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Trauma > Environmental > Flashcards

Environmental Flashcards

1
Q

Most common bite

A

dogs younger than one year

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2
Q

Common pathogen found in dog bites

A

pasteurella multocida

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3
Q

Dog bite antibiotic

A
  1. Augmentin 875/125mg
  2. Clindamycin
  3. Cipro 750mg
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4
Q

Highest infection rate for domestic animal bites

A

cats

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5
Q

Wild animal bite antibiotic

A

Bactrim 160mg

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6
Q

Larger animal injuries

A

penetrating trauma
deep arterial damage
nerve damage
organ damage

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7
Q

Hymenopteras

A

ants, bees, and wasps

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8
Q

Most common hymenoptera reaction

A

local reaction

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9
Q

Victims of multiple stings sx

A

NVD
dyspnea
hypotension
tachy
syncope

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10
Q

Sting tx

A

remove stinger in a horizontal fashion
wash site
cold compress

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11
Q

Sting meds

A

antihistamines

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12
Q

Non-infectious ascending paralysis within 5 days of a tick bite

A

tick paralysis

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13
Q

Tick bite tx

A

removal
wash site
Doxy

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14
Q

Do nots of tick removal

A

petroleum jelly
nail polish
rubbing alcohol
hot match
gasoline

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15
Q

What snake toxin causes respiratory paralysis?

A

neurotoxins from coral snake

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16
Q

What releases cytolytic venom?

A

rattlesnakes and pit vipers

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17
Q

Cytolytic venom destroys

A

tissue and endothelial lining of blood vessels

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18
Q

Pit viper head

A

triangular shape
nostril with pit

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19
Q

Coral snake head

A

round head
nostril without pit
*split anal plate

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20
Q

Nonvenemous snake head

A

oval shape
oval pupil

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21
Q

Cytolytic bite sx

A

pain
swelling
tingling
metallic taste

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22
Q

Neurotoxic bite sx

A

ptosis
dysphagia
diplopia
respiratory arrest

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23
Q

Snake bite tx

A

imobilize
remove jewelry
clean bite
loose dressing
MEDEVAC

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24
Q

Black Widow bite sx

A

muscle pain
spams
rigidity

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25
Q

Spider Bite tx

A

pain control and muscle relaxers

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26
Q

Scorpion bite sx

A

convulsions
muscle spasm
pulmonary edema

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27
Q

Jellyfish meds

A

antihistamines
corticosteroids
pain meds

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28
Q

Jellyfish tx

A

rinse with sea water
vinegar
sand
shaving cream
baking SODA

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29
Q

Jellyfish sting sx

A

pain
erythema
pruritis
edema

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30
Q

Sting Ray tx

A

heated water for 30min at 40-45C or 104-113F
poison control for antivenom

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31
Q

Sting ray penetrating wound via

A

barbed spine

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32
Q

Sting Ray med

A

Doxy 100mg 7 days

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33
Q

Coneshell tx

A

Doxy and Medevac

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34
Q

Near Drowning

A

survival after suffocation or LOC in a liquid

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35
Q

Near Drowning risks

A

inadequate supervision
inability or over estimation of swimming
alcohol
hypothermia

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36
Q

Lubricating agent in lung tissue

A

surfactant

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37
Q

Physiology of dying from drowning

A

hypoxemia

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38
Q

Near Drowning physical findings

A

neurologic deficits
arrhythmias
acidosis
renal failure

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39
Q

Near Drowning Tx 3 phases

A

Prehospital
Emergency department
Inpatient

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40
Q

Near Drowning acute inteventions

A

rescue
remove wet clothing
CPR
C-spine
do not Heimlich

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41
Q

Near Drowning airway management

A

neurologic deterioration
inability to maintain SPO2 of 90
PaCO2 above 50

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42
Q

Near Drowning factors of poor prognosis

A

submersion >5 min
BLS after >10 min
Ressucitation >25 min
Glasgow <5
blood ph <7.1

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43
Q

Contaminants concentrate where in polluted water?

