Environmental Flashcards
What’s the disposition of an asymptomatic lightning strike?
Admit for observation 12-24hrs!
late cardiac injuries may present
(rhabdomyolysis and myoglobinuria also possible)
How to treat shivering once cooling has started for hyperthermia?
Benzodiazepines
What’s the first aid care for a snake bite?
keep affected limb in a dependent position
minimize movement
rapid transport to hospital
What are illnesses associated with high altitude? Why?
As PIO2 decreases with ascent, the normal driving pressure of PO2 down the oxygen cascade diminishes, resulting in progressive hypoxemia and tissue hypoxia.
Acute Mountain sickness (AMS): headache and malaise, anorexia
can progress to High Altitude Cerebral Edema (HACE): encephalopathic signs and symptoms
HIgh Altitude Pulmonary Edema (HAPE)
All respond to oxygen but definitive treatment is with descent
What are the clinical manifestations of a scorpion bite? How to manage?
Symptoms occur within minutes, peak at 1-2hrs
excitatory neurotoxin with restlessness, hyperactivity, rotatory eye movements, swelling and local pain most common
Treat supportively, antivenom available
What laboratory finding is suggestive of cyanide poisoning?
How to treat?
lactate >10
hydroxycobalamin IV
In a household minor socket injury, how to manage?
If asymptomatic, no need to investigate
consider CBC, troponins, serum electrolytes, myoglobin and ECG
What is an early poor prognostic sign for radiation exposure?
Prodromal phase – 0 to 2 days after exposure
Latent phase – 2 to 20 days after exposure
Manifest illness – 21 to 60 days after exposure
The earlier the development of symptoms, the worse the exposure, the shorter the latent phase.
follow lymphocyte counts within the first 48hrs, if lymphopenia <100 it is lethal
lymphopenia <1000 it is severe but chance of survival
they will also develop GI syndrome, CNS syndrome
What’s that rhyme for which snakes are nice and which ones aren’t??
RED ON YELLOW, KILL A FELLOW
RED ON BLACK, A FRIEND OF JACK
How to manage a potentially dangerous snake bite presenting to the ED?
Admit for a minimum of 24hrs
Watch for the development of neurotoxic symptoms with paralysis, respiratory failure/insufficiency
What are features of scuba diving decompression sickness?
air bubble precipitating into the joints, skin, lymphatics (pulmonary and neurologic in certain cases)
treat with hyperbaric O2
When should you provide prophylactic antibiotics to animal bites?
moderate to severe bites
all deep puncture bites
bites to the hands, feet of genitals
significant or deep bites to the face
What are symptoms of a black widow bite?
the venom is a neurotoxin which creates systemic sympathomimetic efffects
treat with supportive care: benzos, opioids
What are examples of the crotalus snake family? What are the effects of envenomation?
rattle, copperhead, cottonmouth local edema, ecchymosis, hemorrhage (low platelets, low fibrinogen) Observe 12-24hrs Rx CroFab if unwell and repeat labs in 1hr
What kind of sea venoms are heat labile?
stingray, jellyfish, Portuguese man of war, lionfish, scorpion fish, cat fish, sea urchin
