NREMT Environmental Emergencies 2

Question 1

A patient is retrieved from cold water (58°F/14°C) after 25 minutes of submersion and is in cardiac arrest. Which statement regarding resuscitation is most accurate?

Accepted Answer

Cold water drowning victims may survive prolonged submersion due to the diving reflex and hypothermia-induced metabolic slowdown

Answer

Cold water submersion victims may survive prolonged cardiac arrest due to the mammalian diving reflex and the protective effects of hypothermia on cerebral metabolism — the principle 'not dead until warm and dead' applies.

Question 2

Which rewarming method is most appropriate for a moderate hypothermia patient in the prehospital setting?

Accepted Answer

Passive external rewarming by removing wet clothing and covering with insulating blankets

Answer

Passive external rewarming — removing wet clothing, protecting from wind and ground, and covering with blankets — is the appropriate prehospital method, preventing further heat loss while avoiding complications of aggressive rewarming.

Question 3

A patient presents with painful, red, blistered feet after wearing waterlogged boots for 48 hours in cold but non-freezing conditions. The tissue is not frozen but appears mottled. Which condition is most likely?

Accepted Answer

Immersion foot (trench foot)

Answer

Immersion foot (trench foot) results from prolonged exposure to cold and wet conditions without freezing; it presents with painful, blistered, mottled skin and is treated by gently drying and warming the affected area.

Question 4

When monitoring a severely hypothermic patient, which cardiac dysrhythmia are you most concerned about triggering through rough handling?

Accepted Answer

Ventricular fibrillation

Answer

Severely hypothermic patients are at high risk for ventricular fibrillation, which can be triggered by physical stimulation or movement; gentle handling and continuous cardiac monitoring are essential.

Question 5

A construction worker presents with painful muscle cramps in the legs and abdomen after working in high heat. Vital signs are stable and the patient is alert and oriented. What is the appropriate treatment?

Accepted Answer

Rest, oral electrolyte-containing fluids, and gentle stretching of the affected muscles

Answer

Heat cramps result from electrolyte depletion caused by sweating and are treated with rest, oral electrolyte replacement, and gentle stretching; advanced interventions are rarely required for this mildest heat emergency.

NREMT Practice Test

NREMT Practice Test

NREMT Environmental Emergencies 2