Question is driving me crazy???

asuwrestler

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In medic class we has a chapter test and one of the questions was this and i still canoot find out the answer?

Which creature has the most powerfull neurotoxin:
A-Pit Viper
B-Coral Snake
C-Black Widow
D-Scorpion

Here was another but i think i know this answer:

Your patient presents with audible wheezes, as you are preparing an Albuterol SVN the wheezes stop. What is your next action?
A-Continue with SVN
B-Monitor their condition
C-Prepare to intubate the patient
D-BVM w/high flow O2
 
This first question sent me dlying toward my self of Wilderness EMS Books. And in the end, the question is worded in a way that makes it hard to answer. Most powerfull neurotoxin vs. Most venomous. If you are sure the question is in reference to neurotoxin then where are we talking about? A North American EMS Text Book may be dramaticly differnt in this regard than a Ausie EMS Text Book. For instance, while off the top of my head I would have answered Coral Snake, according to what I just read on some of wilderness EMS handouts: The most power neurotoxins are as follows:

1. The poison Dart Frog (south america). You touch the frog and touoch your lips you are dead in 3 paces.
2. Inland Taipan (Australian Snake). A typical strike contains enough neurotoxins to kill 100 people.
3. Sydney Funnel Web Spider (Australia again). It's agressive and can kill you in 15 minutes.
4. Stonefish (Australia again - glad I don't work there). Stops all fish that it stings... dead in tehir tracks. Causes thock and death in humans.
5. Dead Stalker Scorpion (North Africa and Middle East). Causes an intense and unbearable pain, then fever, followed by coma, convulsions, paralysis and death.

None of these are in North America, but the question you gave didn't specify what type of pit viper or scorpion. If #2 is not a pit viper, I would answer your question as scorpion sicnce teh quetion never specifies if this question is North America specific. However, based on my experience in North America, pit viper hits rarely do anything. I don't have coral snakes in my region, so don;t know. Black Widows are nasty but not usually fatal. Scorpion in my area are pretty tame adn not a big concern... however, according to one of teh NOLS Wilderness EMS Book I have: "Only one type of North American scorpion, a small yellowish species of teh genus Centruroides, is dangerous. It lives in Mexico, Arizona, New Mexico and maybe Utah." Even then, fatalities are usually only in teh old and youn, like most poisonous creatures in North America. Like I said, the question is tooo generic to be truthfully answered. Anyone who gets it wrong has cause to challenge it, as is the case with many multiple choice questions.
 
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Black Widow, by far.


Coral snake is the second most venemous North American snake, but it uses a much larger supply of venom then compared to a black widow when the bite occurs.
 
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Haven't started medic school yet, no clue :sad:


Though my money is on monitor their condition, as that's what you always do before and after a drug administration.
 
Your patient presents with audible wheezes, as you are preparing an Albuterol SVN the wheezes stop. What is your next action?
A-Continue with SVN
B-Monitor their condition
C-Prepare to intubate the patient
D-BVM w/high flow O2


Is the pt still breathing?

Cause the last 2 options wreak of optimism. Is there scope in option 2 to assume all is well and no action is required and we can go home
 
Black Widow, by far.

Coral snake is the second most venemous North American snake, but it uses a much larger supply of venom then compared to a black widow when the bite occurs.

Do you have any references you can link us to on this one, Chief? Because after almost an hour of reading my textbooks and checking out wilderness EMS sites I'm still not sure. If we are talking North America, then the Black Widow might be true. What I read stated that the Black Widow has a neurotoxic concentration 15 times that of a rattler and was the deadlist spider in North America, but NO DEATHS have been reported in North America in 10 years! Even the Brown Recluse has at least one confirmed death in that time and a host of serious conditions that have been survived. Likewise, pit vipers have several deaths a year in the U.S. I know we are not talking most venemous or most deaths, but can you site a place to confirm the Widow as the most powerful neurotoxin in North America?
 
1. The poison Dart Frog (south america). You touch the frog and touoch your lips you are dead in 3 paces.

Why not just kiss the frog?:P


4. Stonefish (Australia again - glad I don't work there). Stops all fish that it stings... dead in tehir tracks. Causes thock and death in humans

They have these in pretty much any warm ocean areas. When I lived on Guam we always had to look out for them when we were swimming or SCUBA diving. Also, the Lionfish is just as deadly. I believe they have the same venom/toxin.

Stonefish:
w_stonefish.jpg


Lionfish:
P7140217_300x400_LionFish.jpg
 
It would be A. Pit Viper-Since 75% of the time they release venomn and only 50% for coral. (11th Edition Brady Emergancy guide).

