environmental emergencies

Question 1

Define hypothermia

Answer 1

drop in core temp below 35

Question 2

mild hypothermia temp range

Answer 2

32-35

Question 3

mild hypothermia signs and symptoms

Answer 3

twmp between 32 and 35
normal mental status
shivering
tachypnea
tachycardia
Ataxia
impaired judgement
“cold diuresis”

Question 4

moderate hypothermia temp tange

Answer 4

28-32

Question 5

moderate hypothermia signs and symptoms

Answer 5

altered mental status
no shivering
bradycardia, decrease in CO
A-FIb, junctional bradycardia
decrease in RR due to CNS depression

Question 6

severe hypothermia temp range

Answer 6

24-28

Question 7

severe hypothermia signs and symptoms

Answer 7

unconscious
severe hypotension
bradycardia
ventricular arrhythmia
asystole

Question 8

true or false, initial treatment of hypothermia should start in a step wise manner with passive re-warming, (blankets), then active rewarming (heated IV solutions,heat packs)

Answer 8

true

Question 9

why does patient become hypotensive with hypothermia?

Answer 9

decreased cardiac output
fluid shift to extracellular causes dehydration

Question 10

temp for heated iv fluids?

Answer 10

37-42 degrees

Question 11

common ECG findings in hypothermia

Answer 11

J or Osborne wave (positive reflections following QRS) most predominent in v2-v5

Question 12

Temp range for pacing in persistent bradycardia in hypothermia

Answer 12

32-35 degrees

Question 13

true or false: epi push dose or infusion can be given for bradycardia in hypothermia patients

Answer 13

false. Just pacing if within 32-35 degrees.

Question 14

in hypothermia cardiac arrest, how much epi can be given?

Answer 14

up to 3 doses of 1mg each

Question 15

what is frostbite?

Answer 15

cold caused ischemic injury

Question 16

whar are the different categories of frostbite?

Answer 16

frost nip, superficial frostbite, deep frost bite

Question 17

what are the categories of high altitude sickness?

Answer 17

acute mountain syndrome
high altitude pulmonary edema
high altitude cerebral edema

Question 18

signs and symptoms of high mountain sickness

Answer 18

all 3:
recent gain of altitude
several hours at altitude
a headache in addition to at least one:
fatigue/weakness
GI sx
dizziness
difficulty sleeping

Question 19

high altitude pulmonary edema signs and symptoms

Answer 19

Dyspnea at rest
cough
chest tightness/congestion
plus one of:
central cyanosis
rales or wheezing
tachypnea
tachycardia

Question 20

high altitude cerebral edema

Answer 20

fatigue
“throbbing” headache
ALOC
ataxia

Question 21

why do high altitude sicknesses occur?

Answer 21

too quick of ascent to altitude
less partial pressure of 02 the higher you go
leads to relative hypoxia
which leads to increase in cappillary pressure and vascular permeability,
which leads to edema - HAPE or HACE

Question 22

treatment for altitude sicknesses

Answer 22

descent
oxygen to spp2 of over 90%
dexamethasone 8mg (for AMS AND HACE)
CPAP for HAPE
anti-emetics

Question 23

in hypothermia cardiac arrest, how many shocks can be given?

Answer 23

3. then transport. do not pause to analyze anymore.

Question 24

at what body temp can analyzes and defibs resume?

Answer 24

30 degrees

Question 25

are fixed, dilated pupils, apparent rigor, dependent lividity contraindications for resus in hypothermia arrest

Answer 25

no

Question 26

what are heat cramps?

Answer 26

acute involuntary muscle pains due to loss of sodium from sweat

Question 27

true or false: a patient eith heat cramps can be hypotensive

Answer 27

true. (vagal response) but remains alert

Question 28

true or false: treatment for heat cramps involves: going to cool environment, giving sports drink to replace sodium, and massaging cramps

Answer 28

false. first 2 are true, but do not massage cramps