Class 9 (3/4/21) - PTSD and thermias Flashcards
PTSD
To be diagnosed with PTSD, an adult must have all of the
following for at least 1 month:
- At least one re-experiencing symptom
- At least one avoidance symptom
- At least two arousal and reactivity symptoms
- At least two cognition and mood symptoms
- Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating.
- Staying away from places, events, or objects that are reminders of the traumatic experience.
PTSD - AVOIDANCE SYMPTOMS INCLUDE:
Staying away from places, events, or objects that are reminders of the traumatic experience
- Avoiding thoughts or feelings related to the traumatic event
PTSD - AROUSAL AND REACTIVITY SYMPTOMS
INCLUDE:
- Being easily startled
- Feeling tense or “on edge”
- Having difficulty sleeping
- Having angry outbursts
- Arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic events.
- These symptoms can make the person feel stressed and angry.
- They may make it hard to do daily tasks, such as sleeping, eating, or concentrating.
PTSD - COGNITION AND MOOD SYMPTOMS
INCLUDE:
- Trouble remembering key features of the traumatic event
- Negative thoughts about oneself or the world
- Distorted feelings like guilt or blame
- Loss of interest in enjoyable activities
PTSD - RE-EXPERIENCING SYMPTOMS INCLUDE:
- Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
- Bad dreams
- Frightening thoughts
PTSD - TREATMENTS AND THERAPIES
The main treatments for people with PTSD are medications, psychotherapy (“talk” therapy), or both
Medications of PTSD
The most studied type of medication for treating PTSD are antidepressants, which may help control PTSD symptoms such as sadness, worry, anger, and feeling numb inside.
PTSD - PSYCHOTHERAPY
- Psychotherapy (sometimes called “talk therapy”) involves talking with a mental health professional to treat a mental illness.
- One helpful form of therapy is called cognitive behavioral therapy, or CBT. CBT can include:
1. Exposure therapy. This helps people face and control their fear.
2. Cognitive restructuring. This helps people make sense of the bad memories. Sometimes people remember the event differently than how it happened.
Hyperthermia - major causes
- Exercise-associated collapse (EAC)
- Heatstroke
- Drug related heat illness
PATHOPHYSIOLOGY OF HYPERTHERMIA
- Core body temperature >41.5°C
- Progressive denaturing of vital cellular proteins
- Failure of vital energy-producing processes
- Loss of cellular membrane function
- Organ dysfunction:
- cardiovascular dysfunction, electrolyte disturbance, renal failure, liver failure, permanent neurological damage
Hyperthermia - Heatstroke
- Hallmark is failure of the hypothalamic thermostat
- Leading to hyperthermia and organ dysfunction
- Exertional heatstroke due to exercise in a thermally stressful environment
- Classic heatstroke occurs in patients with impaired thermostatic regulation
RISK FACTORS FOR HEATSTROKE
- Athletes
- Exertion
- Inappropriate exposure to high heat &/or humidity
- Babies left in cars
- Manual workers
- Drugs: ▸ Anticholinergics ▸ Diuretics ▸ Phenothiazines ▸ Salicylates ▸ Stimulants/hallucinogens
Prevention of heatstroke
- Education of at risk groups
- Exercise in high heat and humidity environments should be limited.
Clinical feature of heatstroke
Neurological dysfunction
▸Loss of consciousness is a constant feature
▸Core temperature >41.5°C
▸Hot dry skin
▸Profuse sweating
▸Other features include, tachycardia, hyperventilation, seizures, vomiting and hypotension
TREATMENT FOR HEATSTROKE
▸Medical emergency!!! Early recognition and early treatment decrease morbidity and mortality.
▸Need aggressive cooling of 0.1°C/min
▸Remove clothing, fine mist spray, ice packs neck, axilla & groin
▸Iced water immersion, ice slush, cool water immersion, iced
peritoneal lavage and drugs (paralysis with ventilatory support)
▸IV fluids should be used judiciously
