Chapter 25 | Poisoning and Overdose Emergencies Flashcards

Question 1

Q

Define:

poison

Answer

A

any substance that can harm the body

sometimes seriously enough to create a medical emergency

Question 2

Q

Define:

toxin

Answer

A

poisonous substance secreted by bacteria/plants/animals

Question 3

Q

List:

factors influencing poison effect severity

5 points

Answer

A

nature of posion
amount/concentration
route of entry
duration of exposure
age/health of patient

Question 4

Q

Fill in the blank:

Local effects occur at [BLANK].

Answer

A

Local effects occur at the area of the body which has been in contact with the chemical/poison/allergen.

Question 5

Q

Define:

Systemic effects of poisons occur after [BLANK].

Answer

A

Systemic effects of poisons occur after the chemical has been absorbed and distributed from the entry point to other parts of the body.

Question 6

Q

Explain:

difference between local effects and systemic effects

Answer

A

local effects occur at the point of contact with toxin

systemic effects are all over after chemical has been absorbed and spread

Question 7

Q

List:

considerations of assessment for poison ingestion

7 points (what do you want to know about scene before arrival)

Answer

A

substance involved
time since exposure
quantity ingested
previous exposures
patient’s experience
interventions used
patient’s stature/health

Question 8

Q

Fill in the blank:

Food poisoning can be caused by [BLANK].

Answer

A

Food poisoning can be caused by improperly handled or prepared food.

Question 9

Q

List:

symptoms of food poisoning

4 points (and when symptoms first appear)

Answer

A

nausea/vomiting
abdominal cramps
diarrhea
fever

(usually within hours of ingestion, but up to 1-2 days)

Question 10

Q

List:

early signs/symptoms of acetaminophen poisoning

3 points (within first [BLANK] to [BLANK] hours)

Answer

A

loss of appetite
nausea
vomiting

(within first 4 to 12 hours)

Question 11

Q

List:

later signs/symptoms of acetaminophen poisoning

2 points (and within [BLANK] to [BLANK] days)

Answer

A

RUQ pain
jaundice

(within 1 to 2 days)

Question 12

Q

Fill in the blank:

The antidote for acetaminophen poisoning should be administered within the first [BLANK] hours.

Answer

A

The antidote for acetaminophen poisoning should be administered within the first 12 hours.

Question 13

Q

List:

common examples of inhaled poisons

5 points

Answer

A

carbon monoxide
ammonia
chlorine
pesticides
carbon dioxide

Question 14

Q

List:

signs/symptoms of inhaled poisons

7 points

Answer

A

difficulty breathing
chest pain
coughing
hoarseness
AMS
headache
syncope/seizures

Question 15

Q

List:

procedure for treating inhaled poison

4 points (from arrival to transport)

Answer

A

move patient away from unsafe environment
open airway and provide high flow supplemental O₂
conduct further assessment
transport with poison labels/containers/bottles

Question 16

Q

Explain:

treatment for CO poisoning

(biggest priority)

Answer

A

provide high flow O₂

Question 17

Q

Fill in the blank:

It can take up to [BLANK] to “wash” CO from bloodstream.

(amount of time)

Answer

A

It can take up to a few days to “wash” CO from bloodstream.

several hours or days

Question 18

Q

Describe:

half-life of CO with room air

Answer

A

3-4 hours

Question 19

Q

Describe:

half-life of CO with 100% oxygen

Answer

A

30-90 minutes

Question 20

Q

Describe:

half-life of CO with hyperbaric chamber with 100% oxygen

Answer

A

as low as 15-23 minutes

Question 21

Q

Define:

carboxyhemoglobin

Answer

A

CO bound to red blood cells (causing poisoning)

binds much easier than oxygen

Question 22

Q

Explain

treatment for absorbed poisons

(the main points)

Answer

A

brush off powder, then irrigate

irrigate some more

keep irrigating

(do that for like 20 minutes)

Question 23

Q

List:

signs/symptoms of DTs or alcohol withdrawal

4 points

Answer

A

AMS (confusion/hallucinations/behavior)
restlessness
profuse sweating
tremors/seizures

(DTs are delirium tremens)

Question 24

Q

Define:

DTs

(abbreviation)

Answer

A

delerium tremens

Question 25

Q

Define:

delerium tremens (DTs)

Answer

A

severe alcohol withdrawal symptoms

i.e. shaking, confusion, hallucinations

Question 26

Q

Fill in the blank:

DTs usually starts [BLANK] after the last drink.

