12 - Toxicology / Behavioral / Gynecological Emergencies

Question 1

Activated charcoal is contraindicated in patients who have ingested what type of poisons?

Answer 1

Ethanol
Organic solvents
Alkali poisons
Cyanide

(833)

Question 2

List two common misconceptions about mental illness.

Answer 2

If you are feeling bad or depressed, you must be sick

Some people believe anyone with a behavioral health disorder is dangerous, violent, or otherwise unmanageable

(854)

Question 3

How does a psychiatric disorder differ from a behavioral crisis?

Answer 3

Psychiatric disorder: is an illness with psychological or behavioral symptoms that may result in impaired functioning. Anxiety disorders are among the most common mental health disorders. (856)

Behavioral crisis: describes the situation involving patients of all ages who exhibit agitated violent, or uncooperative behavior or who are a danger to themselves or others.

(855)

Question 4

List three drugs that will cause stimulation of the central nervous system.

Answer 4

Sympathomimetics: Mimic the effects of the sympathetic nervous system.

Cocaine
Methamphetamine
MDMA
Amphetamines

(839-4)

Question 5

When the ovum is not fertilized within 14 days of ovulation, this leads to:

Answer 5

Menstruation: Which lasts about one week

(896)

Question 6

Which is the most commonly accepted sign of opiate abuse? These drugs are known to produce life-threatening conditions? List two of these drugs.

Answer 6

CNS Depressant

S/S: Appear sedated and exhibit cyanosis, with pinpointed pupils

Life-threatening conditions: Respiratory depression, with decreases volume of inspired air and decreased respirations. Leads to respiratory then cardiac arrest.

Drugs: Fentynal, codeine, Heroin, Morphine

(836)

Question 7

What is organic brain syndrome? List two examples.

Answer 7

Organic brain syndrome is a temporary or permeable dysfunction of the brain caused by a disturbance in the physical or physiologic functioning of brain tissue.

Causes of organic brain syndrome include sudden illness; traumatic brain injury, seizure disorders; drug and alcohol abuse; overdose or withdrawal; and diseases of the brain, such as Alzheimer dementia or meningitis

(857)

Question 8

What two conditions can cause vaginal bleeding in women who do not appear to be pregnant and may not realize that they are pregnant?

Answer 8

Ectopic pregnancy
Spontaneous abortion

NOTE: Additional causes of vaginal bleeding:

Abnormal menstration
Vaginal trauma
Cervical polyps
Cancer

(885)

Question 9

Several workers inside a gardening supply warehouse are complaining of nausea, vomiting, and excessive mucus production. What are the MOST important first steps in managing these patients? What is the MOST likely cause of these S/S?

Answer 9

Cholinergic agent

Action: Over stimulate the normal body functions controlled by the parasympathetic nervous system.

Scene management:

Call for Hazmat support and put on PPE and N99 respirator for myself

Once protected, extricate patients away from the contamination and in open air

(842)

Question 10

There are several infections that when left untreated can progress to PID. List two of these infections.

Answer 10

Bacterial vaginosis
Gonorrhea
Chlamydia

(885)

Question 11

Explain why an SpO2 reading is ineffective as an assessment tool for a patient suffering from CO2 poisoning.

Answer 11

CO2 binds more effectively with hemoglobin than O2.

This would interfere with an accurate SpO2 reading

Question 12

Your patient states they are the president of the United States and is on a secret mission. The patient states they’re late for a spaceship that is going to Mars and can’t go to the hospital. Your patient is MOST likely suffering from what condition?

Answer 12

Psychosis: is a state of delusion in which the person is out of touch with reality.

(862)

Question 13

You are treating an assault patient with multiple lacerations, abrasions and tears to the external area of her genitals. What is the appropriate treatment for these types of injuries?

Answer 13

Treat with sterile compresses, using local pressure to control bleeding and a diaper-type bandage to hold the dressings in place. Leave any foreign bodies in place after stabilizing them with bandages.

(889)

Question 14

In the scenario above, what special considerations should be taken into account while assessing and treating a sexual assault patient?

