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MY Emergency Care And Transportation Of The Sick And Injured > Chapter 21 - Toxicology > Flashcards

Chapter 21 - Toxicology Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Almost any substance may be a __________ in certain circumstances.

A

poison

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2
Q

Different doses can turn even a remedy into a ___________ for example aspirin.

A

poison

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3
Q

Acute poisoning affects ____ million people each year.

A

2

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4
Q

____________ poisoning is more common than acute poisoning.

A

Chronic

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5
Q

Death by poisoning are fairly ________.

A

rare

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6
Q

Rates of death as the result of poisoning in children have decreased steadily since the 1960s due to ____________-___________ caps.

A

Child-resistant

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7
Q

Deaths caused by chronic poisoning to adults have been rising as a result of ______ _____.

A

drug abuse

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8
Q

__________ is the study of toxic or poisonous substances.

A

Toxicology

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9
Q

A _____ is any substance whose chemical action can damage body structures or impair body function.

A

poison

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10
Q

A ______ is a poisonous substance produced by bacteria, animals, or plants that acts by changing the normal metabolism of cells or destroying them.

A

toxin

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11
Q

_________ abuse is the misuse of any substance to produce a desired effect.

A

Substance

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12
Q

A common complication of substance abuse is __________, when a patient takes a toxic dose of a substance.

A

overdose

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13
Q

Your primary responsibility to the patient who has been poisoned is to __________ that a poisoning has occurred.

A

recognize

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14
Q

For your own safety, you must pay attention to your ___________ or you could be exposed to the same substance.

A

surroundings

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15
Q

The _______, __________, and ________ of the toxic exposer is important.

A

where
what
how

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16
Q

Very small amounts of some poisons can cause considerable ________ or _________.

A

damage

death

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17
Q

If you suspect that ingestion or exposure to a toxic substance has occurred, notify ______ _____ and begin emergency treatment at once.

A

medical control

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18
Q

The signs and symptoms of poisoning vary according to the _______ _______.

A

specific agent

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19
Q

For your own safety, you must pay attention to your surroundings or you could also become _______ to the same substance.

A

exposed

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20
Q

The _____, _____, and _______ of the exposure is important.

A

where
what
how

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21
Q

Very _______ amounts of some poisons can cause considerable damage or

A

small

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22
Q

If you suspect that ingestion or exposure to a toxic substance has occurred, notify _______ _______ and begin emergency tratment at once.

A

medical treatment

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23
Q

The signs and symptoms of poisoning vary according to the _____ _____.

A

specific agent

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24
Q

The presence of injuries at the patient’s mouth strongly suggests the _______ of a poison,

A

ingestion (swallowing)

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25
Q

If possible, while obtaining the SAMPLE history, ask the patient:

A
  • What substance did you take?
  • When did you take it (or become exposed to it)?
  • How much did you ingest?
  • Did you have anything to eat or drink before or after you took it?
  • Has anyone given you an antidote or any substance orally since you ingested it?
  • How much do you weigh?
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26
Q

Try to determine the ___________ of the poison.

A

Nature

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27
Q

Look around the immediate _______ for an overturned bottle, a needle or syringe, scattered pills, chemicals, remains of food or drink items, or even an overturned or damaged plant.

A

Area

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28
Q

Place any suspicious ___________ in a plastic bag and take it with you.

A

material

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29
Q

Containers at the scene can provide critical information, such as

A 
name and concentration of the drug
ingredients
number of pills originally in the bottle
name of the manufacturer
prescribed dose
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30
Q

If a patient vomits, examine the contents for ______ fragments.

A

pill

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31
Q

Wear proper _____ _____ ______.

A

personal protective equipment

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32
Q

Emergency care for a patient who has been poisoned may include actions that range from ________ an anxious parent to performing ___.

A

reassuring

CPR

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33
Q

Most often, you will not be administering a specific _____ because most poisons do not have one.

A

antidote

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34
Q

The medication antidote most commonly available to prehospital providers is _________, which is used to reverse the effects of an opioid overdose.

A

naloxone (Narcan)

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35
Q

Definitive treatment can only be provided at the _____, so transport promptly.

