Chemical, Electrical, Hypo, Hyper Flashcards by Joshua Villella | Brainscape

Q

What is occurring to the tissue in an Acid chemical burn?

A

Coagulation

- Formation of touch eschar (dark scab, or flailing of dead skin), this may limit further damage

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Q

What is occurring to the tissue in an Alkalis burn?

A

Liquefactive necrosis; the transformation of tissue into a liquid mass
Will have deeper penetration

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Q

What are some factors that may alter signs and symptoms of a chemical burn?

A

pH
Concentration of agent
Contact time
TBSA
Physical form of the agent
Ingestion/inhalation/absorption

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Q

What considerations need to be made for the ingestion/inhalation of a chemical agent?

A

Dysphagia, stridor, wheezing, dyspnea, tachypnea

- Abdominal tenderness guarding, subcutaneous air

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Q

What forms of chemical burns should not be water irrigated?

A

Calcium
Metallic lithium
Potassium
Sodium
Magnesium

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Q

Do chemical burns receive the same fluid therapy as thermal burns?

A

Yes

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Q

Why does IOP ↑ in eye related chemical injuries?

A

Due to collagen hydration and inflammatory mediators

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Q

What are alkali chemical burns to the eye more detrimental?

A

Because alkali are lipophilic and can penetrate the eye structure.

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Q

What is the most dangerous acid known and why?

A

Hydrofluoric acid

- It contains fluoride ion that readily penetrates the skin causing destruction of deep tissue layers.

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Q

Can burns from Hydrofluoric acid be painless?

A

Yes

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Q

Why is the fluoride in HF so concerning?

A

Because fluoride has a high affinity to calcium, this results in the bones being attacked and causing hypocalcaemia.

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Q

What may fluoride poisoning cause?

A

Hypocalcaemia
Hyperkalaemia
Hypomagnesia
Death

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Q

What will retard diffusion of fluoride ion?

A

Ice pack

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Q

What are the categories of electrical burns?

A

Low voltage <1000v
High voltage >1000v
Lightning strike

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Q

What are the voltage distances that high voltage electricity will discharge through air?

A

1000v – will clear a few millimetres
5000v – will bridge 10mm
40,000v – will clear 130mm

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Q

What is the largest risk group for electrical burns?

A

Toddlers
Teenagers
Those who work with electricity

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Q

What may help determine the severity of electrical burns?

A

Current type – AC/DC
Volts
Intensity
Resistance
Area
Duration of contact
Environmental factors

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Q

What are the symptoms of electrical burns?

A

Contact burns
Thermal heating
Flash arc and flame burns
Blunt trauma
Prolonged muscle tetany

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Q

What typed of voltage will cause what rhythms?

A

Low V = VF

- High V = AF

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Q

What potential damage can domestic AC voltage cause?

A

Significant contact wounds
Cardiac arrest
But will not cause deep tissue contact

Q

What injuries can occur from high tension cables?

A

Flash burns – the significant electrical charge will cause combustible substances to ignite → burns.
Deep muscle damage may occur under apparently normal skin and may be life threatening.

Q

How does the pathway of damage appear in lightning strikes?

A

Over the skin, rather than through.

- Pt will have significant exit burns on their feet.

Q

What are treatment management of electrical burns?

A

12 lead – assess for arrhythmia
IV fluids to maintain renal perfusion
Manage entry and exit burns as per thermal burns
Pain relief
Manage arrhythmias accordingly

Q

What are causes of cryogenic burns?

A

Coolants such as, liquid nitrogen, methane and propane

Q

What is the treatment for cryogenic burns?

A

Rewarm with water between 40-42 degrees for 15-30 min
Analgesia
Active movement/motion
Avoid massaging the affected area

Q

What are the levels of hypothermia severity?

A

Mild – 32 to 35 c
Moderate - 28 to 32 c
Severe - <28 c
Death - <24 c

Q

How will a patient present with mild hypothermia?

A

Conscious
Increase HR and BP
Shivering
Lethargy
Hunger

Q

How will a Pt present with moderate hypothermia?

A

ACS/confusion
No shivering
Uncoordinated movement
Myocardial irritability /potential for arrhythmias

Q

How will a Pt present with Sever hypothermia?

A

Unconscious
Present vital signs
Hypercapnic
Mya be cyanosed
Arrhythmias

Q

Explain the pathophysiology of hypothermia.

A

Exposure of cold stimulus = peripheral vasoconstriction and an increase in catecholamine release.
↑ results in an over increase in basal metabolic rate
Shivering results in try increase Temp
Once <32c occurs shivering will stop
Dehydration
<30 c no glucose transfer = energy depletion
Decrease HR, BP and RR
Drop in Ph = Acidosis
Fluid shift from intravascular space to interstitial space
<24c cardiac and resp failure

Q

Hypothermia risk factors

A

Elderly
Dementia
Neonates
Children
Trauma – Can be fatal in this pT
Alcohol
Immersion

Q

What are the progression of cardiac rhythms in hypothermia?

A

ST > SB > AF > VF
Osborne /J-waves will be seen
Lower the body temp the Higher the J-wave

Q

What is the worst part of frostbite?

A

Secondary thawing

Q

What is the classification of Hyperthermia?

A

Marked warming of the core body temp >38c

Q

What is the classification of sever hyperthermia?

A

CBT >39.5c

Q

What controls the bodies core temperature?

A

Hypothalamus

Q

What are the body mechanism for heat loss?

A

Radiation
Conduction
Convection
Evaporation
Vasodilation

Q

In hyperthermia what are the causes of loss of fluid?

A

External heat source
Exercise
Infection
Seizures

Q

List some risk factors of hyperthermia.

A

Long periods of warm weather
High humidity
Athletes
Military
Labourers
Elderly
Infants and small children

Q

Explain the pathophysiology of hyperthermia.

A

The excessive heat denatures proteins and de-stabilizes lipids
Redistribution of blood flow + loss of fluids and electrolytes
Apoptosis in cells occurs
Organ system failure

Q

At what temp do convulsion occur?

A

41 c

Q

At what temp does death occur in hyperthermia?

A

43c

Q

What are the causes of cramps?

A

Water and sodium loss an water replacement.

Q

How will Pt present with Heat stress /cramps?

A

Alert
Pale sweaty
Tachycardia
Weakness
Nausea
Painful cramps lasting minutes

Q

Treatment of Pt with heat stress/cramps

A

Gentle stretching
Move to cooler place
Oral fluids
Avoid salt tablets.

Q

At what temp is heat exhaustion categorised as?

A

CBT <40c

Q

At what temp is heat stoke categorised as?

A

CBT >40c

Q

What is occurring to the body during heat stroke?

A

The body is unable to regulate temperature through hypothalamic thermostat.

Q

What is the ideal temp for cool fluids?

A

<10c but as close to 4 c as possible.