Endocrine & Hematologic Emergencies

Question 1

What is a common presentation for diabetic emergencies?

Answer 1

Altered Mental Status (changes in consciousness level or behavior).

Question 2

Which condition, hyperglycemia or hypoglycemia, is particularly time-sensitive and requires immediate glucose administration?

Answer 2

Hypoglycemia, to prevent permanent brain damage.

Question 3

How does the endocrine system primarily affect bodily functions?

Answer 3

Through hormone messengers that influence nearly every cell, organ, and function.

Question 4

What are the four main components of blood?

Answer 4

Red blood cells, white blood cells, platelets, and plasma.

Question 5

Which component of blood is responsible for carrying oxygen to tissues?

Answer 5

Hemoglobin in red blood cells.

Question 6

Which two hormones, produced by the Islets of Langerhans, maintain blood glucose balance, and what do they do?

Answer 6

Insulin (lowers blood glucose) and Glucagon (raises blood glucose).

Question 7

What two substances does the brain require a constant supply of to function properly?

Answer 7

Glucose and Oxygen.

Question 8

What is the underlying cause of Type 1 Diabetes?

Answer 8

Autoimmune attack where the immune system destroys pancreatic beta cells, resulting in total insulin deficiency.

Question 9

What is the classic triad of symptoms (the 3 P’s) for new-onset Type 1 Diabetes?

Answer 9

Polyuria (excessive urination), Polydipsia (extreme thirst), and Polyphagia (increased hunger).

Question 10

What is the cause of DKA, and what type of breathing/breath odor is indicative of it?

Answer 10

Severe insulin deficiency leading to uncontrolled fat metabolism and ketone production. Sign: Kussmaul respirations (deep, rapid) and sweet, fruity breath odor.

Question 11

What is the primary problem in Type 2 Diabetes?

Answer 11

Insulin resistance at the cellular level (cells don’t respond properly to insulin).

Question 12

Why is symptomatic hypoglycemia so dangerous?

Answer 12

It causes brain starvation because brain cells cannot function without adequate glucose supply.

Question 13

Describe the skin signs typically seen in hypoglycemia.

Answer 13

Pale appearance, moist texture, and Diaphoresis (sweating) is common.

Question 14

Describe the skin and circulatory signs typically seen in hyperglycemia (DKA/HHS).

Answer 14

Dry, warm skin and signs of dehydration (potentially weak, thready pulse).

Question 15

When should oral glucose (gel, tablets, or liquid) never be given?

Answer 15

To unconscious patients or those who cannot swallow safely.

Question 16

What is the mnemonic used to remember potential causes of Altered Mental Status?

Answer 16

AEIOU-TIPS (Alcohol, Epilepsy, Insulin, Oxygen, Uremia, Trauma, Infection, Psychological, Stroke/Sepsis).

Question 17

What causes the painful symptoms in a Sickle Cell Crisis?

Answer 17

Abnormally shaped red blood cells block small blood vessels, impairing oxygen binding and creating clots.

Question 18

What is the core defect in Hemophilia?

Answer 18

Decreased ability to create blood clots after injury, which can be life-threatening.

Question 19

What is the primary danger associated with Thrombophilia?

Answer 19

Blood clot formation (thrombosis) that can create blockages, such as a Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE).

Question 20

Why can pulse oximetry be misleading in a patient with Anemia?

Answer 20

Pulse oximetry may show normal values even though the blood’s oxygen-carrying capacity is reduced, leading to tissue hypoxia.

Question 21

EMT-Basic (EMT)

Answer 21

The backbone of the EMS system, providing Basic Life Support (BLS) care, including automated external defibrillation and airway management. Training is typically 150-200 hours.

Question 22

Emergency Medical Responder (EMR)

Answer 22

Provides immediate basic care for a patient while waiting for an ambulance and higher-level providers to arrive.

