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VTS > Environmental Emergencies > Flashcards

Environmental Emergencies Flashcards

1
Q

Why does water decrease the body’s resistance to electrical flow?

A
  • Due to Ohm’s Law (Q = P/R)
  • Wet skin = less resistance = more damage
  • Dry skin = more resistance = less damage
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2
Q

What does alternating current (AC) do to the body?

A
  • Results in muscle tetany
  • Muscles contract & patient is unable to let go
  • Increases exposure time and overall injury
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3
Q

Which current is more severe, AC or DC?

A

AC. DC does not cause muscle contraction, meaning less exposure time

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4
Q

What is electroporation?

A
  • The development of holes in the cellular membrane, cellular pore disruption. The holes allow the movement of larger molecules such as fluids or ions across the cellular membrane
  • This causes excessive swelling or shrinking of cells, resulting in osmotic damage and cell death
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5
Q

What is thermal injury secondary to electrocution?

A
  • Occurs when electrical energy turns into heat
  • This increases the temp of the ICF & ECF
  • This causes breakdown of tissue proteins which causes necrosis of the overheated tissue
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6
Q

What arrhythmia does AC cause?

A

Vfib - low voltage

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7
Q

What arrhythmia does DC cause?

A

Asystole - high voltage

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8
Q

What is a possible sequaela to electrocution?

A

Pulmonary edema, thought to be neurogenic

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9
Q

What height qualifies a high rise fall?

A

2 or more stories (20 feet)

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10
Q

High rise fall injury results from ___?

A

Vertical deceleration trauma

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11
Q

What is responsible for attempting to correct abnormal position while falling in cats?

A

The vestibular system

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12
Q

Why is it possible that cats may land on their side instead of their feet in a fall >7 stories?

A

Terminal velocity results in deactivation of the vestibular system

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13
Q

What is the pathophysiology of drowning?

A

Following submersion, a rise in CO2 levels in the bloodstream stimulates resps and water is absorbed

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14
Q

Aspiration of ____ml/kg of fluid leads to impaired gas exchange

A

1-3

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15
Q

Does sea water or fresh water lead to a more severe hypoxemia?

A

Sea water - hypertonic sea water aspiration leads to surfactant washout and diffusion of interstitial water into alveoli, thus preventng ventilation

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16
Q

How does fresh water drowning contribute to hypoxemia?

A

Pulmonary surfactant is diluted, leading to alveolar instability and collapse, which prevents normal ventilation of affected alveoli

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17
Q

Why does dry drowning sometimes lead to NCPE?

A

NCPE is likely secondary to intrathoracic pressure changes associated with continued respiratory effort in the presence of persistent laryngospasm

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18
Q

What is the diving reflex?

A

When the face hits water <41F, CNS activation from the trigeminal nerve will cause bradycardia and hypertension, resulting in shunting of blood to cerebral circulation

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19
Q

What are the 4 mechanisms of thermoregulation?

A
  • Conduction (heat to surface)
  • Convection (heat to air)
  • Radiation (heat to objects not in contact)
  • Evaporation (heat from moist surfaces)
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20
Q

What signs are seen at body temp of 90-99F?

A
  • Vasoconstriction
  • Ataxia
  • Shivering
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21
Q

What signs are seen at body temp of 82-90F?

A
  • Decreased LOC
  • Hypotension
  • May or may not be shivering (losing the ability to do so)
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22
Q

What signs are seen at body temp of 68-82F?

A
  • Complete loss of shivering reflex
  • +/- cardiac abnormalities
  • +/- extreme CNS deficits
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23
Q

What signs are seen at body temp <68F?

A
  • CV & CNS deficits
  • Coag deficits leading to hypocoagulable state
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24
Q

What are the two types of hypothermia?

A
  • Primary: heat loss in the face of normal heat production, encompassing environmental exposure. Unable to keep up with heat loss
  • Secondary: result of dz process, drug administration (GA) or injury. Diseases can alter thermoregulation and increase/decrease metabolic rate
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25
Q

Anesthetic agents reset the T threshold needed to cause a ______?

