Write  the letter of the best answer in the space provided.


                  1.    Insulin can best be described as a(n)

A.  amino acid.                                                    C.  blood sugar.

B.  hormone.                                                        D.  platelet.


                  2.    The organ(s)  responsible for the production of insulin is (are) the

A.  liver.                                                             C.  pancreas.

B.  kidneys.                                                         D.  spleen.


                  3.    All of the following are signs or symptoms commonly associated with a diabetic emergency except

A.  an elevated heart rate.                                      C.  seizure activity.

B.  combativeness.                                               D.  hot, dry skin.


                  4.    The simple form of sugar that is the body’s main source of energy is

A.  insulin.                                                         C.  adrenalin.

B.  glucose.                                                         D.  diabanese.


                  5.    Glucose is administered  in the form of a

A.  tablet.                                                           C.  suspension.

B.  liquid for injection.                                        D.  gel.


                  6.   Which memory aid should be used to gather a history from a patient with an altered mental status?

A.  SAMPLE                                                       C.  START

B.  AVPU                                                           D.  DCAP-BTLS


                  7.    The type of diabetes that requires a patient to inject insulin daily is

A.  Type 1.                                                         C.  “maturity-onset diabetes.”

B.  Type 2.                                                         D.  diabetic ketoacidosis.


                  8.    If a patient has excessive thirst, breath with a fruity odor,  and warm, dry skin, you would suspect

A.  hypoglycemia.                                                C.  hyperglycemia.

B.  epilepsy.                                                        D.  cerebral edema.


                  9.    All of the following are medications  often taken by diabetics except

A.  Glynase®.                                                            C.  nitroglycerin.

B.  Humalog®.                                                     D.  Orinase®.


                10.    For the EMT to administer oral glucose, the patient must meet all of the following criteria except

A.  an altered mental status.

B.  a baseline blood pressure that is greater than 90 mmHg systolic.

C.  a history of diabetes controlled  by medication.

D.  the ability to swallow.

                11.    Proper administration of oral glucose usually produces

A.  headache.                                                       C.  diaphoresis.

B.  bradycardia.                                                    D.  no side effects.


                12.    What action does oral glucose take in the bloodstream?

A.  decreases blood sugar                                      C.  decreases insulin level

B.  increases blood sugar                                       D.  increases insulin level


                13.    If you are in doubt  as to whether  the patient is suffering from an emergency related to hypoglycemia or hyperglycemia, err to benefit the patient and

A.  allow the patient to drink.                              C.  administer oral glucose.

B.  withhold  liquids from the patient.                    D.  withhold  oral glucose.


                14.    Which of the following is a contraindication to the administration of oral glucose?

A.  history of diabetes                                          C.  trauma

B.  altered mental status                                       D.  unresponsiveness


                15.    Patients with an altered mental status and without  suspected spinal injury should be transported in what position?

A.  shock                                                            C.  prone

B.  lateral recumbent                                             D.  supine






Review the following real-life  situation. Then answer the questions that follow.


You and your partner are dispatched  at 1015  to the Riverside Apartments  on Montgomery Drive, Apartment 323, for an unconscious male. Upon  your arrival, the patient’s excited wife meets you at the door. As she leads you to the kitchen, she explains that her husband,  who is diabetic, has not been feeling well and stayed home from work today due to nausea and vomiting. While they were sitting at the kitchen table, he suddenly passed out and she immediately called 911.  As you enter the kitchen,  you see a male patient  in his late 50s slumped  in a kitchen  chair. Your  primary assessment reveals that  the  patient  is unresponsive and bradypneic (10 breaths per minute), with a weak and rapid radial pulse and pale, cool, and clammy skin.


1.  What condition do these signs and symptoms suggest?





2.  In addition  to a SAMPLE history, what additional  questions  would you ask the patient’s wife?




3.  Is oral glucose indicated for this patient? Why or why not?






4.  What additional  emergency medical care would you provide to this patient?




Write  the word or words that best complete each sentence in the space provided.


1.   The body’s main source of energy is                                                  .


2.   The hormone secreted by the pancreas that is needed  to promote the movement  of glucose from the blood into the cells is known as          .

3.   When there is a(n)                                                   of insulin, glucose cannot enter the cells; instead, it remains in the bloodstream, causing a high level of glucose in the blood,  a condition known as     .

4.   When a diabetic’s insulin level is too high, too much sugar enters the cells and not enough  sugar remains in the blood,  a condition called             .

5.                                                                     is the medication  of choice in the emergency medical care of the diabetic patient with an altered mental status.

6.   Assess and document the mental status of a diabetic patient using the                                         scale.