A

sediment

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44
Q

Polluted water protection

A

dry suit and full facemask

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45
Q

Biological water conatminants

A

algal bloom
bacteria
virus
parasites

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46
Q

After a storm Urban areas are at higher risk for contaminants for how long?

A

36 hours

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47
Q

5 most common water* bacteria producing soft tissue infection

A

aeromonas
Edwardsiella tarda
Erysipelothrix
vibrio
mycobacterium marnium

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48
Q

Polluted Water empiric antibiotics (non-seawater)

A

Keflex 250mg
or
Clindamycin / Metronidazole

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49
Q

Vibrio antibiotic

A

Doxy

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50
Q

4 mechanisms of inhaled agents

A

physical particles
siple asphyxiants
chemical irritants
checmil asphyxiants

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51
Q

Upper airway injury symptoms

A

difficulty breathing
edema

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52
Q

Lower respiratory injury symptoms

A

SOB
productive cough

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53
Q

Toxic gas tx

A

remove from source
100% O2
BVM
ET tube if indicated

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54
Q

Simple asphyxiants examples

A

CO2
Nitrogen
Methane
Natural Gas

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55
Q

Simple asphyxiants affect on body

A

only hypoxemia

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56
Q

Simple asphyxiant tx

A

remove from source
100% O2
CPR

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57
Q

Chemical irritant that are highly reactive with water

A

hydrophilic chemical

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58
Q

Hydrophilic reaction

A

react with moist membrane and cause immediate burning and pain

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59
Q

Non-hydrophilic agent reaction

A

pass deep into lungs causing acute lung injury

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60
Q

Chemical irritant tx

A

Supportive care and irrigation of eyes with water or saline
albuterol
O2
Intubation

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61
Q

Most common chemicals asphyxiant

A

Carbon monoxide

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62
Q

H2S smell

A

rotten egg

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63
Q

3 drugs in cyanide antidote kit

A
  1. inhaled amyl nitrite
  2. IV sodium nitrite
  3. IV sodium thiosulfate
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64
Q

Most common overdose method

A

ingestion

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65
Q

Tox exam

A

mental status
pupil size
skin temp
sweat or lack of
muscle tone
GI motility

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66
Q

Toxidrome

A

collection of signs and sx after an exposure to a substance; aka toxic fingerprint

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67
Q

If tox PT has AMS or coma administer

A

Naloxone .2 to rule out overdose

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68
Q

Alcohol withdrawal PT medication

A

Thiamine

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69
Q

GI tox decontamination

A

OG/NG tube lavage
Activated charcoal 1mg/kg

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70
Q

Anticholinergic toxidrome

A

dry as a none
red as a beet
hot as a hare
blind as bat
mad as a hatter
stuffed as a pipe

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71
Q

Anticholinergic most common use for overdose

A

antihistamines via ingestion, inhalation, or ocular

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72
Q

Anticholinergic inhibits what system

A

PNS

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73
Q

Most common EKG finding for anticholinergic

A

sinus tachycardia

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74
Q

Anticholinergic overdose tx

A

symptomatic
MEDEVAC

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75
Q

Dystonic reaction

A

akathisias
dyskinesia
hypokinesia
Parkinson syndrome

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76
Q

SSRI overdose tx

A

supportive care
d/c SSRI (with taper)
IV access MEDEVAC

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77
Q

Serotinin syndrome

A

fatal adverse drug reaction to SSRI causes neurological /muscular dysfunction

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78
Q

SSRI overdose sx

A

hypothermia
diaphoresis
tachy
bp changes
dilated pupils
confusion
agitation
nystagmus
MUST RULE OUT PYSCH CONDITIONS

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79
Q

SSRI overdose hallmark

A

myoclonus (twitching and jerking)

