Environmental and toxicology emergencies

Question 1

What is the antivenom given for pit vipers bite?

Answer 1

CroFab

Question 2

What drug would you give for scorpion bites? If it’s not available, what is the second line of drug?

Answer 2

Anascorp

Benzos and atropine

Question 3

What is the clinical benchmark where heat exhaustion turns into heat stroke?

Answer 3

Upon onset of altered mental status

Question 4

What internal body temp is severe hypothermia?

Answer 4

< 90 F or 32.2 C

Question 5

What internal body temp does shivering stop?

Answer 5

89.6 F or 32 C

Question 6

What specific EKG sign will you see in Hypothermia?

Answer 6

J wave or Osbourne wave

Question 7

What temp should IV fluids be warmed to?

Answer 7

102.2 F or 39C

Question 8

In patient’s suffering from wet drowning, what therapy is necessary to maximize ventilation?

Answer 8

NIPPV

Consider increasing PEEP

Question 9

How long after diving should you wait to fly?

Answer 9

12 hours

Question 10

What are the two types of Decompression Sickness?

Answer 10

Type 1 is painful, mottled skin, itching

Type 2 is neurologic signs and symptoms, hypovolemic shock

Question 11

In a patient with Decompression sickness, what altitude should you try to stay under if there is not a pressurized cabin?

Answer 11

1,000 msl

Question 12

What gas law causes Decompression sickness?

Answer 12

Henry’s Law

Question 13

At what altitude and time since ascent does acute mountain sickness begin?

Answer 13

Recent gain in altitude of >8200 feet

Within 24 hours

Question 14

With decompression sickness, what is the treatment and what should you avoid?

Answer 14

High flow O2, analgesics, sedatives and hyperbaric treatment.
Avoid CPAP

Question 15

What are some signs of Acute mountain sickness?

Answer 15

Headache, dizziness, GI symptoms, fatigue, weakness and difficulty sleeping

Question 16

At what time and and altitude does high altitude pulmonary Edema (HAPE) begin?

Answer 16

2-4 days after a rapid ascent of over >10,000 feet

Question 17

What are some signs of high altitude pulmonary edema?

Answer 17

Rales, tachycardia, tachypnea, dyspnea at rest, fever, non-productive cough

Question 18

At what altitude and time since ascent does high altitude cerebral edema (HACE) begin?

Answer 18

5 days after rapid ascent to >12,000 ft

Question 19

What are some signs of High altitude cerebral edema?

Answer 19

Visual changes, paresthesia, mental status changes, coma

Question 20

What is the treatment for HACE?

Answer 20

Descend, O2, Dexamethasone, hyperbaric therapy.

Question 21

What is the treatment for HAPE?

Answer 21

Descend, O2, Nifedipine, Consider CPAP and hyperbaric therapy