7.   As an alternative to squeezing  small portions  of the tube of oral glucose into the patient’s mouth, the EMT could use a(n)                     .

8.   Type                                                   diabetes typically develops in adulthood and is controlled  by diet, exercise, oral medications,  and, in severe cases, with insulin.

9.                                                       is a disease characterized  by an altered relationship between glucose and insulin.

10.    If no mechanism of injury is apparent,  you would suspect that a patient’s altered mental status is a result of a(n)             .

11.    Never administer oral glucose to a patient who cannot swallow or who is                             .


12.    For a patient with an altered mental status, repeat the ongoing  assessment every




13.    The most common sign of hypoglycemia is a(n)




14.    An altered mental status from hypoglycemia will typically have a(n)



15.    A patient may take as long as                                                   minutes before showing improvement from receiving oral glucose.







1.  List five medications  often taken by diabetics.








2.  List nine signs and symptoms associated with a diabetic emergency.







3.  List the three indications for administering  glucose to a diabetic patient.







4.  List the four steps in the administration of glucose.







Write  in  the missing  information on the medication flash card below and  save the completed card for future reference.


Medication  Names:


1.  Generic:


2.  Trade:
















Medication  Form:                                                                                                                                                 Dosage:                                                                                                                                                                   Actions:





Side Effects:                                                                                                                                       


Write  the letter of the best answer in the space provided.


                 1.    A sudden  and temporary  alteration  in brain function  caused by massive electrical discharge in a group of nerve cells in the brain is called

A.  a convulsion.                                                  C.  postictal activity.

B.  a seizure.                                                       D.  dysrhythmias.


                 2.    The chronic brain disorder that is characterized  by recurrent  seizures is called

A.  the aura.                                                        C.  epilepsy.

B.  CVA.                                                            D.  postictal activity.


                 3.    All of the following are common  causes of seizures except

A.  shock.                                                           C.  infection.

B.  hypoxia.                                                        D.  hypoglycemia.


                 4.    The period following a seizure in which the patient may be unresponsive,  extremely sleepy, weak, and disoriented  is called the

A.  grand mal state.                                             C.  tonic phase.

B.  postictal state.                                                D.  clonic phase.


                 5.    Many patients will tell the EMT that they knew they were going to seize because of the

A.  tonic phase.                                                   C.  clonic phase.

B.  postictal state.                                                D.  aura.


                 6.    The period of a seizure when the patient’s muscles become contracted and tense with arching of the back is called the

A.  tonic phase.                                                   C.  clonic phase.

B.  postictal state.                                                D.  aura.


                 7.    The period of a seizure when muscles spasm and then relax, producing violent and jerky activity, is called the

A.  clonic phase.                                                  C.  aura.

B.  tonic phase.                                                   D.  postictal state.


                 8.    A life-threatening condition characterized  by a patient’s seizing for more than 5 minutes or consecutive seizures without  an intermittent period of consciousness is called

A.  a grand mal seizure.                                        C.  status epilepticus.

B.  a convulsion.                                                  D.  epilepsy.


                 9.    A sudden  and temporary  loss of consciousness is called

A.  epilepsy.                                                        C.  syncope.

B.  a convulsion.                                                  D.  seizure.


                10.   The type of seizure most common  in children between 6 months  and 6 years old that is caused by high fever is called a(n)     seizure.

A.  absence (petit mal)                                          C.  grand mal

B.  febrile                                                            D.  complex partial

                11.   A type of seizure most common  in children, which is characterized  by a blank stare, lasting only a few seconds, and beginning  and ending abruptly, is called a(n)  ______ seizure.

A.  complex partial                                               C.  Jacksonian

B.  focal sensory                                                   D.  absence (petit mal)


                12.   If a patient’s seizures last longer than 10 minutes,  the EMT should begin

A.  endotracheal intubation.                                    C.  positive-pressure ventilations.

B.  CPR.                                                            D.  AED use.


                13.   All of the following are common  medications  used in the treatment of epilepsy except

A.  Dilantin®.                                                      C.  insulin.

B.  Mysoline®.                                                    D.  phenobarbital.


                14.   The term for weakness on one side of the body is

A.  aphasia.                                                         C.  hemiparalysis.

B.  dysphasia.                                                      D.  hemiparesis.


                15.   Usually, a postictal patient should be placed in the           position.

A.  Trendelenburg                                                 C.  lateral recumbent

B.  Fowler’s                                                        D.  prone




Review the following real-life  situation. Then answer the questions that follow.