Answer

A

Delirium tremens (DTs) usually starts 2 to 5 days after the last drink.

Question 27

Q

Fill in the blank:

DTs [CAN/CAN’T] be fatal.

Answer

A

DTs can be fatal

(DTs are delerium tremens)

Question 28

Q

List:

signs/symptoms of narcotics overdose

4 points

Answer

A

pinpoint pupils
respiratory depression (shallow and low RR)
AMS (lethargy/unconsciousness)
cool skin

Question 29

Q

signs/symptoms of volatile chemical overdose

4 points

Answer

A

AMS (confusion/disorientation)
swollen membranes in nose/mouth
numbness/tingling in head
chemical residue on face

may also cause changes in heart rhythm

Question 30

Q

List:

examples of volatile chemicals

3 points

Answer

A

whippets
glue
canned air

Question 31

Q

List:

examples of hallucinogens

4 points

Answer

A

LSD
psilocybin mushrooms
PCP
ecstasy

Question 32

Q

List:

signs/symptoms of hallucinogens

4 points

Answer

A

rapid HR
dilated pupils
flushed face
hallucinations (seeing/hearing things)

Question 33

Q

Choose:

Absorbed poisons that are corrosives or irritants may:

A. cause respiratory arrest.

B. injure the skin.

C. injure the heart.

D. cause respiratory failure.

Answer

A

B

absorbed poisons (poisons taken into the body through unbroken skin) may or may not damage the skin

many are corrosives or irritants that will injure the skin then be slowly absorbed into body tissues and the bloodstream (possibly causing widespread damage)

Question 34

Q

Choose:

Which of the following best describes one way in which systemic poisons cause harm to the body?

A. They enter the bloodstream using the same route as ingested foods.

B. They critically depress or overstimulate the central nervous system.

C. They act as a corrosive or irritant, destroying skin and other body tissues.

D. They act as a suffocating agent, displacing oxygen in the air.

Answer

A

B

systemic poisons (causing harm to entire body or body system) can critically depress or overstimulate the central nervous system, cause vomiting and diarrhea, prevent red blood cells from carrying oxygen, or interfere with the normal biochemical processes in the body at the level of the cell

Question 35

Q

Choose:

Why is activated charcoal best administered in an opaque container and through a straw?

A. Because of the unpleasant appearance of the mixture

B. Because activated charcoal is light-sensitive

C. Because if activated charcoal is spilled, it is toxic, and permanently stains clothing and skin

D. So that the patient cannot know how close the patient is to consuming the entire dose

Answer

A

the medication looks like mud

patient compliance is improved if the patient cannot see it

Question 36

Q

Choose:

Why must activated charcoal be shaken before being administered to the patient?

A. Shaking causes the charcoal to float to the top.

B. Shaking activates the medication.

C. Shaking the medication will reduce the risk of nausea.

D. The medication tends to settle in the solution, and shaking will mix it.

Answer

A

D

activated charcoal is heavy and will settle in the solution

shaking it will mix the charcoal in the solution

Question 37

Q

Choose:

You have administered activated charcoal to your patient. What should you do next?

A. Continue with administration of activated charcoal

B. Immediately begin chest compressions

C. Apply high-concentration oxygen via a nonrebreather mask

D. Position the patient for vomiting, and be prepared to suction the airway

Answer

A

D

position patient so that the emesis can easily escape the mouth

be ready to suction

Question 38

Q

Choose:

Medical control has ordered you to dilute the poisonous substance an adult patient has ingested, which means you should have the patient drink:

A. one or two glasses of water or milk.

B. several gulps of running water.

C. three glasses of milk.

D. two cups of coffee.

Answer

A

occasionally, medical direction will give an order for dilution of a poisonous substance

this means adult patient should drink one or two glasses of water or milk (whichever is ordered)

Question 39

Q

Choose:

If a husband and wife are both unconscious in their home and there is no outward evidence of a safety threat, which of the following possible causes should be foremost in your mind?

