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Emergency Medicine > Environmental > Flashcards

Environmental Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Dog’s younger than what year are more responsible for highest incidence of bites?

A

1 year

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2
Q

Abx indications timeline for dog bite?

A

Bite on face present for > 24 hours OR bite on extremity > 8 hours
without irrigation

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3
Q

What abx is used for bites?

A

Augmentin

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4
Q

What if PCN allergy, what abx is used for bites?

A

Clinda + cipro

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5
Q

Cat bites have a higher infection rate in comparison

A

True

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6
Q

Treatment for cat bites?

A

Same as dog bites

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7
Q

70% of cat bite infections are due to?

A

Pasteurella

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8
Q

Abx for bites in the water?

A
  • Bactrim

* Doxy

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9
Q

What are you treating for in fresh water bites?

A

Aeromonas hydrophila

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10
Q

What are tou treating for in salt water bites?

A

Vibrio Species

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11
Q

Tx for salt water bites?

A

Doxy + Ceftriaxone

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12
Q

Hymenoptera is?

A

includes ants, bees, and wasps

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13
Q

Tx for stingers?

A

(a) Remove the stinger
1) Scrape away the stinger in a horizontal fashion.
2) Try not to grasp the stinger sac.
3) However, if one is unable to remove the stinger in a horizontal fashion, it is most important to remove it as soon as possible by any available means.
(b) Wash the site with soap and water.
(c) Place a cold compress or ice on the site.
(d) Give oral analgesics as needed for pain relief.
(e) Topical steroid cream can be helpful for swelling, as are oral antihistamines.

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14
Q

What antihistamines are given for stingers?

A

Loratadine (Claritin) -
Desloratadine (Clarinex) -
Fexofenadine (Allegra) –
Cetirizine (Zyrtec) -

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15
Q

What if hives and or resp difficulty happens?

A

EPI, then every 5-10 minutes
Albuterol
Oral steroids

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16
Q

Tick removal?

A

1) Use thin-tipped tweezers or forceps to grasp the tick as close to the skin surface as possible.
2) Pull the tick straight upward with steady even pressure

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17
Q

What snake is neurotoxic?

A

Coral snake

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18
Q

What does neurotixns cause?

A

Respiratory paralaysis

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19
Q

Signs of neurotoxin?

A

ptosis, dysphagia, diplopia, and respiratory arrest via diaphragmatic paralysis

20
Q

What snakes are cytolytic?

A

Rattlesnakes and other pit vipers

21
Q

What does cytolytic venom do?

A

tissue destruction by digestion and hemorrhage due to hemolysis and destruction of the endothelial lining of the blood vessels

22
Q

Signs of cytolytic venom? *

A

Pain

  • redness
  • tingling
  • Metallic taste
  • nausea and vomit
  • Hypotension
23
Q

So diff between neurotoxin and cytolytic?

A

Cytolitic is blood

24
Q

Tx for snake bite?

A
  • No tourniquet
  • Irrigate
  • Loose dressing
  • MEDEVAC
  • Immobilize
25
Q

Black widow signs?

A

(neuro) Generalized muscular pains, muscle spasms, and rigidity

26
Q

Black widow tx?

A

Pain may be relieved with pain control and muscle relaxants

27
Q

Brown recluse signs?

A

(hemocytolytic) progressive local necrosis as well as hemolytic reactions (rare). Bite is usually painless

Bites occasionally progress to extensive local necrosis and may require excision of the bite site and oral corticosteroids

28
Q

Tx for brown recluse bite?

A

1) Pain management for secondary local necrosis and close monitoring initially.
2) Consider antibiotic prophylaxis in field setting

29
Q

Initial management on scene?

A 
Scene safety
C - A - B
* Circulation
* airway
* Breathing
30
Q

Scorpion signs?

A

(a) muscle cramps,
(b) twitching and jerking,
(c) occasionally hypertension,
(d) convulsions,
(e) pulmonary edema

31
Q

Initial management of spider bites?

A

Monitor and pain management

32
Q

Tx for north American scorpions?

A

Su[[ortive care

33
Q

Signs of Jellyfish sting?

A

(a) Pain,
(b) erythema,
(c) edema,
(d) pruritus,
(e) vesiculations,
(f) Anaphylaxis

34
Q

Tx for jellyfish?

A
  • Rinse with salt water
  • DO NOT USE FRESH WATER
  • Remove tentacles with a gloved hand the scrape off any remaining nematocyst by covering with sand/shaving cream/baking soda and scraped off with straight edge. Sticky tape may also remove nemocysts

Antihistamines, topical corticosteroids, and pain medications

35
Q

Signs of coneshell?

A

(a) Mild to severe pain,
(b) stinging or numbness,
(c) local to total paralysis

36
Q

Tx for coneshell?

A
  • pressure immobilization dressing
  • Monitor for resp status
  • MEDEVAC if needed
37
Q

Stingray and stinging fish sx?

A

(a) Barbed spines that are a penetrating injury and envenomation.
(b) Spine commonly remains lodged in wound.

38
Q

Tx for stingray and stinging fish?

A
  • Remove and irrigate
  • TOXIN is heat labile so place wound in water heated 40-45 Celsius (104-113 Fahrenheit) for 30min intervals
  • Does not respond well to pain relievers
39
Q

What are you also concerned with for stingrays or stinging fish?

A

Vibrio

40
Q

What is vibrio treated with?

A

Doxy

41
Q

Stonefish stings not responsive to hot water immersion- should receive antivenom, and patient closely monitored for anaphylaxis

A

Ok

42
Q

(f) Treatment for scorpionfish and catfish envenomation should be treated in a similar manner.

A

Ok

43
Q

most persistent biological and chemical contaminants tend to concentrate in sediment rather than in the water column

A

Cool

44
Q

b. Chemical Contaminants

A

Chemical contaminants include any chemicals which have leaked, spilled or dumped, or have been otherwise found in a body of water

45
Q

c. Biological Contaminants

A

(a) harmful algal blooms (e.g., red tide),
(b) bacteria (e.g., fecal coliforms),
(c) viruses and parasites which could potentially harm an unprotected diver.
(2) Biological contaminants may be present in storm water runoff and pose hazards to divers and to surface support personnel, especially when diving in near shore, urban areas within 36 hours of a storm event.

46
Q

Tx for soft tissue infections following water exposure?

A

(a) Assessment to determine whether treatment requires hospitalization,
(b) Empiric antibiotic administration, assessment of tetanus vaccination status,
(c) Surgical consultation for potential debridement in patients with necrotizing infections.

47
Q

Abx tx for soft tissue infections following water exposure?

A

Look up abx in tg

Emergency Medicine (13 decks)

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