You and your partner  are dispatched  to the local mall for a man having a seizure. Upon  your arrival, you are greeted  by a mall security guard who reports  that  your patient  was noted  walking alone through the mall when he suddenly fell to the ground and began having a “convulsion.” The guard tells you that the episode must have lasted about  6 or 7 minutes.  Your patient  is a male, approximately 30 years old, who is in a semi-sitting position next to a water fountain. He appears to be breathing  adequately and is conscious, although a bit dazed.


1.  What type of seizure did the security guard describe to you?





2.  In what stage of the seizure is the patient upon your arrival? How long should this stage last?





3.  What emergency care measures should you take with this patient?





4.  What should you do if the patient states that this is normal for him and he doesn’t want to go to the hospital?





Write  the word or words that best complete each sentence in the space provided.


1.   A(n)                                                   is a sudden  and temporary  alteration  in brain function  caused by massive electrical discharge in a group of nerve cells in the brain.

2.   A common  cause of seizures is                                                   , a chronic brain disorder characterized  by recurrent  seizures.

3.   The                                                  state follows the seizure and is the recovery period for the patient.

4.   Seizure activity that is related to an injury or a medical condition may be an ominous  sign of


or even permanent brain damage.


5.   You cannot force a patient to accept transport  or treatment, but you do need to


the call.


6.   If the patient is talking normally, it indicates a(n)                                                     airway and




7.   A patient who suffers seizures that last more than 5 minutes or seizures that occur consecutively without  a period of responsiveness between them is considered  to be in                                               .


8.   Perform a(n)                                                                                                               if the patient is postictal and still has an altered mental status or if she does not have a past medical history of epilepsy or seizures.

9.   The                                                  serves as a warning that a seizure is going to begin and involves some type of sensory perception  by the patient.

10.                                                    is a sudden  and temporary  loss of consciousness.


11.    The EMT should place the syncopal patient in the  position to allow for improved blood flow to the brain.

12.                                                    seizures, caused by high fever, are most common  in young children.


13.    The EMT needs to be aware that medical conditions such as  __________________

and                                                  may be confused with a seizure or may produce  a seizure.

14.    A seizing patient’s movements should be  __________________ rather than


to prevent further injury.


15.    The EMT should gather a(n)  __________________ history from the responsive seizure patient, relatives, and/or  bystanders.






1.  List five common  causes of seizures.




2.  List seven steps in the emergency medical care for a seizing patient.



3.  List the stages or phases of a seizure.





4.  List four steps of emergency medical care for a syncope patient.



Write the letter of the best answer in the space provided.


                  1.    A severe form of allergic reaction is called

A. an allergen.                                                     C. epinephrine.

B. anaphylaxis.                                                    D. an immune reaction.


                  2.    Harmless to most individuals, allergens are foreign substances that cause an abnormal immune system response known as

A. mitosis.                                                          C. an allergic reaction.

B. hypotoxemia.                                                  D. an immune response.


                  3.    An EMT who notices that his hands are red and itchy after a call may be experiencing an allergic reaction to

A. latex gloves.                                                    C. exercise.

B. talcum powder.                                               D. heat exposure.


                  4.    Signs and symptoms of an allergic reaction include all of the following except

A. itching.                                                          C. decreased blood pressure.

B. increased appetite.                                            D. watery eyes.


                  5.    A sign of a severe allergic reaction is

A. runny nose.                                                    C. mild edema.

B. cyanosis.                                                        D. malaise.


                  6.    The dose of epinephrine that should be given to an adult suffering severe allergic reaction is   mg.

A. 0.3                                                                C. 0.05

B. 0.5                                                                D. 0.15


                  7.    Epinephrine is most commonly administered as a(n)

A. tablet.                                                            C. prescribed inhaler.

B. gel.                                                                D. auto-injector.


                 8.     When administered as a medication, epinephrine will accomplish all of the following except

A. constrict blood vessels.                                    C. relax the bronchioles.

B. lower blood pressure.                                       D. stimulate the heartbeat.


                  9.    The dose of epinephrine that should be given to infants/children is             mg.

A. 0.5                                                                C. 0.15

B. 0.3                                                                D. 0.05


                10.    If the patient’s condition improves following the administration of epinephrine, you should

A. perform reassessment.                                       C. initiate CPR.

B. administer a second dose.                                 D. connect the AED.




Review the following real-life situations. Then answer the questions that follow.


The patient is an 8-year-old boy with a known history of allergies and asthma. His mother tells you that she administered his EpiPen® 5 minutes before your arrival. However, you believe that she gave it incor- rectly. “He pulled away when I tried to give the shot,” explains the mother. “I saw some of the medicine form a mist in the air.”