A

ED

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36
Q

The most important treatment you can perform for a poisoning is _____ and/or physically removing the poisonous agent.

A

diluting

removing

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37
Q

How you provide treatment depends on ____ the poison got into the patient’s body in the first place.

A

how

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38
Q

The four routes of poisoning to consider are:

A

inhalation
absorption (surface contact)
ingestion
injection

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39
Q

All four routes of poisoning can lead to serious and possibly life-threatening conditions. Take care to treat ________ appropriately and to keep ______ safe from harm.

A

patients

yourself

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40
Q

If you are uncertain how to treat a patient who has been poisoned or exposed to a specific substance, find the container, if possible, and contact _______ ______ and/or the _____ _____ _____ before you proceed.

A

medical control

poison control center

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41
Q

For ______ poisons, move the patient into fresh air immediately.

A

inhaled

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42
Q

For _______ poisons, the patient may require supplemental oxygen.

A

inhaled

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43
Q

If you suspect the presence of a toxic gas, call for specialized resources such as the _______ team.

A

HazMat

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44
Q

A ____-____ breathing apparatus is necessary to protect yourself from poisonous fumes.

A

self-contained

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45
Q

Some patients may need ____________ by the HazMat team after removal from the toxic environment.

A

decontamination

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46
Q

The patient may have the following signs and symptoms:

A 
burning eyes
sore throat
cough
chest pain
hoarseness
wheezing
respiratory distress
dizziness
confusion
headache
stridor
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47
Q

All patients who have inhaled poison require ___________ transport to an emergency department.

A

immediate

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48
Q

Be prepared to use supplemental oxygen via a _______ mask and/or ventilator support with a ______, if necessary.

A

nonrebreathing

BVM

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49
Q

Pulse oximetry readings may not be accurate with ________ poisons.

A

inhaled

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50
Q

Make sure a suctioning unit is available in case the patient _________.

A

vomits

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51
Q

Some patients use inhaled poisons to commit _________ in a vehicle.

A

suicide

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52
Q

Leaving a car engine running in an enclosed garage can cause exhaust fumes, which contain high levels of ________ ________, to cause the patient to lose consciousness and eventually stop breathing.

A

carbon monoxide

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53
Q

A recent variation involves using chemicals or detergent in a tightly sealed vehicle as a type of _____ ________.

A

gas chamber

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54
Q

When you open the door of a vehicle, you may be overcome by the ________ in side of it.

A

poison

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55
Q

Contact ________ responders and have them remove the victim in a poisoned vehicle situation.

A

HazMat

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56
Q

Two type of contact poisons are:

A

absorbed

surface

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57
Q

Absorbed and surface poisons can affect the patient in many ways such as:

A

skin, mucous membrane, or eye damage
chemical burns
rashes or lesions
systemic effects

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58
Q

It is important to distinguish between contact ______ and contact ______.

A

burns

absorption

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59
Q

Signs and symptoms of absorbed poisoning include:

A 
a history of exposure
liquid or powder on the patient's skin
burns
itching
irritation
redness of the skin
typical odors of the substance
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60
Q

Emergency treatment for a typical contact poisoning includes:

A

avoid contamination yourself or others

while protecting yourself, remove the substance from the patient as rapidly as possible

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61
Q

For all absorbed and surface contact poisons, remove all contaminated ________.

A

clothing

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62
Q

For absorbed and surface contact poisons, flush and wash the ______.

A

skin

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63
Q

For absorbed and surface contact poisons, if dry powder has been spilled, brush off the powder, then flood the area with water for 15 to 20 minutes, then wash skin with ______ and _______.

A

soap

water

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64
Q

For absorbed and surface contact poisons, if liquid has been spilled onto the skin, flood with water for _______ to _______ minutes.

A

15

20

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65
Q

For absorbed and surface contact poisons, if a chemical agent is introduced to the eyes, _______ them quickly and thoroughly.

A

irrigate

66
Q

Many chemical burns occur in an __________ setting.

A

industrial

67
Q

Safety showers and specific protocols for handling _________ burns may be available in an industrial setting.