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80
Q

Main inhibitory neurotransmitter in the CNS

A

GABA

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81
Q

Benzo overdose sx

A

dizziness
slurred speech
ataxia

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82
Q

Sedatives and hypnotics effect what system

A

CNS

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83
Q

Sedative and hypnotic overdose tx

A

ABCs
flumazenil

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84
Q

Most frequently ingested intoxicant in the US

A

Ethanol

85
Q

Opiods affect what systems

A

PNS/CNS and GI

86
Q

Opiod work as agonist on 3 primary receptors

A

Mu
Kappa
Delta

87
Q

Mu receptors

A

analgesia, sedation, respiratory depression

88
Q

Opiod overdose tx

A

ABC
Naloxone
Activated Charcoal if ingested

89
Q

Cocaine OD sx

A

mydriasis
tachycardia
hypertension
diaphoresis
hyperthermia

90
Q

Cocaine OD tx

A

Sedation
EKG
Benzos

91
Q

Contraindicated meds for cocaine use

A

beta blocker

92
Q

Salicylates/ASA effect

A

medullary respiratory center

93
Q

Salicylates/ASA emergency care

A

ABC
Activated Charcoal 1mg/kg
IV fluids
Glucose check
Sodium Bicarb
MEDEVAC

94
Q

Most common cause of overdose/liver failure

A

Acetaminophen

95
Q

Max acetaminophen in 24h

A

4g

96
Q

Acetaminophen toxic metabolite

A

NAPQI

97
Q

APAP stage 1

A

24 hours N/V malaise, anorexia

98
Q

APAP stage 2

A

day 2-3, N/V, toxiicty, RUQ Px, jaundice

99
Q

APAP stage 3

A

day 3-4 hepatic failure, lactic acidosis, coagulopathy, renal failure, encephalopathy

100
Q

APAP stage 4

A

those who survive will begin to reover

101
Q

APAP OD tx

A

NAC

102
Q

NAC dose Oral/NG

A

140 mg/kg loading dose
wait four hours
70mg/kg Q4 x17

103
Q

NAC IV dose

A

150mg/kg loading
wait four hours
50mg/kg over 4H
100mg/kg over 16H

104
Q

Cholinergic/Insecticide binding type
(ORGANOPHOSPHATES)

A

irreversible binding to cholinesterase

105
Q

Cholinergic sx SLUDGE

A

salivation
lacrimation
urinary
incontinence
defecation
GI px
Emesis

106
Q

Cholinergic tx

A

Atropine 1mg Q5 min
2-PAM
Benzos

107
Q

Cholinergic agent aka

A

Nerve

108
Q

Heat Edema

A

mild swelling of feet, ankles, hands within first few days of heat expsure

109
Q

Heat Edema Tx

A

leg elevation; selve resolving

110
Q

Prickly Heat

A

pruritic , maculopapular rash in clothed areas

111
Q

Prickly Heat tx

A

chlorhexidine
light, clean clothing

112
Q

Heat cramps

A

painful involuntary spasm of skeletal muscle

113
Q

4 electrolytes for muscle movement

A

calcium
magnesium
potassium
sodium

114
Q

Heat cramp tx

A

fluid/salt
rest
IV NS

115
Q

Heat Tetany

A

hyperventilation resulting in alkalosis, paresthesia and carpopedal spasm

116
Q

Heat Tetany hallmarks

A

no pain; paresthesia of extremities and perioral region

117
Q

Heat Tetany tx

A

remove from heat and dec respiration rate

118
Q

Heat Syncope sx

A

postural hypotension

119
Q

Most common non-acclimitized heat injury

A

Heat Syncope

120
Q

Heat Syncope tx RRR

A

remove from heat
rehydration
rest

121
Q

Heat Exhaustion criteria

A

difficulty continuing exercise
101F-104F
None or Mild CNS dysfunction

122
Q

Heat exhaustion sx

A

tachycardia
hypotension
weakness
dehydration and electrolyte loss
ataxia
pallor
headache
NVD
muscle cramps

