CPR Toxicological Emergencies and Overdose Management 3

Question 1

Which ECG finding is most characteristic and specific for severe digoxin toxicity?

Accepted Answer

Bidirectional ventricular tachycardia

Answer

Bidirectional ventricular tachycardia, characterized by alternating QRS axis polarity beat-to-beat, is a highly specific ECG marker for severe digoxin toxicity and requires urgent treatment with digoxin-specific Fab fragments.

Question 2

A patient presents with severe agitation, hypertension, and hyperthermia after cocaine intoxication. Which is the most appropriate initial treatment?

Accepted Answer

IV benzodiazepines for CNS and cardiovascular stabilization

Answer

Benzodiazepines reduce CNS stimulation from cocaine, addressing agitation, hypertension, and hyperthermia simultaneously; non-selective beta-blockers are contraindicated due to the risk of unopposed alpha-adrenergic stimulation.

Question 3

What is the Rumack-Matthew nomogram used for in the emergency management of overdose?

Accepted Answer

Determining hepatotoxicity risk in acetaminophen overdose based on serum level and time since ingestion

Answer

The Rumack-Matthew nomogram plots acetaminophen serum concentration against time post-ingestion to identify which patients are at risk for hepatotoxicity and need N-acetylcysteine treatment.

Question 4

A worker exposed to hydrofluoric (HF) acid has severe burns, hypocalcemia, and life-threatening cardiac dysrhythmias. What specific treatment is required?

Accepted Answer

Calcium gluconate gel topically and IV calcium replacement

Answer

Hydrofluoric acid depletes tissue calcium; calcium gluconate gel neutralizes fluoride ions locally at the burn site, and IV calcium corrects systemic hypocalcemia that drives life-threatening dysrhythmias.

Question 5

A patient with severe lithium toxicity presents with tremor, confusion, ataxia, and seizures. Which intervention is the highest priority?

Accepted Answer

Supportive care and urgent hemodialysis consultation

Answer

Hemodialysis is the definitive treatment for severe lithium toxicity as there is no specific antidote; activated charcoal does not bind lithium, and supportive care manages acute symptoms until dialysis can clear the drug.

(CPR) Certified Paramedic Response Practice Test

(CPR) Certified Paramedic Response Practice Test

CPR Toxicological Emergencies and Overdose Management 3