As for #2 I am not a medic, I would say Either monitor or BVM/O2
 
Sorry for got to look at widow and recluse. The widow has more devastating effect up front, but usually not deadly more like having a bad food poisoning effect (have been bit). Recluse of fiddleback, I think is more neuro do to it kills off tissue and can cause limbs to have to be removed in 48-72hour period.
 
For the second question, I would prepare to intubate. When the chest becomes quiet, the wheezes have not spontaneously resolved - the patient is no longer moving air. Note that preparing to intubate includes pre-oxygenation with BVM and high flow O2...
 
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In medic class we has a chapter test and one of the questions was this and i still canoot find out the answer?

Which creature has the most powerfull neurotoxin:
A-Pit Viper
B-Coral Snake
C-Black Widow
D-Scorpion

Here was another but i think i know this answer:

Your patient presents with audible wheezes, as you are preparing an Albuterol SVN the wheezes stop. What is your next action?
A-Continue with SVN
B-Monitor their condition
C-Prepare to intubate the patient
D-BVM w/high flow O2

Did they stop wheezing because they stopped breathing?
intubate then BVM
 
It would be A. Pit Viper-Since 75% of the time they release venomn and only 50% for coral. (11th Edition Brady Emergancy guide).

As for #2 I am not a medic, I would say Either monitor or BVM/O2

I'm reading out of a 9th Edition Brady and (assuming it is worded similar to the 11th) there is no mention of any on the mentioned species as have a "more powerfull neurotoxin". The mention that approx 8,000 people in the U.S get bit by a poisonous snake every year and there are fewer than 10 deaths a year. The numbers you mention have nothing to do with the power of the neurotoxin, but with the ratio of dry bites versus envenomations. the next line in my book reads; "The venomous bite from a diamondback rattler or coral snakes is considered very serious." That's why I stated Coral Snake, but I have yet to see the words in any tect book that says, "MOST POWERFUL NEUROTOXIN." Death rates and the number of bites in the U.S. is not in question.
 
I'm reading out of a 9th Edition Brady and (assuming it is worded similar to the 11th) there is no mention of any on the mentioned species as have a "more powerfull neurotoxin". The mention that approx 8,000 people in the U.S get bit by a poisonous snake every year and there are fewer than 10 deaths a year. The numbers you mention have nothing to do with the power of the neurotoxin, but with the ratio of dry bites versus envenomations. the next line in my book reads; "The venomous bite from a diamondback rattler or coral snakes is considered very serious." That's why I stated Coral Snake, but I have yet to see the words in any tect book that says, "MOST POWERFUL NEUROTOXIN." Death rates and the number of bites in the U.S. is not in question.

Yes, I am re answered back to the spiders in post two, for got about them in my answer, and was thinking venom, i apologize. and ya, it reads about the same as your 8th edition.
 
It asked for most powerful neurotoxin, not deadliest. Therefo, Black Widow, as you stated you read.
 
It would be the Blackwidow, by concentration.

Coral snake is a hemotoxin.
 
In medic class we has a chapter test and one of the questions was this and i still canoot find out the answer?

Which creature has the most powerfull neurotoxin:
A-Pit Viper
B-Coral Snake
C-Black Widow
D-Scorpion

truthfully don't know or care, Going to be way more concerned with how to fix it.

Here was another but i think i know this answer:

Your patient presents with audible wheezes, as you are preparing an Albuterol SVN the wheezes stop. What is your next action?
A-Continue with SVN
B-Monitor their condition
C-Prepare to intubate the patient
D-BVM w/high flow O2

I just have to ask did the patient miraculously get better? But given the options I would choose A unless it stipulated breathing stopped.
 
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In medic class we has a chapter test and one of the questions was this and i still canoot find out the answer?

Which creature has the most powerfull neurotoxin:
A-Pit Viper
B-Coral Snake
C-Black Widow
D-Scorpion

Here was another but i think i know this answer:

Your patient presents with audible wheezes, as you are preparing an Albuterol SVN the wheezes stop. What is your next action?
A-Continue with SVN
B-Monitor their condition
C-Prepare to intubate the patient
D-BVM w/high flow O2

No idea on the first one.

The second one, if you assume that the patient has asthma (why are you preparing albuterol?) then when wheezes stop, the patient is in ventilatory failure. I'm not sure I like the question, but I base the answer on this:
Michigan EMS Expo 2004 ; Bob Page, AAS, NREMT-P, CCEMT-P, I/C ; Asthma: Pathophysiology
You can find the document here: Asthma Pathophysiology

It states under asthma assessment findings: Absence of wheezing = ventilatory failure

stay safe
-B
 
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