type of seizure most common in children between 6 months and 6 years old that is caused by high fever is called a(n) seizure.

A. absence (petit mal) C. grand mal

B. febrile D. complex partial

11. A type of seizure most common in children, which is characterized by a blank stare, lasting only a few seconds, and beginning and ending abruptly, is called a(n) ______ seizure.

A. complex partial C. Jacksonian

B. focal sensory D. absence (petit mal)

12. If a patient’s seizures last longer than 10 minutes, the EMT should begin

A. endotracheal intubation. C. positive-pressure ventilations.

B. CPR. D. AED use.

13. All of the following are common medications used in the treatment of epilepsy except

A. Dilantin®. C. insulin.

B. Mysoline®. D. phenobarbital.

14. The term for weakness on one side of the body is

A. aphasia. C. hemiparalysis.

B. dysphasia. D. hemiparesis.

15. Usually, a postictal patient should be placed in the position.

A. Trendelenburg C. lateral recumbent

B. Fowler’s D. prone

IN THE FIELD

Review the following real-life situation. Then answer the questions that follow.

You and your partner are dispatched to the local mall for a man having a seizure. Upon your arrival, you are greeted by a mall security guard who reports that your patient was noted walking alone through the mall when he suddenly fell to the ground and began having a “convulsion.” The guard tells you that the episode must have lasted about 6 or 7 minutes. Your patient is a male, approximately 30 years old, who is in a semi-sitting position next to a water fountain. He appears to be breathing adequately and is conscious, although a bit dazed.

1. What type of seizure did the security guard describe to you?

2. In what stage of the seizure is the patient upon your arrival? How long should this stage last?

3. What emergency care measures should you take with this patient?

4. What should you do if the patient states that this is normal for him and he doesn’t want to go to the hospital?

Write the word or words that best complete each sentence in the space provided.

1. A(n) is a sudden and temporary alteration in brain function caused by massive electrical discharge in a group of nerve cells in the brain.

2. A common cause of seizures is , a chronic brain disorder characterized by recurrent seizures.

3. The state follows the seizure and is the recovery period for the patient.

4. Seizure activity that is related to an injury or a medical condition may be an ominous sign of

or even permanent brain damage.

5. You cannot force a patient to accept transport or treatment, but you do need to

the call.

6. If the patient is talking normally, it indicates a(n) airway and

breathing.

7. A patient who suffers seizures that last more than 5 minutes or seizures that occur consecutively without a period of responsiveness between them is considered to be in .

8. Perform a(n) if the patient is postictal and still has an altered mental status or if she does not have a past medical history of epilepsy or seizures.

9. The serves as a warning that a seizure is going to begin and involves some type of sensory perception by the patient.

10. is a sudden and temporary loss of consciousness.

11. The EMT should place the syncopal patient in the position to allow for improved blood flow to the brain.

12. seizures, caused by high fever, are most common in young children.

13. The EMT needs to be aware that medical conditions such as __________________

and may be confused with a seizure or may produce a seizure.

14. A seizing patient’s movements should be __________________ rather than

to prevent further injury.

15. The EMT should gather a(n) __________________ history from the responsive seizure patient, relatives, and/or bystanders.

SEIZURES AND SYNCOPE: LISTING

1. List five common causes of seizures.

2. List seven steps in the emergency medical care for a seizing patient.

​

3. List the stages or phases of a seizure.

4. List four steps of emergency medical care for a syncope patient.

ANAPHYLACTIC EMERGENCIES QUIZ

Write the letter of the best answer in the space provided.

1. A severe form of allergic reaction is called

A. an allergen. C. epinephrine.

B. anaphylaxis. D. an immune reaction.

2. Harmless to most individuals, allergens are foreign substances that cause an abnormal immune system response known as

A. mitosis. C. an allergic reaction.

B. hypotoxemia. D. an immune response.

3. An EMT who notices that his hands are red and itchy after a call may be experiencing an allergic reaction to

A. latex gloves. C. exercise.

B. talcum powder. D. heat exposure.

4. Signs and symptoms of an allergic reaction include all of the following except

A. itching. C. decreased blood pressure.

B. increased appetite. D. watery eyes.

5. A sign of a severe allergic reaction is

A. runny nose. C. mild edema.

B. cyanosis. D. malaise.

6. The dose of epinephrine that should be given to an adult suffering severe allergic reaction is mg.

A. 0.3 C. 0.05

B. 0.5 D. 0.15

7. Epinephrine is most commonly administered as a(n)

A. tablet. C. prescribed inhaler.

B. gel. D. auto-injector.

8. When administered as a medication, epinephrine will accomplish all of the following except

A. constrict blood vessels. C. relax the bronchioles.

B. lower blood pressure. D. stimulate the heartbeat.

9. The dose of epinephrine that should be given to infants/children is mg.

A. 0.5 C. 0.15

B. 0.3 D. 0.05

10. If the patient’s condition improves following the administration of epinephrine, you should

A. perform reassessment. C. initiate CPR.

B. administer a second dose. D. connect the AED.

IN THE FIELD

Review the following real-life situations. Then answer the questions that follow.