You examine the arm where the mother says that she gave the injection, but find no puncture mark. The child’s distress has worsened since your arrival, and he now seems barely conscious.

“I have three more EpiPens®,” offers the mother.


1. What action(s) should you take at this time?






Your next patient is an unconscious construction worker named Fred. “He had barely started to work with some fiberglass insulation when he fainted,” explains one of his coworkers.


You ask the coworkers more questions and find out that Fred was sneezing and coughing just before he fainted. They also noticed that he was using a handkerchief to wipe his watery eyes and runny nose. “He usually wears a respiratory mask on the job site,” adds one of the coworkers, “but he forgot to bring it today.”


Upon conducting a physical examination of the patient, you find a Medic Alert tag indicating that Fred has a number of allergies. His vital signs include a blood pressure of 70/42 and a weak pulse of 136. During your initial assessment, the foreman hands you an EpiPen® kit. “I found this in Fred’s lunch box,” he says. “Will it help?”


2. What action(s) should you take at this time?




Write the word or words that best complete each sentence in the space provided.


1.     An abnormal or excessive response of the body’s immune system to a foreign material is called a(n)




2.   Foreign substances recognized by the cells of the immune system and eventually destroyed by the body’s response are called          .

3.   A severe form of an allergic reaction is called




4.   Antibodies are proteins that search for the antigen, combine with it, and then help to destroy it in a process known as     .

5.                                                   ________________ from insect bites or stings, especially of wasps, hornets, yellow jackets, and fire ants, may cause an allergic reaction and anaphylaxis.

6.   Red, itchy, possibly raised blotches on the skin are known as                                                    .


7.   Management of the airway during anaphylaxis may require


, the placement of a tube in the trachea to facilitate breathing.


8.   When administered as a medication, epinephrine will                                                        blood vessels to improve the patient’s                                     .

9.   A spring-loaded needle and syringe with a single dose of epinephrine is known as a(n)


–                                               .


10.    The correct dose of epinephrine for an adult is                                                      mg; for a child, it is









Indicate if the following statements are true or false by writing T or F in the space provided.


                  1. Generally, an individual must come into contact with an allergen more than once for an anaphylactic reaction to occur.


                  2. Antibodies are proteins that search for an antigen, combine with it, and destroy it.


                  3. After 15 to 20 minutes, a patient suffering an allergic reaction has little risk of slipping into anaphylactic shock.


                  4. During an allergic reaction, you can expect to discover a higher-than-average blood pressure.


                  5. Epinephrine auto-injectors may not be administered to unconscious patients.


                  6. Epinephrine has no contraindications when used in a life-threatening situation.


                  7. A possible side effect of epinephrine use is chest pain.


                  8. Some anaphylactic reactions require repeated doses of epinephrine before the allergic reaction stops.


                  9. The two key categories of signs and symptoms that specifically indicate anaphylaxis are respiratory compromise and shock.


                10.  A patient experiencing an allergic reaction with no signs of respiratory distress or shock should receive epinephrine.



Place a check mark in front of the signs and symptoms commonly associated with anaphylaxis or anaphylactic shock.


increased pulse




decreased respirations


increased appetite




altered mental status


flushed skin


absent radial and/or pedal pulses




decreased pulse


increased respirations


decreased blood pressure


feeling of impending doom










Write in the missing information on the medication flash card below, and save the completed card for future reference.



Epinephrine Auto-Injector


Medication Names:


1. Generic:


2. Trade:











Medication Form:                                                                         











Side Effects:
















Write the letter of the best answer in the space provided.


                  1.  Any substance—liquid, solid, or gas—that impairs health or causes death by its chemical                                    action when it enters the body or comes into contact with the skin is called a(n)

A. allergen.                                                           C. antigen.

B. poison.                                                             D. caustic.


                  2.  The most common poisons ingested by children include all of the following except

A. fertilizers.                                                          C. cleaning products.

B. plants.                                                              D. toiletries.


                  3.  Carbon monoxide is an example of an _______ poison.

A. ingested                                                            C. absorbed

B. inhaled                                                             D. injected


                  4.  When treating an absorbed poisoning patient, if the poison is a liquid, you should irrigate all              parts of the patient’s body for at least _________ minutes.

