A 24-year-old man has called 911 after experiencing heart palpitations and dizziness. You direct your partner to apply a 4-lead ECG and see a narrow complex tachycardia on the monitor at a rate of 196 bpm. The patient is wearing a halter monitor and states, My doctor is making me wear this because I keep having these episodes. How should you handle the presence of the halter monitor?
A) Leave it in place and alter your treatment so as not to disturb the monitor.
B) Remove the monitor and treat the patient per protocol.
C) Leave the monitor on and delay treatment until you arrive at the ED.
D) Contact the hospital for medical direction.
Question 2
A patient has been pulled from a pool in which he was submerged for several minutes. He is pulseless and apneic. An Emergency Medical Responder asks you if you want to press on the man's abdomen to remove the water from his stomach. Which one of the following is the most appropriate reply?
A) That sounds good. We need to get that water out of him to minimize the risk for an infection.
B) Let's hold off on that until we see how well we can ventilate the patient.
C) That is no longer recommended in the care of the submersion patient.
D) Yes. But let's turn the patient onto his front so the water can drain naturally.
The nitrogen cycle. Numbers represent fluxes as 1012 g N per year (data from Schlesinger 1991, after
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