The patient is an 8-year-old boy with a known history of allergies and asthma. His mother tells you that she administered his EpiPen® 5 minutes before your arrival. However, you believe that she gave it incor- rectly. “He pulled away when I tried to give the shot,” explains the mother. “I saw some of the medicine form a mist in the air.”

You examine the arm where the mother says that she gave the injection, but find no puncture mark. The child’s distress has worsened since your arrival, and he now seems barely conscious.

“I have three more EpiPens®,” offers the mother.

1. What action(s) should you take at this time?

Your next patient is an unconscious construction worker named Fred. “He had barely started to work with some fiberglass insulation when he fainted,” explains one of his coworkers.

You ask the coworkers more questions and find out that Fred was sneezing and coughing just before he fainted. They also noticed that he was using a handkerchief to wipe his watery eyes and runny nose. “He usually wears a respiratory mask on the job site,” adds one of the coworkers, “but he forgot to bring it today.”

Upon conducting a physical examination of the patient, you find a Medic Alert tag indicating that Fred has a number of allergies. His vital signs include a blood pressure of 70/42 and a weak pulse of 136. During your initial assessment, the foreman hands you an EpiPen® kit. “I found this in Fred’s lunch box,” he says. “Will it help?”

2. What action(s) should you take at this time?

Write the word or words that best complete each sentence in the space provided.

1. An abnormal or excessive response of the body’s immune system to a foreign material is called a(n)

.

2. Foreign substances recognized by the cells of the immune system and eventually destroyed by the body’s response are called .

3. A severe form of an allergic reaction is called

.

4. Antibodies are proteins that search for the antigen, combine with it, and then help to destroy it in a process known as .

5. ________________ from insect bites or stings, especially of wasps, hornets, yellow jackets, and fire ants, may cause an allergic reaction and anaphylaxis.

6. Red, itchy, possibly raised blotches on the skin are known as .

7. Management of the airway during anaphylaxis may require

, the placement of a tube in the trachea to facilitate breathing.

8. When administered as a medication, epinephrine will blood vessels to improve the patient’s .

9. A spring-loaded needle and syringe with a single dose of epinephrine is known as a(n)

- .

10. The correct dose of epinephrine for an adult is mg; for a child, it is

mg.

ALLERGIC REACTIONS: TRUE OR FALSE

Indicate if the following statements are true or false by writing T or F in the space provided.

1. Generally, an individual must come into contact with an allergen more than once for an anaphylactic reaction to occur.

2. Antibodies are proteins that search for an antigen, combine with it, and destroy it.

3. After 15 to 20 minutes, a patient suffering an allergic reaction has little risk of slipping into anaphylactic shock.

4. During an allergic reaction, you can expect to discover a higher-than-average blood pressure.

5. Epinephrine auto-injectors may not be administered to unconscious patients.

6. Epinephrine has no contraindications when used in a life-threatening situation.

7. A possible side effect of epinephrine use is chest pain.

8. Some anaphylactic reactions require repeated doses of epinephrine before the allergic reaction stops.

9. The two key categories of signs and symptoms that specifically indicate anaphylaxis are respiratory compromise and shock.

10. A patient experiencing an allergic reaction with no signs of respiratory distress or shock should receive epinephrine.

RECOGNIZING SIGNS AND SYMPTOMS OF ANAPHYLAXIS

​

Place a check mark in front of the signs and symptoms commonly associated with anaphylaxis or anaphylactic shock.

increased pulse

constipation

decreased respirations

increased appetite

vomiting

altered mental status

flushed skin

absent radial and/or pedal pulses

diarrhea

decreased pulse

increased respirations

decreased blood pressure

feeling of impending doom

stridor

EPINEPHRINE AUTO-INJECTOR

Write in the missing information on the medication flash card below, and save the completed card for future reference.

Epinephrine Auto-Injector

Medication Names:

1. Generic:

2. Trade:

Indications:

1.

2.

3.

Contraindications:

Medication Form:

Dosage:

Actions:

1.

2.

3.

4.

Side Effects:

1.

2.

3.

4.

5.

6.

7.

TOXICOLOGIC EMERGENCIES QUIZ

Write the letter of the best answer in the space provided.

