Environmental Flashcards
Dog’s younger than what year are more responsible for highest incidence of bites?
1 year
Abx indications timeline for dog bite?
Bite on face present for > 24 hours OR bite on extremity > 8 hours
without irrigation
What abx is used for bites?
Augmentin
What if PCN allergy, what abx is used for bites?
Clinda + cipro
Cat bites have a higher infection rate in comparison
True
Treatment for cat bites?
Same as dog bites
70% of cat bite infections are due to?
Pasteurella
Abx for bites in the water?
- Bactrim
* Doxy
What are you treating for in fresh water bites?
Aeromonas hydrophila
What are tou treating for in salt water bites?
Vibrio Species
Tx for salt water bites?
Doxy + Ceftriaxone
Hymenoptera is?
includes ants, bees, and wasps
Tx for stingers?
(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.
What antihistamines are given for stingers?
Loratadine (Claritin) -
Desloratadine (Clarinex) -
Fexofenadine (Allegra) –
Cetirizine (Zyrtec) -
What if hives and or resp difficulty happens?
EPI, then every 5-10 minutes
Albuterol
Oral steroids
Tick removal?
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
What snake is neurotoxic?
Coral snake
What does neurotixns cause?
Respiratory paralaysis
Signs of neurotoxin?
ptosis, dysphagia, diplopia, and respiratory arrest via diaphragmatic paralysis
What snakes are cytolytic?
Rattlesnakes and other pit vipers
What does cytolytic venom do?
tissue destruction by digestion and hemorrhage due to hemolysis and destruction of the endothelial lining of the blood vessels
Signs of cytolytic venom? *
Pain
- redness
- tingling
- Metallic taste
- nausea and vomit
- Hypotension
So diff between neurotoxin and cytolytic?
Cytolitic is blood
Tx for snake bite?
- No tourniquet
- Irrigate
- Loose dressing
- MEDEVAC
- Immobilize
Black widow signs?
(neuro) Generalized muscular pains, muscle spasms, and rigidity
Black widow tx?
Pain may be relieved with pain control and muscle relaxants
Brown recluse signs?
(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
Tx for brown recluse bite?
1) Pain management for secondary local necrosis and close monitoring initially.
2) Consider antibiotic prophylaxis in field setting
Initial management on scene?
Scene safety C - A - B * Circulation * airway * Breathing
Scorpion signs?
(a) muscle cramps,
(b) twitching and jerking,
(c) occasionally hypertension,
(d) convulsions,
(e) pulmonary edema
Initial management of spider bites?
Monitor and pain management
Tx for north American scorpions?
Su[[ortive care
Signs of Jellyfish sting?
(a) Pain,
(b) erythema,
(c) edema,
(d) pruritus,
(e) vesiculations,
(f) Anaphylaxis
Tx for jellyfish?
- 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
Signs of coneshell?
(a) Mild to severe pain,
(b) stinging or numbness,
(c) local to total paralysis
Tx for coneshell?
- pressure immobilization dressing
- Monitor for resp status
- MEDEVAC if needed
Stingray and stinging fish sx?
(a) Barbed spines that are a penetrating injury and envenomation.
(b) Spine commonly remains lodged in wound.
Tx for stingray and stinging fish?
- 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
What are you also concerned with for stingrays or stinging fish?
Vibrio
What is vibrio treated with?
Doxy
Stonefish stings not responsive to hot water immersion- should receive antivenom, and patient closely monitored for anaphylaxis
Ok
(f) Treatment for scorpionfish and catfish envenomation should be treated in a similar manner.
Ok
most persistent biological and chemical contaminants tend to concentrate in sediment rather than in the water column
Cool
b. Chemical Contaminants
Chemical contaminants include any chemicals which have leaked, spilled or dumped, or have been otherwise found in a body of water
c. Biological Contaminants
(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.
Tx for soft tissue infections following water exposure?
(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.
Abx tx for soft tissue infections following water exposure?
Look up abx in tg