123
Q

Heat exhaustion tx

A

ORS
supine with feet elevated
remove excess clothing
cool patient to 101
rehydrate

124
Q

Heat Exhaustion disposition

A

LLD 7 days
two weeks activity in a cool environment
if unable to return after 4 weeks: refer

125
Q

Heat Stroke Sx

A

104F
confusion
seizures
coma
CNS dysfunction
anhidrosis**

126
Q

Heat stroke tx

A

ABC
O2
IV NS
serial temps
active cooling

127
Q

Core temp associated with AMS

A

105F

128
Q

Chilblains sx

A

edema
pruritic
paresthesia
erythema
cyanosis
nodules

129
Q

Pale skin, mottled, anesthetic, pulseless, and immobile that does not change after rewarming

A

Chilblains

130
Q

Chilblians tx

A

rewarm, bandage, elevate, corticosteroids

131
Q

Chilblain prevention

A

warm
good boot fit
change socks

132
Q

First degree frost bite

A

superficial, pallor and anesthesia of the skin

133
Q

Second degree frost bite

A

large blisters with clear fluid with surrounding edema and erythema; eschar that sloughs off

134
Q

Third degree frost bite

A

deeper, smaller blisters with hemorrhagic appearance; black eschar “Feels like block of wood”

135
Q

Fourth degree frost bite

A

complete tissue necrosis

136
Q

Frostbite tx

A

warm
remove wet clothing
pad or splint area
avoid walking

137
Q

Hypothermia

A

core temp below 95

138
Q

Hypothermia stages

A

mild 90-95F
moderate 82-90F
sever below 82F

139
Q

Cold stressed

A

symptoms without hypothermia

140
Q

Conduction

A

transfer of heat to an adjacent object

141
Q

Convection

A

transfer of heat to currents of air or water

142
Q

Mild Hypothermia sx

A

tachypnea
tachycardia
hyperventilation to ataxia
joint pain
shivering

143
Q

Moderate Hypothermia sx

A

CNS depression
drop in heart rate
hypoventilation
loss of shivering
dysrhythmias (A-fib)

144
Q

Severe Hypothermia sx

A

Pulmonary edema
oliguria
hypotension
bradycardia
ventricular arrhythmias

145
Q

Most important cold injury lab

A

fingerstick glucose

146
Q

Rewarm hypothermia patients requiring resuscitation to what temperature

A

90-95F

147
Q

Mild hypothermia tx

A

passive warming

148
Q

Moderate and mild refractory hypothermia tx

A

active external warmings

149
Q

Severe hypothermia tx

A

active external and internal warming

150
Q

HACE occurs above what elevation

A

2500 meters (8250ft)

151
Q

HACE results from

A

cerebral vasogenic edema and hypoxia

152
Q

HACE sx

A

headaches
confusion
truncal ataxia
urinary changes
focal deficits
NV

153
Q

HACE tx

A

immediate decent at least 610 meters (2k feet)
O2

154
Q

HAPE elevation

A

3000 meters (9840ft)