1. Any substance—liquid, solid, or gas—that impairs health or causes death by its chemical action when it enters the body or comes into contact with the skin is called a(n)

A. allergen. C. antigen.

B. poison. D. caustic.

2. The most common poisons ingested by children include all of the following except

A. fertilizers. C. cleaning products.

B. plants. D. toiletries.

3. Carbon monoxide is an example of an _______ poison.

A. ingested C. absorbed

B. inhaled D. injected

4. When treating an absorbed poisoning patient, if the poison is a liquid, you should irrigate all parts of the patient’s body for at least _________ minutes.

A. 5 C. 20

B. 10 D. 45

5. Use of activated charcoal is indicated in some cases of poisoning.

A. injected C. absorbed

B. inhaled D. ingested

6. Activated charcoal is administered in the form of a(n)

A. tablet. C. gel.

B. suspension. D. inhaler.

7. All of the following are trade names for activated charcoal except

A. SuperChar. C. Liqui-Char.

B. CharCoal. D. Actidose.

8. The usual dose of activated charcoal for an adult is

A. 12.5–25 grams. C. 30–100 grams.

B. 3 grams/kg of body weight. D. 10 grams/kg of body weight.

9. In treating cases of inhaled poisons, the drug of first choice is

A. activated charcoal. C. glucose.

B. syrup of ipecac. D. oxygen.

10. The most common sources of injected poisons are

A. drugs. C. plants.

B. bites and stings. D. over-the-counter medications.

IN THE FIELD

Review the following real-life situation. Then answer the questions that follow.

The emergency medical dispatcher sends you to a residence at 7290 Riverside. The young woman who placed the 911 call is waiting for you on the doorstep, even though the day is chilly.

The woman reports that she dropped by the house to visit her friend Randy Johnson and saw through the window that he was passed out on the couch. The door was unlocked, so she went in to try to wake him but couldn’t. She tells you, “I wanted to stay and help him, but I just started feeling so bad. I felt sick to my stomach and my head hurt, almost like there was a band around it. Then I remembered that Randy had been having trouble with his furnace and was using a kerosene heater until he could get the furnace fixed. So I was afraid maybe something was wrong with the heater and came outside and called 911 from my cell phone. What’s going on?”

1. Based on your scene size-up, what answer would you give the woman?

2. What action(s) would you take?

Write the word or words that best complete each sentence in the space provided.

1. The ingestion of poisonous plants is an extremely common poisoning emergency, especially in

.

2. Protect the ingested poison patient from aspiration by placing him or her, if possible, in the

position.

3. In some cases of ingested poisoning, medical direction will order administration of

.

4. Unless directed otherwise by medical direction, give both adults and children

of activated charcoal per

of body weight.

5. Activated charcoal absorbs poisons in the stomach, prevents their by the body, and enhances their elimination from the body.

6. poisoning is the leading cause of death among people who inhale smoke from fires.

7. Any treatment recommended by the poison control center should be discussed with

before it is administered to the

patient.

8. If poison has been splashed into the eye, the affected eye with clean water for at least .

9. No matter what else is done regarding poisoning treatment, if the

and are not maintained, the patient will die.

POISONING: LISTING

1. List the four ways that poisons can enter the body.

2. List nine questions that should be asked during assessment of a patient with ingested poisoning.

3. List four contraindications for administration of activated charcoal.

​

4. List the emergency care steps for treating patients with inhaled poisoning.

POISONING: MATCHING

Write the letter of the type of poisoning next to the appropriate scenario below.

1. You are called to a suburban home to assist an 18-year-old male who has been found on the floor of his bathroom.

He has a reduced pulse rate and reduced rate of breathing. His pupils are constricted to pinpoint size. He seems very sleepy and unresponsive. There is a constricting band tied around his upper arm. You find a hypodermic needle behind a clothes hamper.

A. ingested poisoning

B. inhaled poisoning

C. absorbed poisoning

D. injected poisoning

2. A 19-year-old male farm worker stumbles while carrying an open drum of pesticides. The powder spills all over his clothes and body. Within minutes, a stinging, burning sensation spreads across his hands, arms, neck, and face. “It’s like being on fire,” he tells another farm worker. “Get some help fast!”

3. A 38-year-old woman collapses on the floor of her garage while cleaning out her car. She had left the car idling so that she could listen to her favorite radio station without running down the battery. By the time her husband discovers her, the woman is barely breathing. He rushes to call an EMS unit.

4. A 45-year-old man in extreme pain from a recent back operation decides to double his self-administered dosage of Demerol. By the end of the day, he feels extremely lethargic and is sweating profusely. His pupils look pinpoint in size. Sensing trouble, his teenage son calls the nearest ambulance service.

