Pick your Poison
A patient is unresponsive with pinpoint pupils, a pulse of 58, and respirations of 4 per minute with minimal chest rise. This toxidrome is most likely.
What is opioid poisoning?
A suspected opioid-overdose patient has a pulse but is breathing four times per minute. Naloxone is available. This intervention takes priority over giving the medication.
What is opening the airway and providing BVM ventilation with oxygen?
A patient reports dark, tarry stools, weakness, and dizziness when standing. Their blood pressure is normal, but their pulse is rapid and skin is cool. This emergency is occurring.
What is a gastrointestinal hemorrhage with compensated shock?
A patient who missed dialysis has hypertension, severe dyspnea, bilateral crackles, and swollen legs. This complication is most likely.
Correct response: What is fluid overload with pulmonary edema?
A patient with a psychiatric history suddenly becomes confused, combative, and diaphoretic. Before assuming the cause is psychiatric, the EMT should first consider this broad category.
What is an underlying medical, traumatic, or toxicologic emergency?
A patient has fatigue, weakness, pallor, tachycardia, and exertional dyspnea because the blood has a reduced ability to carry oxygen. This condition is present.
What is anemia?
A confused patient has dilated pupils, hot and dry skin, tachycardia, urinary retention, and decreased bowel sounds. This toxidrome is present.
What is anticholinergic poisoning?
After naloxone, a patient becomes awake and agitated but remains hypoxic with shallow respirations. This should be the EMT’s next action.
What is continue ventilatory support and reassess the airway and breathing?
A patient’s abdominal pain began near the umbilicus and later moved to the right lower quadrant. The patient has nausea, fever, and rebound tenderness. This condition is most likely.
What is appendicitis?
A dialysis patient has a functioning fistula in the left forearm. This routine assessment should not be performed on that arm.
What is obtaining a blood pressure?
A patient insists that government agents implanted a transmitter in their tooth despite evidence to the contrary. This false, fixed belief is called this.
What is a delusion?
A patient with severe anemia has an SpO₂ of 99% but remains weak, pale, and tachycardic. This explains why the pulse-oximeter reading may be misleading.
What is the pulse oximeter measures the percentage of available hemoglobin that is saturated, not the amount of hemoglobin present?
After pesticide exposure, a patient develops pinpoint pupils, vomiting, diarrhea, excessive salivation, sweating, and muscle twitching. This toxidrome is present.
What is cholinergic poisoning?
Naloxone improves a patient’s pupils and mental status, but respirations remain inadequate. Empty opioid and benzodiazepine containers are nearby. This best explains the incomplete response.
What is a mixed overdose involving another central nervous system depressant?
A patient has severe right-upper-quadrant pain after a fatty meal, nausea, and pain felt in the right shoulder. This condition should be suspected.
What is cholecystitis?
A patient has uncontrolled bleeding from a dialysis fistula after treatment. State the initial intervention.
What is focused direct pressure over the bleeding site?
A patient says, “Sometimes I think everyone would be better without me.” This is the most appropriate EMT response.
What is directly ask whether the patient is considering suicide and whether they have a plan?
A patient with hemophilia reports worsening knee pain and swelling after a minor bump, but no external bleeding is visible. This complication should be suspected.
What is internal bleeding into the joint?
Both anticholinergic and sympathomimetic poisoning may cause agitation, tachycardia, hypertension, and dilated pupils. This finding most strongly supports a sympathomimetic rather than anticholinergic exposure.
What is profuse diaphoresis?
A patient swallowed an unknown household cleaning product and is vomiting with burns around the mouth. These two common poisoning interventions should not be performed unless specifically directed.
What are inducing vomiting and administering activated charcoal?
An older patient has sudden abdominal and lower-back pain, hypotension, and a pulsating abdominal mass. This condition should be suspected, and repeated abdominal palpation should be avoided.
What is an abdominal aortic aneurysm?
A patient receiving peritoneal dialysis develops abdominal pain, fever, nausea, and cloudy drainage from the dialysis catheter. This complication should be suspected.
What is peritonitis?
An agitated patient is restrained face down on the floor by bystanders. The patient is obese, diaphoretic, and breathing rapidly. State the EMT’s immediate concern and action.
What is positional asphyxia; move the patient from the prone position, assess the airway and breathing, and monitor continuously?
A patient with sickle cell disease develops severe generalized pain after dehydration and prolonged cold exposure. This emergency should be suspected.
What is a vaso-occlusive sickle cell crisis?
Three family members have headache, nausea, confusion, and weakness after using a generator inside their home. Their pulse-oximeter readings are normal. This poisoning should be suspected.
What is carbon monoxide poisoning?
You find an unresponsive patient inside a vehicle with a warning note taped to the window. There is a strong rotten-egg odor near the vehicle. State the EMT’s first action.
What is remain outside the contaminated area, prevent others from entering, and request trained hazardous-materials resources?
A patient has diffuse abdominal pain, fever, vomiting, involuntary guarding, and pain that worsens with movement. These findings indicate inflammation of this membrane.
What is peritonitis involving the peritoneum?
A patient who missed dialysis reports profound weakness and nausea. Their pulse is slow and irregular despite adequate breathing. This potentially fatal electrolyte disturbance should be suspected.
What is hyperkalemia?
A depressed patient previously described a specific suicide plan. The patient suddenly appears calm, gives away important possessions, and says, “Everything will be over soon.” Interpret this change and state the appropriate action.
What is the patient may be at immediate risk for suicide; do not leave them alone, secure access to lethal means with appropriate assistance, and arrange compassionate transport for emergency evaluation?
A patient with sickle cell disease has fever, chest pain, tachypnea, hypoxia, and increasing respiratory distress. This life-threatening complication should be suspected.
What is acute chest syndrome?