A

surface

68
Q

A __________ team should be available to assist you in an industrial setting.

A

HazMat

69
Q

In an industrial setting, ensure you, your team members, and the exposed patient are thoroughly ___________.

A

decontaminated

70
Q

After decontamination, promptly transport to the ______ for definitive care.

A

ED

71
Q

In an industrial setting, obtain ______ ______ _______ ______ and transport with the patient; if not immediately available, have the company fax them to the hospital.

A

material safety data sheets

72
Q

With ingested poisons, about ________% of poisoning is by mouth.

A

80

73
Q

Types of ingested poisons include:

A 
liquids
household cleaners
contaminated food
plants
drugs
74
Q

Ingested poisoning is usually ________ in children and ______ in adults.

A

accidental

deliberate

75
Q

Signs and symptoms of ingested poisons vary greatly with the:

A

type of poison
age of the patient
time that has passed since the ingestion

76
Q

Signs and symptoms of ingested poisons include:

A

burning around the mouth, gastrointestinal pain, vomiting, cardiac dysrhythmias, and seizures

77
Q

With ingested poisons, if the patient has altered mental status, protect the patient from ___________ on vomit.

A

aspiration

78
Q

With ingested poisons, consider whether there is unabsorbed poison remaining in the gastrointestinal tract and whether you can safely and effectively prevent its ___________.

A

absorption

79
Q

Some EMS systems allow EMT’s to administer active __________.

A

charcoal

80
Q

You should always immediately access the airway, breathing, and circulation (ABCs) of every patient who has been _________.

A

poisoned

81
Q

Exposure by ___________ includes intravenous drug abuse and envenomation by insects, arachnids, and reptiles.

A

injection

82
Q

Injected poisons are usually absorbed quickly into the body or cause intense _____ tissue destruction.

A

local

83
Q

Injected poisons cannot be ________ or _______ from the body in the field.

A

diluted

removed

84
Q

With injected poisons, the patient’s condition can be life threatening; you must act _________.

A

quickly

85
Q

Signs and symptoms of injected poisons include:

A 
weakness
dizziness
fever
chills
unresponsiveness
excitability
86
Q

With injected poisons, monitor the airway, provide ___-_____ oxygen, and be alert for nausea and vomiting.

A

high-flow

87
Q

Activated charcoal binds to specific toxins and prevents their absorption by the body; the toxins are then carried out of the body in the ______.

A

stool

88
Q

Activated charcoal is not indicated for patients who have ingested:

A 
alkali poisons,
cyanide
ethanol
iron
lithium
methanol
mineral acids
organic solvents
or those who have a decreased level of consciousness and cannot protect their airway
89
Q

If local protocol permits, you will likely carry plastic bottles of premixed suspension, each containing up to ____ g of activated charcoal.

A

50

90
Q

Some common trade names for activated charcoal include:

A

InstaChar
Actidose
LiquiChar

91
Q

The usual dose for an adult or child is ____ g of activated charcoal per kilogram of body weight.

A

1

92
Q

Activated charcoal for adults is ___ to ____g.

A

30

100

93
Q

Activated charcoal for children is ____ to ___ g.

A

15

30

94
Q

Before you give a patient charcoal, obtain approval from ________ _______.

A

medical control

95
Q

Side effects of ingesting activated charcoal are _____ and ______ _______.

A

constipation

black stools

96
Q

If the patient has ingested a poison that causes nausea, he or she may vomit after taking activated charcoal and the dose will have to be ________.

A

repeated

97
Q

When giving activated charcoal, be sure to shake the bottle vigorously to mix the __________.

A

suspension.

98
Q

Over time, a person who routinely misuses a substance may need increasing amounts of it to achieve the same result. This is called devolving a ___________.

A

tolerance

99
Q

Dilute airborne exposures with ________.

A

oxygen

100
Q

Remove contact exposures with copious amounts of ___________ unless contraindicated.

A

water

101
Q

1 in ____ deaths among working-age adults in the United States can be attributed to excessive alcohol use.

A

10

102
Q

Alcohol can damage the ________, whether through chronic overuse or occasional heavy use (binge drinking).

