Environmental

Question 1

Hypothermia degrees

Answer 1

Mild = 32-35’
Moderate = 28-32’
Severe = <28’

Question 2

Hypothermia management

Answer 2

Mild
-non-invasive, passive rewarming + encourage active movement
-encourage sweet drinks if alert
-remove wet clothing
-transfer if rewarming not possible in field

Moderate
-handle gently to avoid cardiac arrhythmias
-lay patient down but encourage alertness
-full body active rewarming (external, minimally invasive)

Moderate AND
-airway management
-consider invasive rewarming
-if in VT/VF provide single shock max Js, recurrent doses of adrenaline
-provide CPR until warm, regardless of apparent dilated pupils or rigor

Question 3

Complications of electrocution

Answer 3

Cardiac arrhythmias
Seizures
Rhabdomyolysis/AKI
Fractures or dislocations
Resulting trauma eg if thrown from a height by shock
Burns
Skin damage
Compartment syndrome
Peripheral nerve injury

Question 4

Types of electrocution

Answer 4

Flash (ie arc. Current stops at skin)
Flame (arc + clothes on fire - burns but current usually stops at skin)
Lightning
True

20% children/adolescents

Question 5

Electrocution

Answer 5

Degree of skin affected does not necessarily indicate degree of internal damage
Tissue with highest resistance has most damage. Skin, bones and fat high resistance.
Heart most affected if current passes hand to leg or hand to hand
AC (household electrical) 5x more damaging than DC (batteries, AED) and more likely to result in tetany
Morbidity in general tends to be higher in low-voltage injuries - lower voltage more likely to result in tetany which can cause more serious injury
Higher voltage more likely to cause burns

Determine voltage, AC vs DC, time of contact, symptoms