13 Environmental Flashcards
what is chillblains
aka Pernio
red/blue plaques on skin with itchy, burning pain
difference btwn frostnip and frostbite
retrospective dx: after rewarming, if no tissue loss, it is frostnip not frostbite
frostbite grading
1-2 degree: superficial, dermis only, good prognosis
3-4 degree: deep, SQ to bone. poor prog
Debride blisters in frostbite?
per hippo:
generally ok to debride clear blisters, leave hemorrhagic ones alone
hypothermia stages by temp
what are the signs/sxs
mild 32-35: shivering etc
mod 30-32: NO shivering. AMS, ataxia, osbourne J waves
severe <30: dysrhtyhmias,
when does shivering stop in hypothermia
when <32: going fromild to mod hypothermia
hypothremic arrest pt
shock?
can try 1 shock for Vfib
hypothermia rewarming goal in arrest
goal of 30C from severe to mod) in arrest. If still arrest likely not hypothermia the cause
X
X
High altitude emergencies:
acute mountain sickness, HAPE, HACE
Diving pathology/emergencies:
how to think about them
2 classes:
- Barotrauma–localized, POPS-AGE
- Dissolved gas problems–O2 tox, nitrogen narcosis, DCS
What is POPS-AGE
Pulmonary over pressurization syndrome,
Acute gas embolism (severe POPS)
When you ascend during diving but don’t breathe out-> alveoli rupture. you can get PTX, pneumomediastinum,
AGE is severe POPS. Can get arrest/AMS/sz/stroke. THIKN THIS IF SXS OCCUR WITHIN 10 MIN of surfacing
Diver surfaces, then upon arriving at surface becomes unconscious
think what
Think AGE- acute gas embolism (severe POPS)
as opposed to DCS which is usu more gradual like hours
nitrogen narcosis
- what is it
- when does this happen
- ‘drunk’ bx
- occurs when >100 ft below surface, tx to ascend
02 toxicity in diving
-what is it, sxs
Too deep->too much O2 breathed in, causes seizures, vision change, muscle twitch
- occurs in industrial divers going very deep, think >300ft deep). Or in divers increasing O2 % in tank