Question 23

Advanced EMT (AEMT)

Answer 23

An EMS provider level that includes training in IV therapy and the administration of limited medications, in addition to BLS skills.

Question 24

Paramedic

Answer 24

The highest level of prehospital care provider, with the most comprehensive training (1,000-1,300+ hours), authorized to perform Advanced Life Support (ALS) procedures.

Question 25

1966 White Paper

Answer 25

The landmark document, "Accidental Death and Disability: The Neglected Disease of Modern Society," which highlighted the need for improved prehospital emergency care and formally established modern EMS.

Question 26

Emergency Medical Services Act of 1973

Answer 26

Federal legislation that provided funding and created a framework to formalize and improve EMS systems across the United States.

Question 27

NHTSA's EMS Agenda for the Future

Answer 27

A policy document from the 1990s that helped standardize EMS training and guide the future development of the profession.

Question 28

Public Access

Answer 28

The initial component of the EMS system, beginning with the 9-1-1 system and dispatchers who obtain information and coordinate resources.

Question 29

Emergency Medical Dispatch (EMD)

Answer 29

Protocols used by dispatchers to provide pre-arrival instructions to callers, which can include CPR guidance or bleeding control.

Question 30

Medical Direction

Answer 30

Physician oversight of patient care in the EMS system, provided through standing orders (off-line) and direct communication (online).

Question 31

Off-line Medical Direction (Indirect)

Answer 31

Physician oversight provided through standing orders, protocols, and training, without needing to directly speak to the EMT on a call.

Question 32

Online Medical Direction (Direct)

Answer 32

Physician oversight that occurs when the EMT calls or communicates directly with a physician or nurse at the receiving facility to obtain orders for a specific patient.

Question 33

Quality Management

Answer 33

A vital responsibility of the medical director to ensure all staff consistently meet the standard of care; often uses the Plan-Do-Study-Act cycle for improvement.

Question 34

Just Culture

Answer 34

A quality management approach in EMS that balances accountability with a learning environment, focusing on improving systems rather than merely assigning blame for errors.

Question 35

Mobile Integrated Health Care (MIH)

Answer 35

An evolution of EMS that expands the scope beyond emergency response to include preventive care, chronic disease management, and home visits within the community.

Question 36

Community Paramedicine

Answer 36

A component of MIH where specially trained paramedics provide extended, non-emergency services outside of the traditional emergency context.

Question 37

EMT Responsibility: Scene Leadership

Answer 37

Involves evaluating the scene for safety, gaining safe patient access, and coordinating any additional resources needed.

Question 38

EMT Professional Conduct

Answer 38

Essential behaviors including integrity, empathy, self-motivation, clear communication, teamwork, and patient advocacy.

Question 39

HIPAA (Health Insurance Portability and Accountability Act)

Answer 39

Federal law that governs patient confidentiality and requires EMTs to maintain strict privacy regarding all patient information.

Question 40

Informed Consent

Answer 40

The patient's right to accept treatment after an EMT explains the nature of the treatment, the risks, and the benefits; required except in specific emergency situations.

Question 41

Patient Autonomy

Answer 41

The legal and ethical principle that patients have the right to accept or refuse treatment (the right to self-determination).

Question 42

Evidence-Based Practice (EBP)

Answer 42

An approach to prehospital care focusing on procedures and interventions proven to improve patient outcomes through systematic research and analysis.

Question 43

National Model EMS Clinical Guidelines

Answer 43

A resource from the National Association of State EMS Officials (NASEMSO) that synthesizes research and expert consensus to establish evidence-based protocols for EMS systems.

Question 44

Primary Prevention

Answer 44

EMS involvement in community education about injury prevention, healthy lifestyles, and early recognition of medical emergencies (e.g., CPR classes, child safety seat checks).

Question 45

Secondary Prevention

Answer 45

EMTs helping identify health risks during patient encounters and connecting individuals with appropriate resources (e.g., screening for chronic conditions or recognizing signs of abuse).