3 Pearls Flashcards
stages of hypothermia
Mild HT I
conscious, shivering
Moderate HT II impaired consciousness (may or may not be shivering)
Severe HT III
Unconscious, vital signs present
Hypothermic cardiac arrests HT IV
vital signs absent
classic ECG findings seen in a hypothermic patient
The classic Osborn J waves usually occur below 32 C
- can be misdiagnosed as ST elevation MI
Models of heat injury in heat stroke
classic
exertional
confinement
Classic heat stroke
occurs during periods of high environmental heat stress
INcrease in core temp seen is often slow over period of HOURS TO DAYS
cardinal feature of heat stroke
altered sensorium
considered as early metabolic complication of heat stroke
hypokalemia
recommended first aid measures in snake bites
- retreat
- remain calm. movemen increases venom absorption
- immobilize extremity in a neutral position below the heart
- transport to a medical facility
- constriction bands
dosing of epinephrine
IM, 0.3-0.5 mg
(0.3 to 0.5 mL of 1:1000 conc’n)
pedia:
0.01 mg/kg
(up to 0.3 mg)
some indications for referrral for HBOT
Carboxyhemoglobin level ≥25% pregnancy carboxyhemoglobin level ≥15% AMI Hypotension Severe metabolic acidosis
which is used as prevention and treatment of hape?
High altitude pulmonary edema
Nifedipine
pathognomonic pattern of lightning injury
lichtenburg
most common chemical burns to the scalp in women
acetic acid
“The dilute (<40%) acetic acid solution found in hair-wave neutralizer solutions is perhaps the most common cause of chemical burns to the scalp in women
describe alkali burns
produce soft, gelatinous, friable, brownish eschars
treatment of acetic acid burn
initial treatment is copious water irrigation
oral antibiotics should be prescribed if the sdalp burn has created open skin lesions
remarks on exposur to white phosphorus
wood’s lamp examination aids identification of remaining phosphorus
copper sulfate solution should NOT be used espite its ability to detoxify phosphorus because it causes HEMOLYSIS and INCRESES MORTALITY
Most common sites of chemical burns
- hands
2. eyes
critical event in frostbite
endothelial damage, beginning at the point of thaw
tissue most susceptible to frostbite
bone marrow
tissue leaset susceptible to frostbite
cartilage
first degree frostbite
numbness, central pallor with surrounding erythema and edema, desquamation, dysesthesia
“frostnip”
second degree frostbite
blister of the skin with surrounding edema and erythema
full-thickness skin freezing
formation of clear blisters filled with fluid rich in thromboxane and prostaglandins
third degree frostbites
tissue loss involving the entire thickness of the skin
extends into the subdermal plexus
hemorrhagic blisters form and are assoc’d with skin necrosis and a BLUE-GRAY discoloration of the skin
patient may complain that the involved extremity feels like a “block of wood”, which is followed later by burning, throbbing, and shooting pains
fourth degree frostbites
extension into subcutaneous tissues, muscle, bone, and tenden
little edema
skin is mottled with nonblanching cyanosis
eventually forms a deep, dry, black, mummified eschar