ACTIVATED CHARCOAL

Write in the missing information on the medication flash card below, and save the completed card for future reference.

Activated Charcoal

Medication Names:

1. Generic:

2. Trade:

Indications:

1.

2.

3.

Contraindications:

1.

2.

3.

4.

Medication Form:

Dosage: _

Actions:

1.

2.

Side Effects:

1.

2.

ABDOMINAL, HEMATOLOGIC, GYNECOLOGIC, GENITOURINARY

AND RENAL EMERGENCERIES QUIZ

Write the letter of the best answer in the space provided.

1. All of the following vital organs are located in the abdominal cavity except the

A. stomach. C. lungs.

B. gallbladder. D. liver.

2. Pain that is felt in a body part removed from its point of origin is called _______ pain.

A. referred C. radiating

B. ghost D. provoked

3. Irritation and inflammation of the peritoneum is called

A. costalcongitis. C. appendicitis.

B. diverticulitis. D. peritonitis.

4. An abdominal wall muscle contraction that the patient cannot control, resulting from inflammation of the peritoneum, is called

A. rigidity. C. protecting.

B. guarding. D. posturing.

5. All of the following are common signs and symptoms of a spontaneous abortion except

A. lower abdominal pain. C. rapid pulse.

B. vaginal bleeding. D. increased blood pressure.

6. Abdominopelvic pain in the middle of a patient’s menstrual cycle is known as

A. mittelschmerz. C. endometrial.

B. dysmenorrhea. D. referred.

7. Endometriosis is most commonly diagnosed in patients between the ages of

A. 35–45. C. 15–25.

B. 25–35. D. 45–55.

8. All of the following are part of the urinary system except the

A. kidneys. C. bladder.

B. liver. D. urethra.

9. Risk factors associated with renal calculi include all of the following except

A. hyperthyroidism. C. obesity.

B. dehydration. D. increased dairy intake.

10. The abdomen is divided into ______________ regions.

A. four C. five

B. six D. eight

Write the word or words that best complete each sentence in the space provided.

1. The left lower quadrant of the abdomen contains part of the _______________________ and the female reproductive organs.

2. _______________________ pain is felt when the abdominal organ itself is involved. 3. Pancreatitis, or inflammation of the , may cause severe pain in the middle or the upper quadrants (epigastric area) of the abdomen. 4. While assessing your patient, you note hematochezia. This means that the patient had a onset of gastrointestinal bleeding. 5. The ovaries are the primary sex glands and are located on either side of the . 6. When treating the victim of a sexual assault it is extremely important to not let the patient , bathe, comb, or clean any part of her body. 7. A ______________________ cyst is a fluid-filled sac that forms inside of or on an . 8. Pelvic inflammatory disease is an infection of the female ________________________ tract. 9. The ________________________ are bean-shaped organs located in the retroperitoneal space. 10. ________________________ is an artificial process used to remove water and waste substances from the blood when the kidneys fail to function properly.

ABDOMINAL, GYNECOLOGIC, GENITOURINARY, AND RENAL EMERGENCIES: LISTING

1. List the three types of abdominal pain.

2. List the seven emergency care steps for a patient with acute abdominal pain.

3. List the four psychological effects of sexual assault.

​

4. List the six emergency care steps for a dialysis emergency.

ENVIRONMENTAL EMERGENCIES QUIZ

Write the letter of the best answer in the space provided.

1. Water chill, which occurs when clothing or the body gets wet, is an example of

A. conduction. C. radiation.

B. convection. D. evaporation.

2. Wind chill, which occurs when currents of air pass over the body, is an example of

A. conduction. C. radiation.

B. convection. D. evaporation.

3. All of the following are signs and symptoms of hypothermia except

A. agitation and hyperactivity. C. loss of motor coordination.

B. shivering in early stages. D. cool abdominal skin temperature.

4. In providing emergency care steps for the hypothermic patient who is alert and responsive, an EMT should

A. passively rewarm the extremities. C. get the patient to walk around.

B. provide the patient with stimulants. D. actively rewarm the patient.

5. Rough handling of a patient with hypothermia may result in

A. apnea. C. blood clots.

B. ventricular fibrillation. D. seizures.

6. Superficial local cold injuries are sometimes referred to as

A. “white nose.” C. hyperthermia.

B. frost touch. D. frostbite.

7. All of the following are signs and symptoms you might expect to find in a heat emergency patient with hot, dry skin except

A. rapid, shallow breathing. C. dilated pupils.

B. generalized weakness. D. heavy perspiration.