Environmental / OB / Geriatric Emergencies

Question 1

What does the “E” represent in the GEMS diamond? Give an example of how the EMT can utilize the “E” in the GEMS diamond, while assessing an elderly patient.

Answer 1

Environment

Checking the conditions the patient lives in to raise the index of suspicion to other health problems or abuse

Question 2

What are two potential negative effects of polypharmacy?

Answer 2

Forgetting which medications to take or possibly already took (Overdose / Underdose)

Long-term becoming used to the meds sensitivity

Question 3

The umbilical cord contains three vessels. List the vessels and describe their functions.

Answer 3

Two arteries and one vein

The umbilical vein carries oxygenated blood from the placenta to the heart of the fetus, and the umbilical arteries carry deoxygenated blood from the heart of the fetus to the placenta. (1245)

Question 3

The second stage of labor begins with _________ and ends with _________.

Answer 3

The fetus entering the birth canal

Delivery of the newborn (1256)

Question 4

When should c-spine precautions begin, on an unconscious patient that is still in the water?

Answer 4

While the patient is still in the water

Question 5

A pregnant patient is ℅ a headache and sees spots. Your exam reveals swelling in the hands and feet, and HTN. These S/S are MOST commonly seen in what condition?

Answer 5

Preeclampsia (1248)

Question 6

List two ways the body protects against heat loss.

Answer 6

Shivering
Vasoconstriction

Question 6

Where is the best place to assess the patients heat loss.

Answer 6

Away from further exposure to the cold temperature / environment

Question 7

A patient found unconscious on the ground of a large, walk-in freezer is losing body heat through what method(s)?

Answer 7

Respiration
Conduction
Radiation

Question 8

Laying a patient supine, in her third trimester, could cause what complication?

Answer 8

Supine hypotensive syndrome

Caused by compression of the superior vena cava by the pregnant uterus when a patient lies supine, reducing the amount of blood that is returned to the heart. (1248)

Question 8

You arrive on the scene, post delivery of a newborn to find the infant hyperventilating. You notice a foul-smelling green material in the amniotic fluid. What is this material and what does its presence indicate?

Answer 8

Meconium (Fetal stool)
The presence of meconium can indicate newborn distress (1254)

Question 10

You respond to an outdoor area that has a homeless encampment. Your patient is altered, cool to the touch, with a slow and weak pulse. What is the treatment for this patient?

Answer 10

Warm the patient
Assisted ventilations
Get blood glucose
Rapid transport

Question 11

You are assessing a female patient who has missed her menstrual cycle and is complaining of sudden, stabbing ABD pain in her lower abdomen. There is blood present in her undergarments, and she appears to be anxious with pale skin. What is your working diagnosis? What is the MOST appropriate treatment for this patient?

Answer 11

Spotaneous abortion
Treat for shock (Supine, oxygen, blanket, elevate extremities, rapid transport)
Use sterile dressings to pad bleeding

Question 12

One of the first signs of heat stroke is:

Answer 12

Confusion or change in behavior

Question 12

A construction worker ℅ dizziness and nausea. Coworkers state he has been working in the sun all afternoon. The patient was moved inside where the A/C is on. The patient’s short is wet, skin is moist and warm, HR is 120 and he is shivering. What is the treatment for this patient?

Answer 12

Place clean blanket
High flow oxygen via non-rebreather (if indicated)
Cool patient
Rapid transport

Question 12

You are treating an altered pregnant woman who is in her third trimester. The patient is awake and alert but does not remember what day it is. Her partner tells you that the patient was diagnosed with gestational diabetes. What is the treatment for this patient?

Answer 12

The same treatment for any patient who has diabetes (1247)

Question 13

Profuse sweating in patients will result in changes of the body’s:

Answer 13

CBT and loss of electrolytes and fluids causing dehydration

Question 14

What are two diseases that can be contracted from a tick?

Answer 14

Lyme disease
Rocky mountain fever

Question 14

What is nuchal cord? If this condition is present, outline the appropriate treatment for this emergency.

Answer 14

Umbilical cord wrapped around the newborns neck on delivery
Don’t push baby back into the vagina, don’t overstretch the imbilical cord, manuever the baby safely while trying to untangle the head

Question 15

What is the purpose of the APGAR score and when should it be calculated? What is the perfect score?

Answer 15

To verify if complications after delivery of the fetus are present. Check the first minute and the fifth minute after delivery.

Perfect score is 10