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19-40-1C > Advanced Diving Medicine > Flashcards

Advanced Diving Medicine Flashcards

This topic will familiarize the trainee with Advanced Diving Medicine procedures

1
Q

What is “Half-Time”

A

The amount of time required for a tissue to become 50% saturated with a gas

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2
Q

What is “Saturated”

A

Tissues are considered “Saturated” after six half-times or 98.4%

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3
Q

What is “Tissue Perfusion”

A

The act of getting oxygen via blood from the lungs to the tissues

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4
Q

What is “Tribonucleation”

A

Bubbles created when two surfaces in a vicus are rapidly separated or moved relative to each other

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5
Q

What are seed bubbles

A

pre-exsisting bubbles or gas micronuclei that form into larger bubbles following a dive

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6
Q

What is isobaric counter diffusion

A

Superaturation due to a lighter gas moving into tissue faster than heavier gas can move out

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7
Q

What is a kinin

A

Its a polypeptide that influences smooth muscle contraction inducing hypotension, increasing the blood flow and permeability of small blood capillaries and inciting pain

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8
Q

What is the max time on oxygen

A

Three hours

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9
Q

Type I DCS symptoms

A

Joint Pain
Skin (marbling)
Swelling and pain in the lymph nodes

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10
Q

Type II DCS symptoms

A

Neurological
Inner ear (staggers)
Cardiopulmonary (Chokes)

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11
Q

What do you need to get pulmonary O2 Toxicity

A

History of long exposure of O2 concentration greater then .5 ATA

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12
Q

Pulmonary O2 Symptoms

A

Burning pain on inspiration
Cough
Shortness of breath- dyspnea

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13
Q

What is AVPU

A

Alert
Voice
Pain
Unresponsive

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14
Q

Normal Temperature

A

98.6 +/- a few tenths

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15
Q

Normal Pulse

A

60-80 BPM

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16
Q

Tachycardia

A

> 120 BPM

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17
Q

Bradycardia

A

< 60 BPM

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18
Q

Normal Respirations

A

12-16

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19
Q

Tachypnea

A

> 22-30 Breaths per Min

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20
Q

Normal Blood Pressure

A

120/80 +/- 10

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21
Q

Wheezes

A

high pitch sound, constriction of bronchi/bronchioles

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22
Q

Ronchi

A

coarse gurgling sound

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23
Q

Rales

A

popping sound (crackles)

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24
Q

CNS O2 Toxicity occurs when ppO2 exceeds

A
  1. 3 ATA in wet environment

2. 4 ATA in dry environment

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25
Q

When should a nero exam NOT be completed prior ro recompression

A
  • Acute or recent onset of a gross neurological deficit
  • Diver surfaces unconscious
  • Symptomatic omitted decompression
  • Severe symptoms preventing patient from completing nero exam
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26
Q

What are the six parts of a neurological exam

A 
1 - Mental Status 
2 - Coordination 
3 - Cranial Nerves 
4 - Sensory 
5- strength 
6 - Deep Tendon Reflexes (DTR)
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27
Q

What are the 12 cranial nerves

A 
I Olfactory (Smell)
II Optic (visual)
III Oculomotor (Pupil)
IV Trochlear (Look inward)
V Trigeminal (Facial sensation)
VI Abduction (lateral movement of eyes)
VII Facial (Face movement)
VII Auditory (Hearing)
IX Glossopharyngeal (gagging)
X Vegas 
XI Sinal Accessory 
XII Hypoglossal (Movement of tongue)
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28
Q

Dermatomes are mostly _____ on the trunch of the body

A

Horizontal

29
Q

Dermatomes are mostly _____

on the extremities

30
Q

What is the grading scale for patient strength

A 
5 - Normal
4 - Mild weakness 
3- Moderate weakness 
2- Severe weakness 
1 -Profound weakness 
0 - Paralysis
31
Q

What is the temperature for heat stroke?

32
Q

VENTID-C

A 
V-Visual disturbances 
E-Ears, rining, roaring 
N-Nausea 
T-Twitching
I-Irritability 
D-Dizziness
C-Convulsions
33
Q

When is CO poisoning most likely to occur?

34
Q

What are the 5 types of shock

A 
Anaphylactic 
Cariogenic 
Hemorrhagic 
Neurogenic 
psychogenic
35
Q

Cause of anaphylactic shock

A

Caused by a severe allergic reaction

36
Q

Cause of cardiogenic shock

A

Caused by a heart attack or poor heart function

37
Q

Cause of hemorrhagic shock

A

Large amount of uncontrolled bleeding or hemorrhaging. Also known as hypovolemic

38
Q

Cause of neurogenic shock

A

Uncontrolled dilation of the blood vessels due to nerve paralysis cause by spinal cord injury

39
Q

Cause of psychogenic shock

A

Caused by fright or fear

40
Q

Three stages of shock

A

compensated
decompensated
irreversible

41
Q

What size catheter do you use for needle thoracostomy

A

Large bore Over-The Needle 3.25”

14 or Larger gauge

42
Q

What are the 2 site selection for needle thoracostomy

A
  • 3rd intercostal space, midclavicular over the affected lung
  • secondary 5th intercostal space anterior axillary line
43
Q

What are the two types of IV fluids

A
  • Ringers Lactate

- Normal Saline

44
Q

What is the typical gauge for IV fluid replacement in adult patients

45
Q

Marco drip

46
Q

Standard drip chamber

A

15-20 gtts/ml

47
Q

Micro drip

A

60 gtts/ml

48
Q

What is the only authorized antiseptic used in the chamber

A

Providone iodine solution (Betadine)

49
Q

What is the minimum urine output for a patient

A

30 cc/hr (>.5cc/kg/hr)

50
Q

IV rate for rehydrate

51
Q

IV rate for maintenance

A

100-150ml/hr

52
Q

IV rate limited

A

<100ml/hr (AGE, DCS, head trauma)

53
Q

IV rate bolus

A

500-2000ml ASAP (Shock, dehydration)

54
Q

IV rate keep open KVO

55
Q

When selecting a site for IV start ______ and work ______

A

distal

proximal

56
Q

Insert the IV needle?

A

Bevel up and at a 30 degree angle

57
Q

Indications for a urinary catheterization

A
  • AGE inability to void
  • DCS inability to void
  • Relieve bladder distention
  • Unconscious patient
  • Monitor intake and output
58
Q

Lumbercate ____ of the catheter before insertion for catheterization

59
Q

Only insert ______ of the catheter for females

60
Q

For catheterization in males

A

insert 2 inches and slowly insert further until you note urine flow or hit an obstruction

61
Q

With catheterization only remove how much to prevent bladder shock/spasm

A

700-1000ml

62
Q

If you remove >700ml of urine at once in a catheterization do what?

A

Clamp for 30 minuets to 1 hour and then continue

63
Q

What is adequate urine output during recompression

A

.5cc/kg/hr

64
Q

Rate of O2 administration for non-rebreather and nasal canual

A

12-15lmp non-rebreather

4-6lmp nasal cannula

65
Q

Consider pulmonary oxygen toxicity after

A

Normally after 12 hours on the surface

66
Q

When is the only time fluids are contraindicated

A

Patient suffering from the chokes

67
Q

Lidocaine is used for ___ patients and not used for ____ patients

A

Is used for AGE patients

Is not recommended for DCS

68
Q

What animal gives a symptom of a wound extremely painful and has a bluish trim

19-40-1C (5 decks)

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