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EMS Boards > Clinical mgmt, Caustics, Violatile agents > Flashcards

Clinical mgmt, Caustics, Violatile agents Flashcards

1
Q

Most common cause of poisonings

A

Ingestion (83%)

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2
Q

Prolonged QT toxin antidote

A

Magnesium

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3
Q

Caustics vs Corrosive

A

Caustic: Cause tissue injury via chemical reaction
Corrosive: one that will destroy and damage substances (type of caustic substance)

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4
Q

3 things that cause damage in caustics

A
  1. Concentration and duration of contact
  2. Amount and state (liquid, solid, etc)
  3. Physical properties such as tissue penetration
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5
Q

Solid vs liquid caustic ingestion site of injury

A

Solid: proximal injury (oropharynx, proximal esophagus)
Liquid: distal injury (stomach)

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6
Q

Common acids

A

Toilet bowl cleaners
Batter liquids
Rust removers and metal cleaners
Cement cleaning
Drain cleaning
Zinc chloride

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7
Q

Common bases

A

Bleaches (most common)
Drain and oven cleaning products
Ammonia (tub cleaners)
Swimming pool cleaners
Dishwasher detergent
Hair relaxers
Flintiest tablets
Cement

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8
Q

What should not be used for caustic airway management?

A

Blind insertion devices and nasotracheal airways (due to damaged soft tissue)
Go straight to crich or needle crich
No NG tube, no charcoal

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9
Q

Why do you not induce emesis for caustic ingestion

A

Can cause an exothermic reaction (similar to trying to neutralize)

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10
Q

HF properties

A

Colorless gas or liquid
Used to make refrigerants, herbicides, aluminum, METAL ETCHING

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11
Q

Electrolyte abnormalities in HF exposure

A

Hyperkalemia
Hypomagesemia
Hypocalcemia

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12
Q

Pain in HF acid

A

Out of proportion to injury

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13
Q

Tx for HF

A

SQ 5% calcium gluconate (not CaCl)
Ice packs (slows diffusion of fluoride ion)

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14
Q

Lab abnormality in field for cyanide

A

Markedly elevated lactic acid (>10)

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15
Q

Why is cyano antidote kit not used
What is in it

A

Causes methoglobinemia
Amyl nitrite, sodium nitrite, sodium thiosulfate

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16
Q

How does hydroxycolbamin work in cyanide

A

Combines with cyanide forming really excreted cyanocolabamin

17
Q

AE of hydroxycobalamin

A

Reddish skin and urine
Allergic reaction
Hypertension

18
Q

Toilet bowl cleaner and bleach makes

A

Chloramine gas

19
Q

Hallmark symptoms of phosgene

A

Dyspnea
Cough is prevalent (may be dry, later frothy and pink for non cariogenic pulmonary edema)
Symptoms can be delayed - usually admitted for 1-2 days

20
Q

Phosgene odor

A

Freshly mown hay

21
Q

Blistering agents also called

A

Vesicants

22
Q

Immediate and delayed effects of blistering agents

A

immediate - desquamation/fluid filled painful blisters, corneal damage
delayed- pulmonary edema, secondary infection
can be carcinogenic (bone marrow suppression)

23
Q

Lewisite facts

A

Pain and irritation in seconds to minutes
Geranium odor
Causes low BP and shock (Distributive shock)
Has antidote - Dimercaprol (chelating agent)

24
Q

Ogranophosphate type of toxin

A

Cholinergic (bradycardia, bronchorrhea , bronchoconstriction)

25
Q

Neuromuscular effects of organophosphates

A

Twitching, paralysis, weakness, respiratory failure

26
Q

Intermediate syndrome of organophosphates

A

Late effect 1-4 days after clinical improvement
Return of weakness and neuromuscular symptoms

27
Q

Atropine in cholinergic tox has no effect on what

A

Pupils

28
Q

Hydrocarbon DC criteria

A

6 hour obs and negative chest X-ray

29
Q

hgb shift for CO

A

Shifts to left preventing release of O2

30
Q

CO effects besides O2 curve

A

Binds to other iron containing proteins
-Myoglobin (dysrhythmias and cardiac dysfunction
-Cytochrome oxidase (metabolic acidosis)

31
Q

Non combustable source for CO poisoning

A

Methylene chloride (paint thinner)
Transdermal absorption, may continue to rise as it is already absorbed

32
Q

Why are pregnant patient at higher risk for CO poisoning

A

Fetal Hgb has higher affinity for CO

33
Q

CO elimination

A

Room air: 240-360 minutes
O2 (100%): 80-90 minuts
Hyperbaric: 22 minutes

EMS Boards (32 decks)

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