155
Q

Leading cause of altitude illness death

A

HAPE

156
Q

Early HAPE sx

A

cough
breathlessness at rest and active

157
Q

Late HAPE sx

A

wheezing
orthopnea
hemoptysis

158
Q

HAPE findings

A

fever
tachypnea
cyanosis
rales and rhonchi
presents like pneumonia

159
Q

HAPE tx

A

immediate decent 610meters (2k FT)
O2

160
Q

Shock

A

cirulatory insufficiency that creates imbalance of oxygen supply to to tissue

161
Q

4 shock categories

A

hypovlemic
cardiogenic
distributive
obstructive

162
Q

Hypovlemic shock

A

decreased volume from blood loss or fluid loss

163
Q

Cardiac output formula

A

stroke volume x HR

164
Q

Hypovlemic shock caused by

A

VD**
trauma
hemorrhage
GI bleed
DKA

165
Q

Hypovlemic sx

A

tachycardia
hypotension
oliguria
dec JVP
narrow or weak pulse

166
Q

Hypovolemic shock tx

A

Fluid replacement

167
Q

Hypovelemic shock medications

A

Norepinephrine
Epinephrine

168
Q

Cardiogenic shock

A

pump failure secondary to AMI, arrhythmia, valvular incompetence or stenosis

169
Q

Cardiogenic shock sx

A

elevated JVP
pulmonary edema
limb edema
MI/arrhythmias

170
Q

Cardiogenic shock tx

A

fluid replacement in smaller incriments

171
Q

Cardiogenic shock meds

A

Norepinephrine
Epinephrine

172
Q

Distributive shock

A

severe peripheral vasodilation; most commonly caused by sepsis

173
Q

Distributive shock examples

A

sepsi, anaphylaxis, nuergenic

174
Q

Nuerogenic shock

A

spinal cord injury resulting in los of sympathetic stimulation

175
Q

Sepsis sx

A

fever, tachycardia, hypoperfusion despite fluid

176
Q

Sepsis tx

A

ABC
O2
IV
Ertapenem

177
Q

Obstructive shock associated with

A

poor right ventricle output

178
Q

Obsturctive shock causes

A

massive PE
tension pnuemo
pericardial tamponade
abdominal compartment syndrome

179
Q

Large animal bite common injuries

A

blunt and penetrating trauma, including deep arterial damage, nerve damage and internal organ damage

180
Q

Cat bite medication

A

Augmentin

181
Q

Salt Water bite bacteria

A

vibrio

182
Q

Crocodile bite bacteria

A

Aeromonas hydrophila,

183
Q

ASA overdose lab

A

Serum Levels every 4 hours

184
Q

Diseases transmitted by ticks

A

(a) Lyme Disease
(b) Rocky Mountain spotted fever (RMSF)
(c) Relapsing fever
(d) Colorado tick fever
(e) Ehrlichiosis
(f) Babesiosis
(g) Tularemia
(h) Southern Tick-Associated Rash Illness (STARI)

185
Q

Brown Recluse bite sx

A

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

186
Q

2 chemicals highly reactive with water

A

ammonia
hydrochloric acid

187
Q

Most common physical particle

A

soot

188
Q

Cat bite bacteria

A

Pasteurella

189
Q

Freshwater antibiotic

A

Doxy or Bactrim

190
Q

Active cool Heat Stroke to what temperature

A

102

191
Q

Least concerning body of water for bacteria

A

River

192
Q

Type of shock with JVD

A

Obstructive

193
Q

Naloxone Dose

A

.4 - 2mg

194
Q

Unresponsive with hypotension and no cyanosis; what is most likely diagnosis

A

Cyanide

195
Q

Animal bite med if allergic to penicillin

A

clindamycin and fluoroquinolone

196
Q

APAP overdose first step

A

activated charcoal

197
Q

Do not do what to a stingray injury

A

surgical debrisment

198
Q

South American injury with convulsions caused by

A

scorpion

199
Q

Multiple sting BP hallmark

A

Hypotension

200
Q

Age for poor drowning prognosis

A

> 14 OVER OVER OVER OVER IS POOR POOR POOR

201
Q

Attacked by a moose inury type

A

blunt trauma

202
Q

Patient with J wave is at what risk during transport

A

arrhythmia

203
Q

Near drowning patient that cannot maintain PO2 intervention

A

intubation

204
Q

What important chacteristic appears before 32C

A

loss of shivering

205
Q

Great pain after stepping on something in water disposition

A

MEDEVAC

206
Q

Dry mucus membranes, dilated pupils, decreased VA, temp 105, what med was used of over dose

A

diphenhydramine

207
Q

Fever, chills, SOB what kind of shock

A

distributive

208
Q

What temp of water is at risk for hypothermia

A

any temp

209
Q

Abdominal cramps and salivation require what antidote

A

2PAM and Atropine

Trauma (3 decks)

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