A

liver

103
Q

_________ drinking can be more damaging than chronic use, depending on the frequency of the _______ and the surrounding circumstances.

A

Binge

binging

104
Q

Alcohol is a powerful ______ depressant.

A

CNS

105
Q

Alcohol is a _________ (decreases activity and excitement) and a ________ (induces sleep).

A

sedative

hypnotic

106
Q

A _______ is a drug that produces sleep or altered mental consciousness.

A

opioids

107
Q

An _________ is a type of narcotic medication used to relieve pain.

A

opioid

108
Q

Opioids are named for the opium in poppy seeds, from which ______ and _____ are derived.

A

codeine

morphine

109
Q

Synthetic opioids include:

A 
meperidine
hydromorphone
oxycodone
hydrocodone
methadone
110
Q

_____________ opioid drugs are among the most commonly abused drugs in the United States.

A

Prescription

111
Q

Patients with _________ _________ are the most commonly accepted sign of opiate abuse.

A

pinpoint pupils

112
Q

__________ is an antidote that reverses the effects of opiate or opioid overdose.

A

Naloxone (Narcan)

113
Q

Naloxone (Narcan) can be given __________, _________ or _________.

A

intravenously
intramuscularly
intranasally

114
Q

Naloxone (Narcan) should only be used intranasally when the patient has _____ respirations or is apneic.

A

agonal

115
Q

Place an _________ _______ and ventilate the patient using a BVM prior to administering naloxone.

A

oropharyngeal airway

116
Q

In some areas, lay people are permitted to administer ____________; find out from bystanders if the patient was given naloxone.

A

naloxone

117
Q

___________ and ________ are easy to obtain and relatively cheap.

A

Barbiturates

benzodiazepines

118
Q

Barbiturates and benzodiazepines are ______ depressants and alter the level of consciousness, with effects similar to those of alcohol.

A

CNS

119
Q

Treatment for sedative-hypnotic drugs is to ensure airway is patent, assist ventilations, and provide prompt _______.

A

transport

120
Q

Some common agents of abused inhalants include:

A

acetone
toluene
xylene
hexane

121
Q

Common agents of abused inhalants are often found in:

A

glues
cleaning compounds
paint thinners
lacquers

122
Q

_________ and various halogenated hydrocarbons such as Freon, used as propellants in aerosol sprays, are also abused as inhalants.

A

Gasoline

123
Q

Abused inhalants are commonly abused by _________.

A

teenagers

124
Q

In abused inhalants, the _________ dose and the ________ dose are very close, making them extremely dangerous drugs.

A

effective

lethal

125
Q

Halogentated hydrocarbon solvents can make the heart hypersensitive to the patient’s own _________.

A

adrenaline

126
Q

With abused inhalants, even the act of ________ may cause a fatal ventricular dysrhythmia. Keep such patients from struggling and exerting themselves.

A

walking

127
Q

__________ _______ is a highly toxic, colorless, and flammable gas with a distinctive rotten-egg odor.

A

Hydrogen sulfide

128
Q

With hydrogen sulfide, poisoning usually occurs by ___________.

A

inhalation

129
Q

Hydrogen sulfide affects all organs, but it has the most impact on the _____ and _____.

A

lungs

CHS

130
Q

Hydrogen sulfide is used to commit suicide; referred to as __________ or _________ suicide.

A

chemical

detergent

131
Q

____________ are CNS stimulants that mimic the effects of the sympathetic (fight-or-flight) nervous system.

A

Sympathomimetics

132
Q

Sympathomometic stimulants frequently cause __________, ________ and _________ ________.

A

hypertension
tachycardia
dilated pupils

133
Q

______________ examples include amphetamines, methamphetamines, phentermine hydrochloride, and amphetamine sulfate (Benzedrine).

A

Sympathomometic

134
Q

________ may be taken in a number of different ways. It can be absorbed through all mucous membranes and even across the skin. Immediate effects include excitement and euphoria and last less than an hour. Smoked crack produces the most rapid means of absorption and, therefore, the most potent effect.

A

Cocaine

135
Q

Synthetic cathinones are also called ______ _______.

