Environmental

Question 1

What is a priority in cold exposure patients?

Answer 1

Removing wet clothing, drying and insulating patient

Question 2

What is the non-medication treatment for acute frostbite?

Answer 2

Warm ambient air and/or warm pack wrapped in towel. Only rewarm is no chance of refreezing

Question 3

What medication is given for acute frost bite?

Answer 3

Ibuprofen
Adult - 800mg PO q 8 hours
Peds - 10mg/kg PO, max 400mg

Question 4

What are rewarming options in moderate to severe hypothermia patients?

Answer 4

Warm ambient air, warm humidified O2, warm packs to groin, armpit and neck, warm IV solutions, blankets

Question 5

What is the IV solutions dose for hypothermic patients?

Answer 5

10mL/kg NS until improved perfusion

Question 6

Why should we handle hypothermic patients gently?

Answer 6

Ventricular fibrillation can occur at temps less then 88*F and handling gently reduces the risk

Question 7

How long should you check for a pulse in hypothermic patients and why?

Answer 7

60 seconds. Pulse may be hard to detect and rate may be slow

Question 8

At what temperature does shivering stop?

Answer 8

90*F

Question 9

What are the first steps in any animal sting/bite?

Answer 9

Irrigate/clean the wound, immobilize as needed, remove restrictive clothing/jewelry

Question 10

What are the treatment steps for snake bites?

Answer 10

Rapid transport (contact closest facility regarding anti-venom), monitor airway, keep wound below level of heart, AVOID ice. Mark bite area every 10-15 min

Question 11

Once any hemorrhage is controlled, what is the main concern for mammal bites?

Answer 11

Infection

Question 12

What are appropriate cooling measures for hyperthermic patients?

Answer 12

Remove clothing, initiate evaporative cooling, shade patient from sun/heat

Question 13

What is the IV solutions dose for hyperthermic patients?

Answer 13

20ml/kg NS until improved perfusion/mentation
NOT warmed

Question 14

True/False: Antipyretics are indicated for heat emergencies.

Answer 14

False

Question 15

What are the s/s of heat stroke?

Answer 15

hot, dry skin, cessation of sweating, hypotension, AMS, seizure, coma

Question 16

What is done for cases of severe shivering in hyperthermic patients?

Answer 16

Wrap hands and feet in warm towels, continue core cooling. Monitor temperature and avoid hypothermia

Question 17

What medication is given for sever shivering in hyperthermic patients?

Answer 17

Fentanyl

Question 18

What medical situation is more common than altitude illness?

Answer 18

Acute exacerbations of chronic medical illness at altitude

Question 19

What is the definitive treatment for high altitude emergencies?

Answer 19

Descent

Question 20

What is the most frequent type of altitude sickness and at what elevation does it appear?

Answer 20

Acute mountain sickness, >6500ft

Question 21

What are the symptoms of acute mountain sickness?

Answer 21

headache, insomnia, anorexia, nausea, fatigue

Question 22

What is more common at elevations in Colorado, High Altitude Cerebral Edema (HACE) or High Altitude Pulmonary Edema (HAPE)?

Answer 22

HAPE

Question 23

What are the symptoms of HAPE?

Answer 23

dyspnea, cough, headache, nausea, fever

Question 24

What intervention should be considered for HAPE?

Answer 24

CPAP

Question 25

What medication can be given in AMS and HACE?

Answer 25

Dexamethasone