CFRN Environmental and Toxicological Emergencies 4

Question 1

A patient with frostbite to both hands has been in a warm transport environment for 30 minutes. The thawed tissue now appears blistered and edematous. What is the most important management principle?

Accepted Answer

Avoid refreezing the thawed tissue at all costs

Answer

Refreezing previously thawed tissue causes far greater cellular damage than the original frostbite, making prevention of refreezing the top priority.

Question 2

A patient develops muscle rigidity, hyperthermia, diaphoresis, and clonus after starting a new serotonergic medication. What is the most likely diagnosis?

Accepted Answer

Serotonin syndrome

Answer

Serotonin syndrome presents with the triad of mental status change, autonomic dysfunction, and neuromuscular abnormalities (especially clonus) after serotonergic drug exposure.

Question 3

During a mass casualty event involving nerve agent exposure, patients are being triaged. Which finding indicates the patient is in immediate life threat and requires antidotal therapy without delay?

Accepted Answer

Seizures, loss of consciousness, and severe bronchospasm

Answer

Severe nerve agent toxicity with seizures, unconsciousness, and bronchospasm indicates crisis-level acetylcholinesterase inhibition requiring immediate atropine and pralidoxime.

Question 4

A patient is being transported after a rattlesnake bite to the lower leg. The leg is markedly edematous and the patient's coagulation studies are severely deranged. What is the treatment priority in flight?

Accepted Answer

Initiate antivenom (CroFab) as early as possible and supportive care

Answer

CroFab antivenom is the definitive treatment for Crotalid (rattlesnake) envenomation and should be administered as soon as possible to halt venom-induced coagulopathy.

Question 5

A patient is found unconscious in a garage with an idling vehicle. En route, the patient has been on 100% oxygen for 15 minutes but remains confused. What intervention should be planned at the receiving facility?

Accepted Answer

Hyperbaric oxygen therapy

Answer

Hyperbaric oxygen therapy is indicated for severe CO poisoning (unconsciousness, neurological deficits) to accelerate CO elimination and reduce delayed neurological sequelae.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN Environmental and Toxicological Emergencies 4