casestudystart

EMS Quiz

By Phil Stewart and Rob Keough.

Is early on a cold December morning as you report to your station for duty. Skies are clear and winds are light as you note the heavy frost on the ground and a thermometer reading of –l0 degrees Celsius.

As the morning unfolds you are unaware of a Search and Rescue (S.A.R) operation occurring near your station in a heavily wooded National Park. Local S.A.R teams, firefighters and park officials have searched throughout the night for a 25-year-old inexperienced hiker who was last seen at 1600 hours last afternoon moving off of marked trails. As you complete your morning inspections, your pager and radio requests you to respond hot to a S.A.R scene where a male patient is “hypothermic” and authorities on scene are requesting EMS support.

After a 20-minute response to this remote scene you are lead the hiker, who is lying supine in a nearby rescue vehicle on supplemental oxygen and being monitored by First Responders.

Assessment reveals a patient who responds to loud verbal stimuli and has difficulty speaking. Head to toe exam shows no trauma, he is having difficulty moving and is quite cold to the touch, skin is pale with obvious tissue damage noted on both hands (skin appears white but is soft beneath). Airway is patent, he has a respiratory rate of 8 (shallow but regular), a carotid pulse of 32 (irregular and weak) and after several attempts you obtain a BP of 50/35.

Vitals

Pulse	a carotid pulse of 32 (irregular and weak)
Blood pressure	50/35
Respiration	8 (shallow but regular)
Skin	pale with obvious tissue damage noted on both hands (skin appears white but is soft beneath)

1.Hypothermia is classed as any core temperature (degrees Celsius) less than:

2.The most common way we lose heat from our bodies is by:

3.Based on findings, this patient appears to be in:

4.“Systemic Hypothermia” occurs when:

5.is the initial response to conserve core heat:

6.What percentage of body heat is generated by muscle contraction:

7.Muscle shaking and shivering ceases due to:

8.This region of the brain helps to regulate the body’s temperature:

9.Secondary to hypothermia, you have also found this patient is suffering from:

10. Proper care of this injury would include:

11. For this patient, the most appropriate care would include:

12. Cardiac and/or respiratory arrest are common as core temperature approaches degrees Celsius.

13. is known as the most common cause of death in hypothermic patients:

14. As per A.H.A. / A.C.L.S. guidelines, hypothermic cardiac arrest patients should be defibrillated no more than three times (if indicated) prior to active re-warming.

15. Which of the following patients will usually become hypothermic the fastest:

Please keep in mind the answers to these questions are to industry standards and may not necessarily be correct according to local protocol. If there is any discrepancy between these answers and local protocol, please follow the protocol for your area as set out by your Medical Director.

Submitted by Phil Stewart and Rob Keough. Both are currently studying Paramedicine 3 at Holland College in Charlottetown P.E.I. To offer feedback oil the quiz or for information on the Paramedic Program at Holland College, email us at: mailto:spstewart@ ccgw.cc.hollandc.pe.ca

This Article is reprinted by permission from and the Canadian Emergency News. It originally appeared in the December 1999 / January 2000 issue (volume 22, number 6).

Your comments are appreciated!

Just complete this form. Click on Submit when ready to send.

Your name:
Email address:

Any comments about the Case Study?

Chuck Chivers

EMS Quiz

By Phil Stewart and Rob Keough.

Your comments are appreciated!

Just complete this form. Click on Submit when ready to send.

Your name:

Email address:

Any comments about the Case Study?