A. Natural gas leak

B. Food poisoning

C. Venomous snake bite

D. Carbon monoxide poisoning

Answer

A

D

carbon monoxide is odorless, colorless, and tasteless, and it is undetectable without special equipment

the fact that both the husband and wife have been affected in the same way in an enclosed area suggests carbon monoxide poisoning

Question 40

Q

Choose:

Generally, the longer a patient is exposed to a poisonous gas, the:

A. more poison will probably be absorbed.

B. more altered the patient’s mental status will be.

C. less severe its effects.

D. less urgent the patient’s priority.

Answer

A

knowing the length of a patient’s exposure to a poisonous gas can give you a rough idea of how much of the poison was probably absorbed

it will not necessarily indicate the patient’s mental status or lessen the effects or the patient’s priority

Question 41

Q

Choose:

A patient has inhaled a poison, and specialized personnel have removed the patient to a safe area away from the source of the poison.

You should:

A. take baseline vital signs.

B. establish an open airway.

C. contact medical direction.

D. gather the patient’s history.

Answer

A

B

establish an open airway for this patient before doing anything else

Question 42

Q

Choose:

You are on standby at a structure fire when firefighters pull a victim from the house. He seems to be recovering from unconsciousness but is breathing rapidly, and has soot around his nose and mouth. He has a cough that is productive of dark sputum. He says that he is feeling much better and does not want to go to the hospital.

What is the most important reason for the patient to go to the hospital?

A. He may have other injuries that have gone undetected.

B. The body’s reaction to toxic gases and foreign matter in the airway can be delayed.

C. The sudden transition to a smoke-free environment typically produces an illusory improvement.

D. He likely has first- and second-degree skin burns of which he is unaware.

Answer

A

B

body’s reaction to toxic gases and foreign matter in the airway can often be delayed

convince all smoke inhalation patients that they must be seen by a physician (even if they are not yet feeling serious effects)

Question 43

Q

Choose:

What is the most important part of treatment for a patient suffering from an absorbed poison exposure?

A. Transport the patient to the most appropriate facility.

B. Remove all clothing.

C. Contact poison control and identify the specific treatment algorithm for this patient.

D. Get the poison off the skin or out of the eye.

Answer

A

D

most important part of absorbed poison treatment is to get the poison off the skin or out of the eye

Question 44

Q

Choose:

You respond to the scene of a construction site. On arrival, you find a female patient complaining of pain and irritation in both arms. You note a dry, powder-like substance all over her arms.

Which of the following actions would be your first priority?

A. Contact poison control after identifying the powder substance that is on the patient.

B. Ensure that the patient’s airway is patent and that she did not inhale any of the powder.

C. Irrigate with sterile water for at least 20 minutes.

D. Brush the powder away and irrigate with sterile water for at least 20 minutes.

Answer

A

B

always detect and treat immediately any life-threatening problems in the primary assessment

this includes assessing and managing the patient’s airway before targeting the specific poison

Question 45

Q

Choose:

Why are EMTs tempted to neglect proper treatment and care of a patient who is suffering from alcohol abuse?

A. EMTs assume that alcoholics do not take their health seriously.

B. Chronic drinkers do not call 911 for non-serious injuries or illness.

C. EMTs may disregard alcoholic patients because of their belligerent behavior or frequent calls to EMS.

D. Caring for alcoholic patients takes time away from treating patients with more serious, life-threatening illnesses such as heart attacks or strokes.

Answer

A

C

patients who abuse alcohol may frustrate EMT responders because these patients often are not cooperative or have made frequent calls to EMS while intoxicated

Question 46

Q

Choose:

Which of the following conditions has similar symptoms to alcohol intoxication, and can make a patient appear to be intoxicated?

A. Food poisoning

B. Myocardial infarction

C. Diabetic emergency

D. Abdominal trauma

Answer

A

C

diabetes, epilepsy, high fever, hypoxia, and other medical problems can make a patient appear to be intoxicated

one particular item of note is “acetone breath” (odor of alcohol on the patient’s breath that is associated with diabetic emergency) not alcohol consumption

Question 47

Q

Choose:

Which of the following is an acute life-threatening complication that may result from habitual alcohol abuse?