Answer 14

Preserve patients privacy
Preserve evidence

(891)

Question 15

You are assessing a 25-year-old who is unconscious. The patient withdraws to painful stimuli and has gurgling respirations. The RR is 6/minute, HR is 72 weak and thready, BP is 118/70 and the SpO2 is 91%. Pupils are nonreactive and pinpoint. What is your working diagnosis? You treatment for this patient should include:

Answer 15

Diagnosis: Opiate overdose

Treatment: Open, clear and maintain airway with an OPA, apply O2 with a BVM, treat with Narcan via Intramuscular or Intranasal route, assess vitals, rapid transport

(836-7)

Question 16

What are the 4 routes of entry into the body for a poison, which is the most common?

Answer 16

Ingestion - (Most common, 80%)
Injection
Absorption
Inhalation

(824)

Question 17

You are dispatched to a residence for a patient who has attempted suicide. The scene is safe, your assessment reveals a patient who has recently ingested an entire bottle of Ativan. The patient is awake and alert and appears to be severely depressed. What is your treatment for this patient?

Answer 17

In general, your treatment of patients who have overdosed with sedative-hypnotics and have respiratory depressions is to ensure the airway is patent, assist ventilations, and give supplemental oxygen when appropriate. Rapid transport. Monitor mental status. Attempt to stimulate the person by speaking loudly or gently shaking them.

(838)

Question 18

Which drugs over stimulate the parasympathetic nervous system? What characteristic S/S does an OD of these drugs produce?

Answer 18

(842)

Question 19

The single most significant factor that contributes to suicide is:

Answer 19

Depression

Note: Anytime you encounter an emotionally depressed patient, you must consider suicide

(869)

Question 20

The text states, a disturbing pattern of behavior that lasts ______ may be a symptom of a mental health disorder.

Answer 20

One month

Question 21

Transporting an uncooperative, combative patient in the prone position could result in what condition?

Answer 21

Positional asphyxia: Restriction of chest wall movements and/or airway obstruction; can lead to sudden death

(879)

Question 22

What are the two basic categories of diagnosis for behavioral health emergencies?

Answer 22

Organic brain syndrome (physical): Is a temporary permanent dysfunction of the brain caused by a disturbance in the physical or physiologic functioning of the brain tissue.

Functional disorder (physiological): is a physiologic disorder that impairs function the the body seems to be structurally normal.

(857)

Question 23

The most common presenting sign of PID is:

Answer 23

Generalized lower abdominal pain

(884)

Question 24

You are treating a female patient who c/o an itching, burning pain with a foul-smelling discharge from her vagina. These signs and symptoms are most likely due to what condition?

Answer 24

Bacterial vaginosis

(885)

Question 25

You and your partner have decided to restrain a psychiatric patient. There are several factors that need to be considered prior to carrying out this act, list two.

Answer 25

Discuss a plan of action
Assign a team leader
Make sure you have adequate help (5 People)

(865)

Question 26

PID can lead to what two complications? What does it stand for? How does it occur?

Answer 26

Pelvic Inflammatory disease occurs in sexually active women which is an infection in the reproductive organs that can lead to sterility or ectopic pregnancy.

(884)

Question 27

What is a functional disorder? List an example.

Answer 27

A functional disorder has an unknown cause and no damage to any physical structures. (i.e. Schizophrenia, psychosis, depression)

(857)

Question 28

As you enter the residence of a patient who has possibly overdosed, you should:

Answer 28

Check scene safety and consider ALS backup immediately

Question 29

In most cases, activated charcoal should be administered with what timeframe of ingestion?

Answer 29

Within 1 hour of ingestion

Question 30

A patient spilled some liquid fertilizer on both arms and hands and is now complaining of itching and burning. What is the MOST effective initial treatment for this patient?

Answer 30

Keep yourself from getting contaminated, put on PPE, remove any clothes that contain the poison from the patient to avoid contaminating other objects

Question 31

List three S/S, per the text, that a sympathomimetic drug produces. List two of these drugs.

Answer 31

Hypertension, cardiac dysrhythmias, seizures

Question 32

List two drugs that will cause central nervous system (CNS) depression.

Answer 32

Alcohol
Xanax

Question 33

A patient exhibiting S/S of SLUDGEM is an indication for which type of exposure(S)?

Answer 33

Cholinergic agent

Question 34

You arrive on the scene of an alert adult patient who has consumed an unknown quantity of pills. The local protocol indicates that Activated Charcoal can be administered. List two things that you must first consider, prior to administering Activated Charcoal to this patient.

Answer 34

Assess weight of the patient

Verify that not contraindications are present