A

bath salts

136
Q

Methylenedioxymethamphetamine is also known as ________.

A

MDMA, ecstasy, or Molly

137
Q

Brand names of MDMA include:

A

Ivory Wave and Cloud Nine

138
Q

Synthetic cathinones users typically snort or insufflate the powder _______and effects reportedly last as long as _____ hours.

A

nasally

48

139
Q

Nearly ________ of Americans have tried marijuana.

A

half

140
Q

_____________, or (____), is the chemical in the marijuana plant that produces its high.

A

Tetrahydrocannabinol

THC

141
Q

Ingestions of marijuana can lead to cannabinoid hyperemesis syndrome, characterized by chronic marijuana use and extreme nausea and vomiting that is relieved only by a ______ _______ or _______

A

hot shower

hot bath

142
Q

____________ alter a person’s sensory perceptions

A

Hallucinogens

143
Q

The classic hallucinogen is ________ _______ ________ (______).

A

lysergic acid diethylamide (LSD)

144
Q

Anitcholinergic agents are medications that have properties that block the ____________ nerve.

A

parasympathic

145
Q

Common drugs of anticholinergic agents include:

A

atropine
Benadryl
jimsonweed
amitriptyline (Elavil)

146
Q

Death from anticholinergic agents can be rapid - the patient can go from appearing “normal” to seizure and death within _____ minutes.

A

30

147
Q

____________ agents overstimulate normal body functions that are controlled by the parasympathetic nerves.

A

Cholinergic

148
Q

Cholinergic agents include “nerve gases” designed for _______ _______ and ___________ ___________.

A

chemical warfare

organophosphate insecticides

149
Q

Signs and symptoms of cholinergic drug poisoning are easy to remember with the mnemonic DUMBELS:

A 
Diarrhea
Urination
Miosis (constriction of the pupils_
Bradycardia, bronchospasm, bronchorrea (discharge from the lungs)
Emesis (vomiting)
Lacrimation (tearing)
Seizures, salivation, sweating
150
Q

Sigs and symptoms of cholinergic drug poisoning are easy to remember with the mnemonic SLUDGEM:

A 
Salvation, sweating
Lacrimation
Urination
Defecation, drooling, diarrhea
Gastric upset and cramps
Emesis
Muscle twitching/miosis
151
Q

Your priorities after decontamination of a patient with cholinergic poisoning are to decrease the secretions in the ______ and _______.

A

mouth

trachea

152
Q

The most common antidote kit is the _________ Auto-injector.

A

DuoDote

153
Q

The DuoDote kit consists of a single auto-injector containing ___________ and ____________.

A

atropine

pralidoxime

154
Q

Food poisoning is almost always caused by eating food contaminated by ________.

A

bacteria

155
Q

There are two main types of food poisonings. They are:

A

the organism itself may cause disease

the organism may produce toxins that cause disease

156
Q

One organism that produces direct effects of food poisoning is the ___________bacterium and is characterized by severe gastrointestinal symptoms within 72 hours of ingestion, including nausea, vomiting, abdominal pain, and diarrhea. Proper cooking kills bacteria, and proper cleanliness in the kitchen prevents the contamination of uncooked foods.

A

Salmonella

157
Q

The more common cause of food poisoning is the ingestion of powerful toxins produced by bacteria, often in leftovers and is called _________________ and symptoms usually start within 2-3 hours after ingestion or as long as 8-12 hours after ingestion.

A

Staphylococcus

158
Q

The most severe form of toxin ingestion is __________.

A

botulism

159
Q

___________ can result from eating improperly canned food.

A

Botulism

160
Q

Botulism is caused by the spores of _________ bacteria growing and producing a toxin.

A

Clostridium

161
Q

Symptoms of botulism are __________, and include blurring vision, weakness, difficulty speaking and breathing and is often fatal with symptoms developing within the first 24 hours after ingestion or as long as 4 days later.

A

neurologic

162
Q

Irritation of the skin and/or mucous membranes is a problem with the common houseplant called ___________.

A

Dieffenbachia

MY Emergency Care And Transportation Of The Sick And Injured (8 decks)

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