A. 5                                                                     C. 20

B. 10                                                                   D. 45


                  5.  Use of activated charcoal is indicated in some cases of          poisoning.

A. injected                                                            C. absorbed

B. inhaled                                                             D. ingested


                  6.  Activated charcoal is administered in the form of a(n)

A. tablet.                                                              C. gel.

B. suspension.                                                       D. inhaler.


                  7.  All of the following are trade names for activated charcoal except

A. SuperChar.                                                        C. Liqui-Char.

B. CharCoal.                                                         D. Actidose.


                  8.  The usual dose of activated charcoal for an adult is

A. 12.5–25 grams.                                                  C. 30–100 grams.

B. 3 grams/kg of body weight.                                D. 10 grams/kg of body weight.


                  9.  In treating cases of inhaled poisons, the drug of first choice is

A. activated charcoal.                                              C. glucose.

B. syrup of ipecac.                                                 D. oxygen.


                10.  The most common sources of injected poisons are

A. drugs.                                                              C. plants.

B. bites and stings.                                                D. over-the-counter medications.



Review the following real-life situation. Then answer the questions that follow.


The emergency medical dispatcher sends you to a residence at 7290 Riverside. The young woman who placed the 911 call is waiting for you on the doorstep, even though the day is chilly.


The woman reports that she dropped by the house to visit her friend Randy Johnson and saw through the window that he was passed out on the couch. The door was unlocked, so she went in to try to wake him but couldn’t. She tells you, “I wanted to stay and help him, but I just started feeling so bad. I felt sick to my stomach and my head hurt, almost like there was a band around it. Then I remembered that Randy had been having trouble with his furnace and was using a kerosene heater until he could get the furnace fixed. So I was afraid maybe something was wrong with the heater and came outside and called 911 from my cell phone. What’s going on?”


1. Based on your scene size-up, what answer would you give the woman?




2. What action(s) would you take?





Write the word or words that best complete each sentence in the space provided.


1.     The ingestion of poisonous plants is an extremely common poisoning emergency, especially in




2.     Protect the ingested poison patient from aspiration by placing him or her, if possible, in the




3.     In some cases of ingested poisoning, medical direction will order administration of



4.     Unless directed otherwise by medical direction, give both adults and children


of activated charcoal per


of body weight.


5.  Activated charcoal absorbs poisons in the stomach, prevents their                                                     by the body, and enhances their elimination from the body.

6.                                                poisoning is the leading cause of death among people who inhale smoke from fires.

7.  Any treatment recommended by the poison control center should be discussed with


before it is administered to the




8.  If poison has been splashed into the eye,                                                    the affected eye with clean water for at least                                                                                                                .

9.  No matter what else is done regarding poisoning treatment, if the

and                                                  are not maintained, the patient will die.






1. List the four ways that poisons can enter the body.




2. List nine questions that should be asked during assessment of a patient with ingested poisoning.






3. List four contraindications for administration of activated charcoal.



4. List the emergency care steps for treating patients with inhaled poisoning.






Write the letter of the type of poisoning next to the appropriate scenario below.


                 1.    You are called to a suburban home to assist an 18-year-old male who has been found on the floor of his bathroom.

He has a reduced pulse rate and reduced rate of breathing. His pupils are constricted to pinpoint size. He seems very sleepy and unresponsive. There is a constricting band tied around his upper arm. You find a hypodermic needle behind a clothes hamper.

A. ingested poisoning

B. inhaled poisoning

C. absorbed poisoning

D. injected poisoning


                 2.    A 19-year-old male farm worker stumbles while carrying an open drum of pesticides. The powder spills all over his clothes and body. Within minutes, a stinging, burning sensation spreads across his hands, arms, neck, and face. “It’s like being on fire,” he tells another farm worker. “Get some help fast!”


                 3.    A 38-year-old woman collapses on the floor of her garage while cleaning out her car. She had left the car idling so that she could listen to her favorite radio station without running down the battery. By the time her husband discovers her, the woman is barely breathing. He rushes to call an EMS unit.


                 4.    A 45-year-old man in extreme pain from a recent back operation decides to double his self-administered dosage of Demerol. By the end of the day, he feels extremely lethargic and is sweating profusely. His pupils look pinpoint in size. Sensing trouble, his teenage son calls the nearest ambulance service.





Write in the missing information on the medication flash card below, and save the completed card for future reference.



Activated Charcoal


Medication Names:


1. Generic:


2. Trade:




















Medication Form:                                                                         

Dosage:                                                                                 _






Side Effects:








Write the letter of the best answer in the space provided.


