Question 1

A patient is brought to a clinic after fainting while working outdoors on a hot day. The patient has slurred speech and headache and has a temperature of 104&#176;F. What will the provider do?&#10;A) Administer antipyretic medications to reduce the temperature.&#10;B) Administer intravenous fluids in the clinic and monitoring response.&#10;C) Rehydrate the patient with oral fluids containing electrolytes.&#10;D) Transport the patient to the emergency department (ED).

Accepted Answer

The patient's symptoms suggest heat stroke, a medical emergency that requires immediate treatment at an ED. Antipyretics may help to lower the temperature, but they will not address the underlying issue of dehydration and need for further medical evaluation. Intravenous fluids may be necessary, but ED personnel are equipped to provide more intensive interventions if needed. Rehydration with oral fluids containing electrolytes may also be appropriate, but given the severity of the patient's symptoms, immediate transport to the ED is the best course of action.

Question 2

A provider attending a soccer match on a hot day is assisting a player who feels hot and appears dehydrated, but who is alert and oriented. What does the provider suspect?&#10;A) Heat cramps&#10;B) Heat exhaustion&#10;C) Heat stroke&#10;D) Heat syncope

Accepted Answer

The player is most likely experiencing heat exhaustion, which is characterized by dehydration and usually occurs during heavy sweating on a hot day. Symptoms include fatigue, weakness, dizziness, headache, nausea, and vomiting. The player is still alert and oriented, which suggests that heat stroke, a more severe condition that results in confusion, loss of consciousness, and potentially life-threatening complications, has not yet developed. Heat cramps are painful muscle spasms that can occur during or after exercise in hot climates, and heat syncope is fainting that can occur due to dehydration and vasodilation in response to heat. While both of these are possible conditions in this scenario, the player's symptoms are more consistent with heat exhaustion.

Question 3

A child is brought to the emergency department after getting lost while camping on a cold, rainy day. The child is lethargic on admission. The cardiorespiratory monitor shows a normal heart rate and rhythm, a respiratory rate of 8 to 10 breaths per minute, and a normal blood pressure. The assessment reveals erythema and edema of the child's hands and feet. What treatments are indicated? (Select all that apply.)

A) Administer antibiotics.
B) Apply warmed blankets.
C) Elevate the child's extremities.
D) Massage the hands and feet.
E) Remove all wet clothing.

B, C, E

Accepted Answer

The child's symptoms suggest hypothermia and possible early frostbite (indicated by erythema and edema of the hands and feet). Treatment should focus on rewarming and protecting the affected areas. Applying warmed blankets (B) and removing all wet clothing (E) are immediate steps to prevent further heat loss and start the rewarming process. Elevating the child's extremities (C) can reduce swelling and improve circulation. Administering antibiotics (A) is not indicated without evidence of infection. Massaging the hands and feet (D) is contraindicated in frostbite treatment as it can cause further tissue damage.

Deck 34: Thermal Injuries