FISDAP Special Populations and Environmental Emergencies Flashcards

A 7-year-old child is found unresponsive after submersion in a cold lake. Water temperature was 4°C (39°F). Which statement best guides resuscitation?

Answer: Cold water submersion may extend the resuscitation window due to neuroprotection

Cold water immersion can induce protective hypothermia that slows cerebral metabolism, potentially extending the viable resuscitation window in pediatric submersion victims.

When treating a bariatric patient weighing 180 kg, which airway management consideration is most important?

Answer: Elevate the head of the stretcher 20-30 degrees to improve respiratory mechanics

Positioning a morbidly obese patient with the head elevated (reverse Trendelenburg or ramped position) displaces abdominal contents, improving diaphragmatic excursion and oxygenation.

A nursing home patient with dementia is combative and appears to be in pain but cannot verbalize symptoms. Which assessment approach is most appropriate?

Answer: Use a behavioral pain scale such as PAINAD to assess nonverbal cues

The PAINAD (Pain Assessment in Advanced Dementia) scale uses behavioral indicators such as breathing, vocalizations, facial expressions, and body language to estimate pain in nonverbal patients.

An infant presents with a bulging fontanelle, high-pitched cry, fever of 39.8°C, and petechial rash. What is the most likely diagnosis and priority intervention?

Answer: Bacterial meningitis; establish IV access and transport rapidly

A bulging fontanelle, high-pitched cry, fever, and petechial rash are classic signs of bacterial meningitis, which requires rapid transport for IV antibiotics and possible lumbar puncture.

During a heat wave, a 72-year-old man is found confused in a non-air-conditioned apartment with a core temperature of 40.6°C (105°F) and anhidrosis. Which cooling method is most appropriate in the field?

Answer: Ice packs to groin and axillae combined with misting and fanning

For classic heat stroke, evaporative cooling (misting and fanning) combined with ice packs to high-blood-flow areas (groin, axillae, neck) is the preferred prehospital method due to practical feasibility.

A 16-year-old athlete collapses during football practice on a hot day. He is conscious, sweating profusely, and has muscle cramps. Vital signs are BP 100/60, HR 120, core temp 38.2°C. What is the most likely condition?

Answer: Heat exhaustion

Heat exhaustion is characterized by heavy sweating, weakness, mild hypotension, tachycardia, and core temperature below 40°C, distinguishing it from the neurological dysfunction of heat stroke.

A diver surfaces rapidly after a deep dive and develops joint pain, skin mottling, and neurological deficits. What condition do these signs suggest and what is the definitive treatment?

Answer: Decompression sickness (the bends); recompression therapy in a hyperbaric chamber

Decompression sickness results from nitrogen bubble formation in tissues during rapid ascent, causing joint pain and neurological signs that require hyperbaric recompression therapy.