                 1. All of the following vital organs are located in the abdominal cavity except the

A. stomach.                                                           C. lungs.

B. gallbladder.                                                       D. liver.


                 2.  Pain that is felt in a body part removed from its point of origin is called _______ pain.

A. referred                                                              C. radiating

B. ghost                                                                D. provoked


                 3.  Irritation and inflammation of the peritoneum is called

A. costalcongitis.                                                   C. appendicitis.

B. diverticulitis.                                                     D. peritonitis.


                 4.  An abdominal wall muscle contraction that the patient cannot control, resulting from                           inflammation of the peritoneum, is called

A. rigidity.                                                            C. protecting.

B. guarding.                                                          D. posturing.


                 5.  All of the following are common signs and symptoms of a spontaneous abortion except

A. lower abdominal pain.                                         C. rapid pulse.

B. vaginal bleeding.                                                D. increased blood pressure.


                 6.  Abdominopelvic pain in the middle of a patient’s menstrual cycle is known as

A. mittelschmerz.                                                   C. endometrial.

B. dysmenorrhea.                                                   D. referred.


                 7.  Endometriosis is most commonly diagnosed in patients between the ages of

A. 35–45.                                                             C. 15–25.

B. 25–35.                                                             D. 45–55.


                 8.  All of the following are part of the urinary system except the

A. kidneys.                                                            C. bladder.

B. liver.                                                                D. urethra.


                 9.  Risk factors associated with renal calculi include all of the following except

A. hyperthyroidism.                                                C. obesity.

B. dehydration.                                                      D. increased dairy intake.


               10.   The abdomen is divided into ______________ regions.

A. four                                                                  C. five

B. six                                                                            D. eight


Write the word or words that best complete each sentence in the space provided.


1.     The left lower quadrant of the abdomen contains part of the _______________________                                                   and the female reproductive organs.

2.     _______________________ pain is felt when the abdominal organ itself is involved.   3.   Pancreatitis, or inflammation of the                                                     , may cause severe pain in the middle or the upper quadrants (epigastric area) of the abdomen. 4.   While assessing your patient, you note hematochezia. This means that the patient had a                                                   onset of gastrointestinal bleeding.   5.   The ovaries are the primary sex glands and are located on either side of the                                              .   6.   When treating the victim of a sexual assault it is extremely important to not let the patient                                                  , bathe, comb, or clean any part of her body. 7.   A ______________________ cyst is a fluid-filled sac that forms inside of or on an                                                  .   8.   Pelvic inflammatory disease is an infection of the female ________________________ tract.   9.   The ________________________ are bean-shaped organs located in the retroperitoneal space.   10.  ________________________ is an artificial process used to remove water and waste substances from the   blood when the kidneys fail to function properly.



1. List the three types of abdominal pain.



2. List the seven emergency care steps for a patient with acute abdominal pain.






3. List the four psychological effects of sexual assault.




4. List the six emergency care steps for a dialysis emergency.



Write the letter of the best answer in the space provided.


                  1.  Water chill, which occurs when clothing or the body gets wet, is an example of

A. conduction.                                                       C. radiation.

B. convection.                                                       D. evaporation.


                  2.  Wind chill, which occurs when currents of air pass over the body, is an example of

A. conduction.                                                       C. radiation.

B. convection.                                                       D. evaporation.


                  3.  All of the following are signs and symptoms of hypothermia except

A. agitation and hyperactivity.                                 C. loss of motor coordination.

B. shivering in early stages.                                     D. cool abdominal skin temperature.


                  4.  In providing emergency care steps for the hypothermic patient who is alert and                    responsive, an EMT should

A. passively rewarm the extremities.                          C. get the patient to walk around.

B. provide the patient with stimulants.                    D. actively rewarm the patient.


                  5.  Rough handling of a patient with hypothermia may result in

A. apnea.                                                              C. blood clots.

B. ventricular fibrillation.                                        D. seizures.


                  6.  Superficial local cold injuries are sometimes referred to as

A. “white nose.”                                                   C. hyperthermia.

B. frost touch.                                                       D. frostbite.


                  7.  All of the following are signs and symptoms you might expect to find in a heat                   emergency patient with hot, dry skin except

A. rapid, shallow breathing.                                     C. dilated pupils.

B. generalized weakness.                                          D. heavy perspiration.


                  8.  To rapidly cool a patient with a hyperthermic emergency, apply ice packs to the neck,              groin, and

A. wrists.                                                              C. knees.

B. armpits.                                                            D. ankles.


                  9.  The mildest form of hyperthermia is called

A. heat exhaustion.                                                C. heat stroke.

B. heat cramps.                                                      D. fever.


                10.  All of the following are factors that put a patient at risk for generalized hyperthermia               except

A. environment.                                                     C. age.

B. diet.                                                                                                 D. drugs and poisons.


                11.  Hot skin that is either dry or moist represents

A. a dire emergency.                                               C. heat cramps.

B. heat exhaustion.                                                D. a stable patient.



Review the following real-life situation. Then answer the questions that follow.


