A 10 y/o M is allergic to peanuts. Shortly after sharing some food with a classmate, he began
to complain that his throat felt "itchy". His teacher tells you that she thinks his "face looks
swollen". What should you do?
a. instruct the teacher to administer the epi auto-injector
b. help him self-administer his epi auto-injector
c. administer O2 and monitor the pt for a change in status
d. obtain parental consent to transport the child to the hospital - ANS-b. help him
self-administer his epi auto-injector
An anaphylactic reaction can progress quickly, especially in children. Timely intervention is
essential.
A 14 y/o M is shouting obscenities and not following your directions. His friend tells you, "He
had a few beers." Vital signs are BP 118/66, P 100, R 24, GCS 14, SpO2 94% on room air.
What should you do?
a. restrain him on a long spine board
b. administer oral glucose
c. transport him on his side
d. call his parents - ANS-c. transport him on his side
He has an altered mental status and no signs of trauma. You should transport him on his
side to protect his airway.
A 15 y/o F is sitting in a chair with left-sided facial droop and slurred speech. She has an
acetone odour on her breath. What should you suspect?
a. hyperglycaemia
b. hypoglycaemia
c. intoxication
d. Bell's palsy - ANS-a. hyperglycaemia
The acetone "fruity" odour on her breath is the one thing that should make you suspect
hyperglycaemia. This is caused by an excessive amount of ketones.
A 19 y/o M was stung by a bee and the stinger is still embedded in his skin. He is allergic to
needs. Vital signs are BP 124/76, P 92, R 18, SpO2 98%. What should you do?
a. leave the stinger in place and apply ice to his skin
b. leave the stinger in place and transport emergently
c. remove the stinger with a pair of sterile tweezers
, d. remove the stinger by scrapping the skin with a card - ANS-d. remove the stinger by
scrapping the skin with a card
The stinger should be removed. It may continue to inject venom even after it has been
detached from the insect. Scraping the stinger will limit any additional venom from being
injected.
A 20 y/o M is agitated and complains of nausea. He tells you, "I feel like my heart is going to
jump out of my chest." Vital signs are BP 142/90, P 140, R 24, and warm, moist skin. Which
drug should you suspect?
a. narcotics
b. opioids
c. alcohol
d. amphetamines - ANS-d. amphetamines
Amphetamines stimulate the central nervous system, causing an increase in all vital signs.
He is tachycardia, tachypneoic, and hypertensive.
A 32 y/o M is lying supine and responding to voice commands with unintelligible gurgling
noises. His wife tells you he is an epileptic and had a seizure during which she was able to
assist him to the ground. What should you do?
a. obtain a detailed history of his present illness
b. load him onto a stretcher and apply soft restraints
c. apply a c-collar and place him on a long backboard
d. roll him onto his side and suction his airway - ANS-d. roll him onto his side and suction his
airway
Airway management is your first priority because he is postictal and unable to protect his
own airway. The gurgling noises in the hypopharynx/throat are from secretions. Rolling him
on side and suctioning his airway is the best way to clear this obstruction. It is also important
to determine whether this seizure was different than previous seizures.
A 40 y/o M with a history of bipolar depression is hearing voices and throwing clothing. Law
enforcement is on scene. He has several large lacerations to his forearms that are actively
bleeding. What should you do?
a. restrain the pt and treat his injuries
b. tell him that you hear the voices as well
c. retreat and have the police transport the pt
d. place a hand on his shoulder and speak calmly - ANS-a. restrain the pt and treat his
injuries
He is not displaying threatening behaviour and he has not made any threats towards others.
Restraining him is necessary to prevent him from moving his arms and allows you to treat
his wounds.
A 41 y/oM begins to shake violently while you administer oral glucose to him. What should
you?
a. abandon glucose administration
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