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DipIMC > Environmental > Flashcards

Environmental Flashcards

1
Q

At what altitude is the ‘death zone’ start?

A

7500meters

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2
Q

At 5500meters barometric pressure is at what percentage of that at sea level?

A

50%

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3
Q

Does previous altitude exposure and physical fitness prevent AMS?

A

No

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4
Q

What percentage of individuals who ascend rapidly to 4000m suffer with AMS?

A

60%

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5
Q

Aids to acclimatisation

A

Limit ascent to 300-600m per day.
Incorporate rest days to allow the body to catch up
Climb high, sleep low
Acetazolamide

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6
Q

AMS Symptoms

A

Headache
Anorexia
Fatigue
Nausea
Dizziness
Disrupted sleep

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7
Q

Treatment of AMS

A

Anti-emetics
Rest
Avoid further ascent
Consider descent

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8
Q

What percentage of climbers have hallucinations about 7500m?

A

32%

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9
Q

Classification of altitude

A

High - 1500-3500m
Very high - 3500-5500m
Extreme >5500m

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10
Q

Essential drugs for altitude emergencies

A

Oxygen - AMS/HAPE/HACE
Acetazolamide - AMS/HACE
Nifedipine - HAPE
Dexamethasone - HACE
Ofloxacin - contact lens related microbial keratosis.

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11
Q

Atmospheric pressure

A

760mmHg / 101kpa

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12
Q

Atmospheric gasses

A

Nitrogen - 78.5%
Oxygen - 21%
CO2 - 0.05 %
+ Other gasses

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13
Q

Dalton’s law

A

The total pressure exerted by a gaseous mix is equal to the sum of the partial pressures of each component

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14
Q

Boyle’s law

A

For any gas at a constant temperature the volume of gas will vary inversely to the pressure.

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15
Q

Henry’s Law

A

The amount of gas which dissolves in a liquid is proportional to the pressure of the gas.

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16
Q

Symptoms of Nitrogen narcosis

A
  • Light headedness
  • Poor concentration
  • Poor judgement
  • Anxiety
  • Decreased co-ordination
  • Hallucinations
  • Coma and death
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17
Q

Symptoms of Oxygen toxicity

A
  • Tingling
  • Focal or generalised seizures
  • Vertigo
  • Tinnitus
  • Nausea and vomiting
  • Tunnel vision
  • Personality changes
  • Anxiety
  • Confusion
  • Coma
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18
Q

The pressure increases by 1 atmosphere for each ____m of descent

A

10

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19
Q

Heat stroke mortality

A

10-70%

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20
Q

Key differentiator between heat exhaustion and heat illness

A

CNS dysfunction

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21
Q

Heat exhaustion signs & symptoms

A

> 38 degrees C
Sweating
Oliguria
Nausea +/- vomiting
Irritable or confused
tachycardic
tachypnoeic

22
Q

Heat stroke signs & symptoms

A

> 40 degrees C
Hot dry skin
Decreased sweating
Anuria
Nausea and vomiting
Circulatory collapse
Delirium/seizues/coma
Encephalopathy
Renal failure, liver failure, rhabdomyolysis, DIC

23
Q

2 main types of heat illness

A
  • Exertional (young fit heavy activity - rapid onset)
  • Non-exerttional (elderly and young, over a period of time - exposure to environmental conditions).
24
Q

Heat illness risk factors

A
  • Extremes of age
  • Underlying chronic ill health and debility (esp. cardiac, respiratory and neurological)
  • Mental illness
  • Drugs (diuretics, beta-blockers, alcohol, stimulants, phenothiazines, anticholinergics)
  • Lack of air-conditioning (lower socioeconomic groups)
  • Occupational (miners, fire fighters, military recruits)
25
Q

Methods of heat loss

A

Conduction
Convection
Radiation
Evaporation

26
Q

The ideal environment to maximise heat loss

A

Cool & dry
Breeze

27
Q

Body temperature to cause cell injury & cell death

A

Body temperatures in excess of 40oC can cause direct cellular injury.

Temperatures above 42oC can directly produce cell death.

28
Q

Heat stroke - Cooling Target temperature

A

38.5oC.

29
Q

Heat stroke management

A

Active cooling can be reliably performed by use of tepid water sprays and electrical fans.

Benzodiazepines play a central role in seizure control and making active cooling techniques more tolerable for the patient

Immersing the patients limbs or whole body in cool water is described but impractical.

Icepacks in the groin and axillae

30
Q

Sports events should be cancelled if the WBGT is greater than_____

A

28oC

31
Q

Envenomation symptoms

A
  • Local tissue destruction
  • Bleeding disorders
  • anaphylaxis
  • tissue oedema
  • organ failure
  • paralysis
32
Q

Initial management of snake and spider bites

A

Compression and immobilisation

33
Q

Drowning: Definition

A

A process of experiencing respiratory impairment from submersion/immersion in a liquid.

34
Q

3 Outcomes from drowning

A

Death
Morbidity
No Morbidity

35
Q

Good prognostic indicators for the outcome of a drowning incident

A

Submersion <10mins
No aspiration
Child
Water temp <10oC
Core temp <33-35oC
Neurologically in tact on arrival at hospital.
If cardiac arrest occurs, ROSC <10 mins
Time to effective BLS <10mins

36
Q

Water Temperature at which selective brain cooling may occur

A

6 oC

37
Q

Drowning: groups that should received prolonged resuscitation

A

Submersion less that 30 mins (Tw >6oC)

Submersion less than 90 minutes (Tw <6oC)

Possibility of air pocket

Intermittent submersion

Those showing signs of life on rescue

38
Q

2 main factors determining outcome following drowning

A

Water temperature

Submersion time

39
Q

Swiss Staging model for hypothermia - Stage I

A

Conscious
Shivering
32-35oC

40
Q

Swiss Staging model for hypothermia - Stage II

A

Impaired consciousness
Not shivering
28-32oC

41
Q

Swiss Staging model for hypothermia - Stage III

A

Unconscious
Not shivering
24-28oC
Vital signs present

42
Q

Swiss Staging model for hypothermia - Stage IV

A

Unconscious
No vital signs
<24oC

43
Q

3 Frostbite Classifications

A

Frostnip
Superficial Frostbite
Deep Frostbite

44
Q

Frostnip

A

Shortlived superficial freezing
Respond rapidly to warming

45
Q

Superficial frostbite

A

Superficial skin layers only affected
Clear blisters form 24-48 hours
Underlying tissue is pliable and soft

46
Q

Deep frostbite

A

Full thickness
Blood filled blisters form after 1-3 weeks
Underlying tissues are woody and stony
Loss of digits

47
Q

Hypothermia classifications

A

Mild - 32-25oC
Moderate - 29-32oC
Severe - <29oC

48
Q

ECG changes in hypothermia

A

J Waves
Slow AF
VF

49
Q

Umbles of hypothermia

A

Stumbles, mumbles, grumbles, jumbles

50
Q

Common ECG leads showing J-waves

A

II
V3-V6

51
Q

Hypothermia Drug dosages and intervals

A

30-35 oC - Double intervals

<30oC - Withhold

DipIMC (27 decks)

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