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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
Methods of heat loss
Conduction Convection Radiation Evaporation
26
The ideal environment to maximise heat loss
Cool & dry Breeze
27
Body temperature to cause cell injury & cell death
Body temperatures in excess of 40oC can cause direct cellular injury. Temperatures above 42oC can directly produce cell death.
28
Heat stroke - Cooling Target temperature
38.5oC.
29
Heat stroke management
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
Sports events should be cancelled if the WBGT is greater than_____
28oC
31
Envenomation symptoms
- Local tissue destruction - Bleeding disorders - anaphylaxis - tissue oedema - organ failure - paralysis
32
Initial management of snake and spider bites
Compression and immobilisation
33
Drowning: Definition
A process of experiencing respiratory impairment from submersion/immersion in a liquid.
34
3 Outcomes from drowning
Death Morbidity No Morbidity
35
Good prognostic indicators for the outcome of a drowning incident
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
Water Temperature at which selective brain cooling may occur
6 oC
37
Drowning: groups that should received prolonged resuscitation
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
2 main factors determining outcome following drowning
Water temperature Submersion time
39
Swiss Staging model for hypothermia - Stage I
Conscious Shivering 32-35oC
40
Swiss Staging model for hypothermia - Stage II
Impaired consciousness Not shivering 28-32oC
41
Swiss Staging model for hypothermia - Stage III
Unconscious Not shivering 24-28oC Vital signs present
42
Swiss Staging model for hypothermia - Stage IV
Unconscious No vital signs <24oC
43
3 Frostbite Classifications
Frostnip Superficial Frostbite Deep Frostbite
44
Frostnip
Shortlived superficial freezing Respond rapidly to warming
45
Superficial frostbite
Superficial skin layers only affected Clear blisters form 24-48 hours Underlying tissue is pliable and soft
46
Deep frostbite
Full thickness Blood filled blisters form after 1-3 weeks Underlying tissues are woody and stony Loss of digits
47
Hypothermia classifications
Mild - 32-25oC Moderate - 29-32oC Severe - <29oC
48
ECG changes in hypothermia
J Waves Slow AF VF
49
Umbles of hypothermia
Stumbles, mumbles, grumbles, jumbles
50
Common ECG leads showing J-waves
II V3-V6
51
Hypothermia Drug dosages and intervals
30-35 oC - Double intervals <30oC - Withhold

DipIMC (27 decks)

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