Environment/Toxicology Flashcards
Shivering is limited by _______
Glycogen Availability
The ability to shiver is lost at ____C
32
EKG findings seen in severe hypothermia include:
- Prolonged PRI
- Prolonged QT
- Osborne Waves
Severe Hypothermia is when the core temp falls below ______
28
Mild Hypothermia _________
33c to 35c
Moderate Hypothermia
29c to 32c
At 32c we start to see _________
Shivering Stop LOC decrease SVR fall Acidosis Develop Hyperglycemia Occur
Below 28c we start to see _____
Hypotension
ECG changes
In hypothermic arrest you should hold meds till the body temp increases above ______
30c
The single most critical step in treating a hypothermic pt is ______
removal from the cold environment and appropriate re-warming
Heat Exhaustion is defined as _______
increased core temp without neuro changes.
Blood Glucose level _______ in severe hypothermia
Increases
Cold pt’s don’t _________
Clot
VF risk is the highest at what temp?
22c
In hypothermia only start CPR if the monitor shows _____ or ______
vfib or asystole
In pt’s with hyperthermia a high cardiac output may lead to a ________
AMI
Increase in sweat evaporation can lead to a loss of _____/hr
1-3L
Heat cramps are caused by _______
Hyponatremia
Treat Heat cramps with ____
0.9% NS
Heat Stroke is defined as ____
LOC Altered
Core temp above 42c
In heatstroke pts monitor labs which include: _________
- ABG’s for acidosis
- Monitor Clotting factors and watch for DIC
- Monitor Liver Enzymes
- Watch Sodium levels and monitor for hyponatremia
Rhabdo Treatment:
- Increase urine output to 2ml/kg/hr
- Alkalize urine with Bicarb
- Assist with diuresis with lasix and/or mannitol
TCA overdose treatment:
- Bicarb
2. Norepi first choice pressor
Beta Blocker Overdose Treatment:
- Atropine
- TCP asap
- Glucagon
- Dopamine
Calcium Channel Blockers OD treatment:
- Calcium
- TCP
- Check Blood Sugar
Digitalis OD treatment:
- Digibind
- TCP
- Lidocaine
- Dilantin
- Mag Sulfate
- Correct Electrolyte Imbalances
K+ replacement rate:
Commonly 10-20 meq/hr
Ethylene Glycol OD manifestation:
- Profound Anion-Gap
- Osmolar Gap
- Nystagmus/Blindness
Ethylene Glycol OD Treatment:
- IV Ethanol GTT
2. Fomepizole
Cyanide Poisoning Treatment:
Jewelry Store
- Amyl/Sodium Nitrate
2. Sodium Thiosulfate
Organophosphate Poisoning Treatment:
- Atropine
2. 2-PAM
MetHGB Poisoning Treatment:
Methlyne Blue
Anticholinergic Poisoning Treatment
Atropine Gypsum Weed
Physostigamine
Heparin OD treatment
Protamine Sulfate
Coumadin Reversal
Vit K preferably IM
FFP
Creatinine Phosphokinase=
CPK or CK
Defibrillation is not effective till the body temp is greater then ______
30c
_________ rewarming can prevent after drop phenomenon
Active Internal
The fastest reaction that can occur from blood administration is _______
Acute hemolytic reaction
With electrical injury with hematuria you should maintain a urinary output of ______
100 ml/hr
Critical goal in treatment of heat illness is ______
Cooling
Two street drugs that cause hallucination are _____
PCP
LCD
Lysergic Acid Diethylamide =
LSD
ETOH antidote=
Fomepizol (Antizol)
Dig toxicity is easily exacerbated by ______
Beta Blockers
Benzo Antidotes=
Romazicon
Iron Antidote=
Deferoxamine
Ethylene Glycol creates what kind of metabolic disturbance ?
Metabolic Acidosis
Organophosphate Antidote=
Pralidoxime (2-PAM)
Normal BUN level
6-23
Mydriasis=
Pupil Dilation
Miosis=
Pupil Constriction
Organophosphate S/S
SLUDGE; DUMBELSS
Nitroprusside can cause ______ poisoning
cyanide