Emergency war surgery ch 7 Flashcards
A nuclear weapon of 20 kilaton yield the same total energy output as how many TNT?
20,000 tons
Total energy yield of nuclear weapons are rated in terms of equivalent amounts of what?
TNT
A 1.0 megaton weapon has the energy output of how many tons of TNT?
1,000,000
Energy is released by nuclear detonations in what three forms?
Thermal radiation
Blast
Ionizing radiation
What are the three factors that effect the casualty producing potential of nuclear weapons?
Yield of the weapon
Environmental conditions
Distribution of troops in the target area
Which output of a nuclear weapon is the most significant casualty producer?
Thermal output
Under all circumstances which two outputs of a nuclear weapon will produce the most casualties?
Thermal and blast
What two extra requirements exist if a nuclear weapon were used in theater?
Sorting of casualties
Holding of excess numbers
What four types of patients belong in the holding area, during mass casualties, that are designed for patients who are not fit for field duty but not requiring full care type hospitalization as well as severely injured?
- Minimal burns
- Mild trauma cases
- Mild chemical injury cases
- Severely injured not expected to survive
What type of hematologic injuries are caused by radiation?
Anemia
Infection
Bleeding
Delayed wound healing
At higher doses of radiation dehydration will occur due to what?
Severe fluid and electrolyte loss through the intestinal walls
Not in combined injuries, what will be used as a biological dosimeter to determine the amount of radiation exposure that has occurred?
Lymphocyte levels
Lymphocyte levels in excess of 1,500/mm3 indicate what level of radiation exposure?
Minimal likelihood of significant dose
Lymphocyte levels between 500 and 1,000/mm3 indicates what level of radiation exposure injury?
Severe radiation injury
Lymphocyte levels less than 500/mm3 indicates what level of radiation exposure injury?
May prove fatal
Lymphocyte levels are not detected indicates what type of radiation exposure injury?
Survival is very unlikely
Won’t survive more than two weeks
What are the three tentative classifications used for early DX of radiation exposure?
Radiation injury unlikely
Radiation injury probable
Radiation injury severe
Which symptoms are common for patients in the radiation level probable category?
Anorexia, nausea, vomiting
What symptoms accompany the radiation injury severe category?
Nausea vomiting
Prompt explosive bloody diarrhea
Significant hypotension
Signs of neurological shock
Nausea and vomiting occur when radiation exceeds what amount?
100 and 200 cGy centiGrays
How soon does nausea and vomiting normally subside after exposure to radiation?
A day
Vomiting and explosive diarrhea in the first hour of exposure indicate what?
Associated with a fatal dose
Do patient who have radiation exposure pose a substantial health risk to medical personnel?
No
Cases of 20% or less of body surface burned my nuclear explosion should be treated where?
Outpatient or minimal care facility
They can’t return to their unit
Cases of more than __% of burns from a nuclear blast and have a decreased likelihood of survival and should be given low priority for surgery.
50%
Describe what causes direct blast injuries.
Due to over pressure effects
Describe the cause of indirect blast injuries.
Drag forces of the winds accompanying the blast wave
Which type of blast injury cause is rare and why?
Direct because most patients will die
What are the two basic forms of ionizing radiation produced?
Electromagnetic and particulate
What are the two forms ionizing radiation that are clinically important?
Gamma
Neutron
What type of radiation is emitted at the time of detonation?
Prompt radiation
Residual radiation is that which persist how long after the explosion?
After the first min
Within a few hours after prompt exposure, all patients, regardless of which syndrome follows, pass through what five nonspecific symptoms?
Malaise Weakness Anorexia Vomiting Diarrhea
What is the clinical course of neurovascular syndrome?
Progressive depression leading to coma and finally death
