FISDAP MEDICAL EMERGENCIES EVALUATION TEST
ANSWERS AND QUESTIONS SET A+
✔✔hydrogen sulfide - ✔✔highly toxic, colorless, and flammable gas with distinct rotten
egg odor. usually poisoning by inhalation
affects all organs, but has greatest impact on the lungs and CNS.
naturally occurs in sewers, swamps, volcanoes, and crude petroleum.
often used to commit suicide (chemical/detergent suicide): originated in japan and
reached the US over internet.
pay attention to warning signs, containers, buckets, or pots. if you suspect toxic gas, call
hazmat.
chronic low exposure of hydrogen sulfide can cause eye, nose, and throat irritation -->
headaches and bronchitis (industrial workers),
chronic exposure can lead to an inability to smell the gas
high concentration exposure: nausea, vomiting, confusion, dyspnea, loss of
consciousness, seizures, shock, coma, and cardiopulmonary arrest.
no antidote, hazmat must remove patient from contaminated area, EMS and hospital
support and monitor patient health.
✔✔sympathomimetics - ✔✔CNS stimulants that mimic the sympathetic nervous system
(fight or flight)
cause hypertension, tachycardia, dilated pupils, is a stimulant ,
often taken to feel good, improve performance, suppress, appetite, or prevent
sleepiness. can produce irritability, anxiety, fear, lack of concentration, or seizures
,paranoia and delusions are common symptoms of abuse.
include cocaine: inhaled in the nose, absorbed through nasal mucosa, damages tissue,
causes nosebleeds, destroys the nasal septum. can be IV or subcutaneous. can be
absorbed through all mucous membranes. gives excitement and euphoria. can also be
smoked --> melts at 93F, 33.9C, then vaporizes --> reaches blood and then brain very
quikcly.
acute cocain overdose is a genuine emergency: high risk for seizures, cardiac
dysrhythmias, stroke, hypertension (250/150 mmHg). chronic cocaine abuse may cause
hallucinations. "cocaine bugs" bug hallucinations
patients may be paranoid -- consider law enforcement
monitor the ABCs, reassess every 5 minutes
✔✔common sympathomimetics - ✔✔MDMA, phencyclidine (PCP), amphetamines,
cocaine, heroin, amphetamine, methamphetamine, methcathinone, DOM, 4-
methythiamphetamine, methaqualone, methamphetamine, etc
✔✔synthetic cathinones (bath salts) - ✔✔similar to MDMA (a sympathomimetic)
includes MDPV --> not actual bath salts (magnesium sulfate). names include cloud nine
and ivory wave
produces euphoria, increased mental clarity, and sexual arousal. snorted or insufflated.
effects can last as long as 48 hours
adverse effects: teeth grinding, appetite loss, muscle twitching, lip smacking, confusion,
GI problems, paranoia, headache, elevated heart rate, hallucinations.
keep the patient calm and transport them. manage ABCs, call for ALS for chemical
restraint for safe transport.
✔✔marijuana - ✔✔cannabis sativa.
THC produces the high --> euphoria, relaxation, drowsiness, impairs short term
memory, capacity to think and work critically.
in some, euphoria can progress to depression and confusion. altered time perception is
common, anxiety and panic can occur.
high doses: hallucinations, anxiety, paranoia.
keep the patient calm and transport. be aware that marijuana can be laced with other
drugs like crack or PCP.
, ingestion of marijuana can lead to cannbinoid hyperemesis syndrome: chronic weed
use and extreme nausea and vomiting that is relieved by hot shower or bath. bathing
can become compuslive in these patients. treatment: stop smoking. most patients
believe smoking more weed will help.
✔✔synthetic marijuana/spice - ✔✔a variety of herbal incense or smoking blends that
resemble THC. -- K2, skunk, marketed as safe
according to NIDA, these chemicals have no medical benefit and have a high potential
for abuse. powerful and unpredictable effects may result, ranging from simple euphoria
to complete loss of consciousness
✔✔hallucinogens - ✔✔alter sensory perceptions --LSD, PCP
oral, nasal, pulmnary, IV, etc.
causes severe behavioral changes, self harm (due to AMS) is common
bufotenine (toad skin), dextromethorphan (dxm), dimethyltryptamine (dmt), hashish,
datura stramonium (jimsonweed), lsd, marijuana, mescaline (peyote), morning glory,
nutmeg, PCP, Psilocybin (mushrooms)
many have sympathomimetic properties. treat the same.
don't use restraints unless absolutely necessary. manage ABCs, keep the patient calm,
monitor closely, do not leave unattended or unmonitored, request ALS.
✔✔anticholinergic agents - ✔✔medications that block parasympathetic nerves
OD: hot as a hare, blind as a bat, dry as a bone, red as a beet, mad as a hatter: -->
hyperthermia, dilated pupils, dry skin and membranes, reddened skin, agitation, delirium
atropine, antihistamines (diphenhydramine -- benadryl, datura stramonium -- jimson
weed), tricyclic antidepressants (amitriptyline -- elavil)
usually not abused except jimsonweed.
difficult to distinguish anticholinergic od vs sympathomimetic od -- both present with
agitation, tachycardia, and dilated pupils.
seizure and death from tricyclic antidepressant OD can occur within 30 minutes:
transport immediately. cardiac dysrhythmias are common
call ALS when en route.