A. Overall deterioration in patient’s health leading to cirrhosis of the liver

B. Head injuries

C. An increase in alcohol tolerance

D. Alterations in the ability to maintain a regular blood sugar level

Answer

A

D

chronic drinkers (alcoholics) often have derangements in blood sugar levels

a person can be both intoxicated and experiencing hypoglycemia (with alcohol masking signs/symptoms of hypoglycemia)

while alcohol abuse can lead to other health problems, cirrhosis and other medical conditions do not present as life-threatening emergencies

Question 48

Q

Choose:

Many hallucinogens may be absorbed through:

A. intranasal inhalation.

B. subcutaneous injection.

C. the skin and mucous membranes.

D. injection into the muscle of the thigh.

Answer

A

C

LSD, mescaline, and psilocybin are typically ingested orally — although LSD can be absorbed through the skin (as was the case when it was first discovered by Hofmann)

DMT is typically smoked or administered orally by dissolving it in a drink.

Question 49

Q

Choose:

You arrive on scene to a home for a patient with altered mental status. He is calm and talkative at first, but as you start to talk to family members, he becomes belligerent and hostile.

What should you do next?

A. Back away from the scene and call for police to be dispatched to the scene.

B. Tell the patient that if he does not calm down, you will have him arrested.

C. Try to get the family to calmly restrain the patient, so that he does not hurt himself or others.

D. Calmly place your hands on the patient’s shoulders to try to relax him.

Answer

A

scene safety is always the first priority

all other options could make the scenario worse

Question 50

Q

Choose:

Your patient is very lethargic and, according to family, acting abnormally. During your assessment, you note that the patient has bilateral pinpoint pupils.

This finding is most likely due to:

A. a subdural hematoma.

B. a traumatic brain injury.

C. an allergic reaction.

D. opioid use.

Answer

A

D

Bilateral pinpoint pupils are often associated with opioid use.

Question 51

Q

Choose:

“Bath salts” are classified as:

A. stimulants.

B. hallucinogens.

C. depressants.

D. opioids.

Answer

A

“bath salts” are synthetic drugs with very potent stimulant (and sometimes hallucinogenic) effects

Question 52

Q

Choose:

You are assessing an unresponsive patient with a known overdose of an opioid.

What changes would you expect to find with the patient’s breathing status?

A. The respiratory rate will be increased, but the depth will be shallow.

B. Breathing will be of a normal depth, but the rhythm will be irregular.

C. The respiratory depth will be normal, but the breathing rate will be slow.

D. Breathing may be depressed or absent.

Answer

A

D

opioid abuse/overdose can be a causal factor in respiratory depression and arrest

opioids depress areas of the brain that are responsible for initiating respirations (thus lowering the rate and depth of breathing and possibly causing apnea)

combination can quickly kill the patient without rapid intervention

Question 53

Q

Choose:

A patient is drunk and refusing treatment or transport. You should:

A. respect the patient’s wishes but remain on scene to perform as much of a secondary assessment as possible.

B. call law enforcement to take custody of the patient.

C. treat and arrange for transport of the patient as necessary.

D. respect the patient’s wishes and leave the scene.

Question 54

Q

Choose:

Your patient is experiencing tachycardia, hypertension, nausea, and tremors. Which of the following should most suspect?

A. a benzodiazepine overdose.

B. an aspirin overdose.

C. an antidepressant overdose.

D. an opioid overdose.

Answer

A

C

these are all the common signs and symptoms of antidepressant overdose

symptoms of benzo overdoses include slurred speech, confusion, extreme drowsiness, shallow or slowed breathing, etc.

symptoms of aspirin overdoses include light-headedness, fever, dehydration, hypotension, hypoxia, and pulmonary edema

symptoms of opioid overdoses include constricted pupils and not breathing anymore

Question 55

Q

Choose:

Which of the following is true of absorbed poisons?