It is an overcast March afternoon when you are dispatched to a call for a woman who has fallen at 45 Standish Street. The temperature is in the 30s, with gusty winds. Banks of dirty snow from last week’s storm still line the streets and sidewalks.


1.  What might the information from dispatch plus the weather conditions lead you to expect at this call?





2.  A police car is on the scene when you arrive. The officers assure you that the scene is safe. One officer says he’ll lead you to the patient, who has fallen in a snowdrift near the garbage can next to the garage. Given what you know of the situation to this point and given that the police are on the scene, what step might you take to prepare for this patient before leaving the ambulance?





3.  Behind the house, you see a woman apparently in her 60s, lying just off an icy set of steps in a snow bank. She is wearing only a housecoat and slippers. What injury possibilities do these circumstances suggest? What actions should you take before proceeding further in your assessment?





4.  As you proceed, you discover that the woman is not alert, but does respond inappropriately to loudly spoken questions. She is not shivering, and the skin on her abdomen is cool to the touch. She has a blood pressure of 102/60, a heart rate of 60, and a respiration rate of 14. Her skin is pale, cool, and firm to the touch. What do these findings indicate? How should you proceed?

Write the word or words that best complete each sentence in the space provided.


1.   The mechanism of                                                    causes body heat to be lost through direct contact.

2.   The process of                                                         causes cold air molecules that are in immediate contact with the skin to be warmed.

3.   The most significant mechanism of heat loss is ______________________, which involves the transfer of heat from the surface of one object to the surface of another without physical contact.

4.   Most radiant heat loss occurs from a person’s ______________________,


, and                                                .


5.   The process in which a liquid or solid changes to a vapor is called ______________________.


6.   _________________________ causes loss of body heat as a result of exhaled warm air.


7.   When cooling affects the entire body, a problem known as _________________________



8.   Application of an external heat source to the body is known as _________________________



9.                                                                                is taking measures to prevent further heat loss and giving the patient’s body the optimum chance to rewarm itself.

10.    _______________________________


results from the freezing of body tissue.


11.    Another name for late or deep local cold injuries is                                        .


12.    Heat-related emergencies are grouped under the name _________________.


13.    The patient with a(n) _____________________________ ____________________________


, who also has hot skin, should be considered a priority patient.


14.    Always transport a hyperthermic patient with hot skin that is ____________________________or




15.    Apply a(n) _________________________________________________ to an insect bite or sting to help relieve pain and swelling.



16.  Do not apply cold to bite s of                                                      or to injuries inflicted by



17. The


is characterized by a shiny black body, thin legs, and a crimson red marking on its abdomen, usually in the shape of an hourglass or two triangles.

18.  The                                                                                                  gets its name from the intense, fiery, burning pain its bite causes.

19. The two classes of poisonous snakes in the United States are






20.  Soaking the affected area in                                                     water for 30 minutes or throughout transport will help break down venom from a marine bite or sting.





Indicate if the following statements are true or false by writing T or F in the space provided.


                  1.  Shivering is one of the body’s compensatory mechanisms.


                  2.  Water chill, which happens when the body or clothes get wet, is an example of convectional               cooling.


                  3.  Administering a drink of alcohol is an effective way to reduce the effects of hypothermia.


                  4.  In all cases of hypothermia, an EMT should begin active rewarming with the extremities.


                  5.  If clothing is frozen to the skin, it should be left in place.


                  6.  All heat emergency patients should be allowed to drink cool water.


                  7.  A patient with hot skin that is either moist or dry represents a dire medical emergency.


                  8.  Snakebites are relatively uncommon, and the number of people who die from them each year                is extremely small.


                  9.  Black widow spider bites are the leading cause of death from spider bites in the United                                   States.


                10.  The bite of the brown recluse spider is a serious medical condition that usually does not                                 heal and may require surgical repair.



Write the letter of the best answer in the space provided.


                  1.    A situation in which a person exhibits actions that are unacceptable to the patient, family, or community is known as

A. a panic attack.                                                 C. a behavioral emergency.

B. depression.                                                     D. psychosis.


                  2.    Which one of the following is not a factor in determining whether the use of force with an emotionally disturbed patient is reasonable or not?