ANSWERS AND QUESTIONS SET A+
✔✔hydrogen sulfide - ✔✔highly toxic, colorless, and flammable gas with distinct rotten
egg odor. usually poisoning by inhalation
affects all organs, but has greatest impact on the lungs and CNS.
naturally occurs in sewers, swamps, volcanoes, and crude petroleum.
often used to commit suicide (chemical/detergent suicide): originated in japan and
reached the US over internet.
pay attention to warning signs, containers, buckets, or pots. if you suspect toxic gas, call
hazmat.
chronic low exposure of hydrogen sulfide can cause eye, nose, and throat irritation -->
headaches and bronchitis (industrial workers),
chronic exposure can lead to an inability to smell the gas
high concentration exposure: nausea, vomiting, confusion, dyspnea, loss of
consciousness, seizures, shock, coma, and cardiopulmonary arrest.
no antidote, hazmat must remove patient from contaminated area, EMS and hospital
support and monitor patient health.
✔✔sympathomimetics - ✔✔CNS stimulants that mimic the sympathetic nervous system
(fight or flight)
cause hypertension, tachycardia, dilated pupils, is a stimulant ,
often taken to feel good, improve performance, suppress, appetite, or prevent
sleepiness. can produce irritability, anxiety, fear, lack of concentration, or seizures
,paranoia and delusions are common symptoms of abuse.
include cocaine: inhaled in the nose, absorbed through nasal mucosa, damages tissue,
causes nosebleeds, destroys the nasal septum. can be IV or subcutaneous. can be
absorbed through all mucous membranes. gives excitement and euphoria. can also be
smoked --> melts at 93F, 33.9C, then vaporizes --> reaches blood and then brain very
quikcly.
acute cocain overdose is a genuine emergency: high risk for seizures, cardiac
dysrhythmias, stroke, hypertension (250/150 mmHg). chronic cocaine abuse may cause
hallucinations. "cocaine bugs" bug hallucinations
patients may be paranoid -- consider law enforcement
monitor the ABCs, reassess every 5 minutes
✔✔common sympathomimetics - ✔✔MDMA, phencyclidine (PCP), amphetamines,
cocaine, heroin, amphetamine, methamphetamine, methcathinone, DOM, 4-
methythiamphetamine, methaqualone, methamphetamine, etc
✔✔synthetic cathinones (bath salts) - ✔✔similar to MDMA (a sympathomimetic)
includes MDPV --> not actual bath salts (magnesium sulfate). names include cloud nine
and ivory wave
produces euphoria, increased mental clarity, and sexual arousal. snorted or insufflated.
effects can last as long as 48 hours
adverse effects: teeth grinding, appetite loss, muscle twitching, lip smacking, confusion,
GI problems, paranoia, headache, elevated heart rate, hallucinations.
keep the patient calm and transport them. manage ABCs, call for ALS for chemical
restraint for safe transport.
✔✔marijuana - ✔✔cannabis sativa.
THC produces the high --> euphoria, relaxation, drowsiness, impairs short term
memory, capacity to think and work critically.
in some, euphoria can progress to depression and confusion. altered time perception is
common, anxiety and panic can occur.
high doses: hallucinations, anxiety, paranoia.
keep the patient calm and transport. be aware that marijuana can be laced with other
drugs like crack or PCP.
, ingestion of marijuana can lead to cannbinoid hyperemesis syndrome: chronic weed
use and extreme nausea and vomiting that is relieved by hot shower or bath. bathing
can become compuslive in these patients. treatment: stop smoking. most patients
believe smoking more weed will help.
✔✔synthetic marijuana/spice - ✔✔a variety of herbal incense or smoking blends that
resemble THC. -- K2, skunk, marketed as safe
according to NIDA, these chemicals have no medical benefit and have a high potential
for abuse. powerful and unpredictable effects may result, ranging from simple euphoria
to complete loss of consciousness
✔✔hallucinogens - ✔✔alter sensory perceptions --LSD, PCP
oral, nasal, pulmnary, IV, etc.
causes severe behavioral changes, self harm (due to AMS) is common
bufotenine (toad skin), dextromethorphan (dxm), dimethyltryptamine (dmt), hashish,
datura stramonium (jimsonweed), lsd, marijuana, mescaline (peyote), morning glory,
nutmeg, PCP, Psilocybin (mushrooms)
many have sympathomimetic properties. treat the same.
don't use restraints unless absolutely necessary. manage ABCs, keep the patient calm,
monitor closely, do not leave unattended or unmonitored, request ALS.
✔✔anticholinergic agents - ✔✔medications that block parasympathetic nerves
OD: hot as a hare, blind as a bat, dry as a bone, red as a beet, mad as a hatter: -->
hyperthermia, dilated pupils, dry skin and membranes, reddened skin, agitation, delirium
atropine, antihistamines (diphenhydramine -- benadryl, datura stramonium -- jimson
weed), tricyclic antidepressants (amitriptyline -- elavil)
usually not abused except jimsonweed.
difficult to distinguish anticholinergic od vs sympathomimetic od -- both present with
agitation, tachycardia, and dilated pupils.
seizure and death from tricyclic antidepressant OD can occur within 30 minutes:
transport immediately. cardiac dysrhythmias are common
call ALS when en route.
