Environmental Flashcards
What is a priority in cold exposure patients?
Removing wet clothing, drying and insulating patient
What is the non-medication treatment for acute frostbite?
Warm ambient air and/or warm pack wrapped in towel. Only rewarm is no chance of refreezing
What medication is given for acute frost bite?
Ibuprofen
Adult - 800mg PO q 8 hours
Peds - 10mg/kg PO, max 400mg
What are rewarming options in moderate to severe hypothermia patients?
Warm ambient air, warm humidified O2, warm packs to groin, armpit and neck, warm IV solutions, blankets
What is the IV solutions dose for hypothermic patients?
10mL/kg NS until improved perfusion
Why should we handle hypothermic patients gently?
Ventricular fibrillation can occur at temps less then 88*F and handling gently reduces the risk
How long should you check for a pulse in hypothermic patients and why?
60 seconds. Pulse may be hard to detect and rate may be slow
At what temperature does shivering stop?
90*F
What are the first steps in any animal sting/bite?
Irrigate/clean the wound, immobilize as needed, remove restrictive clothing/jewelry
What are the treatment steps for snake bites?
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
Once any hemorrhage is controlled, what is the main concern for mammal bites?
Infection
What are appropriate cooling measures for hyperthermic patients?
Remove clothing, initiate evaporative cooling, shade patient from sun/heat
What is the IV solutions dose for hyperthermic patients?
20ml/kg NS until improved perfusion/mentation
NOT warmed
True/False: Antipyretics are indicated for heat emergencies.
False
What are the s/s of heat stroke?
hot, dry skin, cessation of sweating, hypotension, AMS, seizure, coma
What is done for cases of severe shivering in hyperthermic patients?
Wrap hands and feet in warm towels, continue core cooling. Monitor temperature and avoid hypothermia
What medication is given for sever shivering in hyperthermic patients?
Fentanyl
What medical situation is more common than altitude illness?
Acute exacerbations of chronic medical illness at altitude
What is the definitive treatment for high altitude emergencies?
Descent
What is the most frequent type of altitude sickness and at what elevation does it appear?
Acute mountain sickness, >6500ft
What are the symptoms of acute mountain sickness?
headache, insomnia, anorexia, nausea, fatigue
What is more common at elevations in Colorado, High Altitude Cerebral Edema (HACE) or High Altitude Pulmonary Edema (HAPE)?
HAPE
What are the symptoms of HAPE?
dyspnea, cough, headache, nausea, fever
What intervention should be considered for HAPE?
CPAP
What medication can be given in AMS and HACE?
Dexamethasone