A. size and strength of patient                                C. mental state of patient

B. dispatch information                                        D. method of restraint


                  3.    The medical condition most likely to cause restlessness and confusion, cyanosis, and altered mental status is

A. excessive heat.                                                 C. excessive cold.

B. inadequate blood to the brain.                           D. lack of oxygen.


                  4.    One method of protecting against false accusations by a behavioral emergency patient is

A. using medical responders of a different gender than the patient.

B. involving third-party witnesses.

C. limiting the involvement of other medical responders.

D. sharply limiting documentation.


                  5.    The first step that an EMT takes in a behavioral emergency is to

A. gather a thorough patient history.                      C. identify him- or herself.

B. complete a primary assessment.                         D. perform a careful scene size-up.


                  6.    A state of painful uneasiness about impending problems is called

A. anxiety.                                                           C. psychosis.

B. depression.                                                     D. mania.


                  7.    In talking with a behavioral patient, an EMT should take all of the following actions


A. identifying him- or herself. B. avoiding direct eye contact. C. being as honest as possible.

D. standing at least 3 feet from the patient.


                  8.    Of the groups listed, the highest suicide rates have been found in which age group?

A. women under age 25                                       C. men ages 15 to 25

B. men over age 40                                             D. women over age 50


                  9.    A patient who has attempted suicide in the past is

A. looking for attention.

B. less likely to commit suicide than one who has not.

C. a candidate for forceful restraint.

D. more likely to commit suicide than one who has not.


                10.    In most localities, an EMT cannot legally restrain a patient without orders from

A. dispatch.                                                         C. the police.

B. the patient’s physician.                                     D. the patient’s family.




Review the following real-life situation. Then answer the questions that follow.


The emergency medical dispatcher reports a 14-year-old girl who is “acting in a bizarre manner.” Her father is currently trying to keep her from leaving the house.


Upon the EMS unit’s arrival at the scene, the father guides the team into the house. He states that his daughter has been depressed for the past few weeks. Today the daughter’s behavior changed dramatically. Instead of appearing to be lethargic, the daughter has become hyperactive. The father indicates that the family has a history of manic depression. “The doctor has a new word for it,” laughs the father nervously. “They call it bipolar disorder.” The father indicates that his daughter is on medication for the condition, but feels that she has stopped using it. The girl’s psychiatrist recommended that the father call 911.


The father takes you to meet his daughter, Stephanie. You see a clean, well-dressed young woman who appears to be happy. She speaks very fast and occasionally exhibits muscle twitches of the face and hands. Although Stephanie indicates no physical complaints, her vital signs are on the high side of normal. She doesn’t want to talk about her medical condition. She also doesn’t want to be transported to the hospital. With her eyes averted, Stephanie says, a little too lightly, “My father worries much too much. I’m just fine.”


1. How should you proceed with patient care?






2. What information might you use to persuade the patient to accompany you to the hospital?






Write the word or words that best complete each sentence in the space provided.


1.     ________________ is defined as the manner in which a person acts or performs.


2.   A(n)                                                                                                  exists when a person exhibits abnormal behavior.

3.   There are many                                                   conditions as well as psychological conditions that are likely to alter a patient’s behavior.

4.   ______________________ is a condition characterized by deep feelings of sadness, worthlessness, and discouragement—feelings that often do not seem connected to the actual circumstances of the patient’s life.

5.   In providing patient care during a behavioral emergency, an EMT should treat any life-threatening conditions during the                .

6.   In talking with a patient experiencing a behavioral emergency, maintain good


and avoid any quick                                                 .


7.   Whenever you are called to care for a patient who has attempted suicide, your first concern must be for                                                      ,                                                .


8.   Suicide is more common among people with a history of                                                     or



9.   Before you restrain any patient for any reason, contact




10.    The best way to protect yourself against false accusations by a patient is to carefully and completely


everything that happens during the encounter, including detailed aspects of the patient’s abnormal behavior.


l. List seven physical conditions that are likely to alter a person’s behavior.







2. List seven basic principles to keep in mind whenever you encounter a behavioral emergency.






Indicate if the following statements are true or false by writing T or F in the space provided.


                  1.  During a behavioral emergency, an EMT should call the police only as a last resort.


                  2. When dealing with a patient with a behavior problem, always consider that the problem may be caused by a physical condition.


                  3. Whenever an EMT is called to the scene of a suicide attempt, his or her first concern should be for the patient’s safety.


                  4. Every suicidal act or gesture should be taken seriously, and the patient should be transported for evaluation.


                 5.   If a patient’s fear or aggression increases, an EMT should not push the issue of transport.


                  6.  In treating a behavioral emergency, an EMT should not leave the patient alone.


                  7.  Once a patient is acting rationally, an EMT may remove soft restraints.


                  8. Under most state laws, any adult of sound mind has the right to determine whether he or she will be treated or, more specifically, touched by another person in the course of treatment.


                  9. The patient who has become calm following a period of combativeness will most likely not revert to the earlier behavior.


                10. Depending on state and local law, a patient who is disoriented, in shock, mentally ill, or under the influence of drugs or alcohol may not be considered competent to refuse care.

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