FISDAP Special Populations and Environmental Emergencies Flashcards

A 3-year-old is found unresponsive with irregular breathing and a glucose of 38 mg/dL. What is the most appropriate pediatric dextrose dose?

Answer: D25W 2 mL/kg IV

For pediatric hypoglycemia, D25W at 2 mL/kg (0.5 g/kg) is the standard prehospital dose, as D50W can cause vascular sclerosis and osmotic injury in small children.

An elderly patient on warfarin sustains a minor head impact and initially refuses transport. What is the most critical reason to strongly encourage transport?

Answer: Anticoagulation significantly increases the risk of delayed intracranial bleeding even after minor trauma

Anticoagulated patients face substantially elevated risk of delayed or expanding intracranial hemorrhage after seemingly minor head trauma, making hospital evaluation with CT imaging essential.

A pregnant patient at 32 weeks gestation is hypotensive and diaphoretic after a motor vehicle collision. What positioning modification is most important?

Answer: Tilt the backboard or manually displace the uterus to the left

Left lateral uterine displacement (LLUD) relieves aortocaval compression by the gravid uterus, improving venous return and cardiac output in the supine hypotensive syndrome of pregnancy.

A rescue team extracts a collapsed miner after a building entrapment of 6 hours. As the patient is freed, he becomes hypotensive and develops dysrhythmias. What syndrome is occurring?

Answer: Crush syndrome with reperfusion releasing myoglobin and potassium

Crush syndrome occurs when prolonged muscle compression causes rhabdomyolysis; reperfusion upon release floods the circulation with myoglobin, potassium, and lactic acid, causing dysrhythmias and renal failure.

You are treating a victim of a lightning strike who is in cardiac arrest. Bystanders are reluctant to help because of concern about residual electrical charge. What is your best response?

Answer: Lightning strike victims retain no electrical charge and rescuers are safe to touch them immediately

Unlike high-voltage electrical contact, lightning victims do not retain electrical charge and can be safely touched immediately; prompt CPR dramatically improves survival in lightning cardiac arrest.

A patient with autism spectrum disorder becomes extremely agitated during your assessment after a minor injury. Which de-escalation strategy is most effective?

Answer: Reduce sensory stimuli, speak calmly using simple direct language, and maintain predictable movements

Patients with ASD are often highly sensitive to sensory overload and unpredictability; minimizing lights, noise, and crowd while using calm, direct communication reduces agitation without chemical or physical restraint.

A hiker is rescued from a remote mountain trail with a core temperature of 28°C, absent pulse, and fixed dilated pupils. What is the most appropriate action?

Answer: Begin CPR and transport to a hospital with rewarming and ECMO capability

Severe hypothermia can mimic death; the principle 'not dead until warm and dead' applies, and patients at 28°C with cardiac arrest may survive with CPR, active rewarming, and ECMO-assisted rewarming at a hospital.