A. Absorbed poisons cause local reactions at the point of contact but rarely cause systemic reactions.

B. For an absorbed liquid, irrigate with clean water for 20 minutes and continue en route, if possible.

C. If the poison is a dry chemical, immediately flush the area with clean water.

D. A contaminated eye should be irrigated from the corner of the eye across the bridge of the nose.

Question 56

Q

Choose:

When providing care for substance abuse patients, make sure you are safe and:

A. do not provide care to any substance abuse patient not in legal custody.

B. identify yourself as an EMT to the patient and bystanders.

C. indicate that law enforcement officers are on their way.

D. do not provide care to patients who are behaving erratically.

Question 57

Q

Choose:

To treat a patient exposed to dry lime powder, you should:

A. dilute the effect of the chemical by having the patient drink water.

B. brush the powder from the patient’s skin.

C. neutralize the chemical with the appropriate substance.

D. soak the affected area with copious amounts of warm water.

Question 58

Q

Choose:

What clinical finding is most suggestive of an inhaled poison?

A. Altered mental status

B. Tachypnea

C. Black-colored sputum

D. Swollen tongue

Question 59

Q

Choose:

Signs and symptoms of alcohol abuse include all of the following except:

A. swaying and unsteadiness of movement.

B. an acetone or ketone odor to the breath.

C. nausea and vomiting.

D. confusion.

Answer

A

B

acetone or ketone odor in breath is more indicative of DKA or other diabetic emergencies

Question 60

Q

Choose:

What is the most important treatment for a patient who has inhaled a poison?

A. Administer high-concentration oxygen.

B. Administer epinephrine via auto-injector.

C. Administer activated charcoal.

D. Administer the correct antidote.

Question 61

Q

Choose:

Regarding activated charcoal, which of the following is not true?

A. It can reduce the amount of poison absorbed by the gastrointestinal system.

B. Ingestion of strong acids or alkalis is a contraindication to its use.

C. It does not work on all poisons.

D. It is an antidote to many poisons.

Answer

A

D

activated charcoal does not reverse the effects of poisons as an antidote would

activated charcoal only works by preventing absorption of ingested poisons

Question 62

Q

Choose:

You are called to a farm for a possible insecticide poisoning of one of the workers. Which of the following should be your first action?

A. decontaminate the patient.

B. bag the patient before he dies.

C. call for specialized hazardous materials units.

D. call for an ALS unit.

Question 63

Q

Choose:

You respond to the county jail for a 48-year-old inmate arrested two days ago for public intoxication. Guards state the patient is a known alcoholic and “frequent flier.” The guards state that for several hours the patient was “acting crazy” and seeing “bugs on the walls.” The patient then began seizing and they called for an ambulance. You notice the patient is no longer seizing, diaphoretic, or confused.

What condition do you suspect?

A. Alcohol poisoning

B. LSD abuse

C. Acute episode of paranoid schizophrenia

D. Delirium tremens

Question 64

Q

Choose:

Your patient is a 17-year-old male who is spitting and coughing after swallowing some gasoline while siphoning from a gas tank.

Which of the following should you do first?

A. Have the patient drink a glass of milk.

B. Contact medical control.

C. Insert a Combitube or another blind insertion device, if you are trained to do so.

D. Administer syrup of ipecac.

Answer 56

A

D

seizure is more indicative of alcohol withdrawal than acute alcohol poisoning

mouthwash and antifreeze have nothing to do with it

Answer 57

A

Volatile chemicals are agents that are able to change easily from a liquid into a gas.

Answer 58

A

pancreatitis (overload with toxins)
hyperglycemia (caused by pancreas problems)
malnutrition (poor consumption habits)
potential GI bleeding (tears away at tissue)

Answer 59

A

Volatile chemicals are agents that are able to change easily from a liquid into a gas.

Answer 60

A

C

How would the lung get bruised from smoke?

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Chapter 25 | Poisoning and Overdose Emergencies Flashcards

• How to know if a patient has been poisoned • Assessment and care for ingested poisons • Assessment and care for inhaled poisons • Assessment and care for absorbed poisons • Types of injected poisons • Assessment and care for alcohol abuse • Assessment and care for substance abuse

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