A

Reflex vasoconstriction

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26
Q

If the ______has been reset, an animal may be intolerant of heat support even if clinically hypothermic

A

Temperature setpoint

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27
Q

What isotonic fluid should be avoided in severe hypothermia?

A

LRS, because lactate requires hepatic metabolism

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28
Q

Below ____F, heat loss increases and the patient becomes colder, faster

A

94F

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29
Q

Where are forced air warmers best placed?

A

On or near areas with a large blood supply such as the neck or abdomen

30
Q

If using active internal rewarming, fluids should not exceed _____F to avoid damage to internal tissues

A

109.5F

31
Q

Why should caution be excerised if infusing warm fluids via central line?

A

The resulting temp gradient at the heart may lead to irritability of the myocardium and cardiac arrhythmias

32
Q

What is afterdrop?

A
  • A decrease in patient temp AFTER warming has been instituted
  • Occurs because the skin is warmed and vasoconstricted tissues begin to dilate, moving cold blood into the central vasculature
33
Q

What is rewarming shock?

A
  • Characterized by vasodilation as a result of applied heat
  • Vasodilation has the potential to negatively impact organ perfusion and DO2 during rewarming
34
Q

What body parts should external rewarming be focused on?

A
  • Core. Avoid limbs
  • This allows the vasculature to vasodilate slowly as warming progresses, allows CV system to adjust and avoids collapse
35
Q

What biochemical changes will be seen in hypothermic patients?

A
  • Metabolic acidosis which can continue to worsen as lactic acid is recruited from limbs and other hypoxic tissues
  • Hyperkalemia as cellular K leaks out from damaged cellular membranes and in rewarming there is a shift of K from the intracellular to the extracellular space
36
Q

What are the two most important fever producing cytokines?

A
  • Interleukin 1& 6
  • Tumor necrosis factor
37
Q

How do NSAIDs bring down a fever?

A
  • Pyrogens go to the anterior hypothalamus stimulating release of prostaglandins, causing an increase in temp
  • NSAIDS inhibit prostaglandin synthesis
38
Q

Why is fever beneficial?

A

It interferes with growth and reproduction of causative organism

39
Q

Fevers >____F are considered life threatening

A

106

40
Q

Why is actively cooling a patient with a fever detrimental?

A
  • The body works harder to maintain its new set point
  • If active cooling measures are suddenly removed, this can cause a patient to rebound to an even higher T
41
Q

Why does humidity hinder heat dissipation?

A

Humidity reduces the evaporation of H2O, therefore the animal has to expend more energy to dissipate heat

42
Q

Irreversible brain damage has been identified at _____F?

A

105.8

43
Q

Why is hypoglycemia common in heat stroke?

A

Secondary to acute hepatic insult and increased metabolic demands

44
Q

Convection, conduction, and radiation are passive cooling processes that are in effect until the ambient T >____F?

A

89.6F

45
Q

Focused cooling efforts should be on what parts of the body?

A

Those with large blood vessels, such as the neck and inguinal area

46
Q

At what temp should active cooling cease?

A

103-103.5F

47
Q

Why should oxygen be provided to a heatstroke patient?

A
  • Hyperthermia causes an increased O2 demand to the body because of increased metabolic activity
  • Perfusion and oxygen delivery will be impaired due to metabolic shock
48
Q

Which snake family can control the amount of toxin released?

A

Crotalidae

49
Q

What animals appear resistance to snake venom?

A
  • Pigs, likely due to slow absorption of venom from fat
  • Cats, but become more critical patients because they antagonize the snake then hide afterwards
50
Q

What is Antivenin?

A
  • Fort Dodge
  • Polyvalent equine origin
  • Effective against numerous snake venoms
  • Carries significant risk of anaphylaxis
51
Q

What are the Fab antivenoms?

A
  • Ovine IgG molecules are cleaved to discard inflammatory portion of antibody
  • Much less likely to cause allergic reaction and more potent than equine origin
52
Q

What is ACP antivenon?

A
  • Boehringer Ingelheim
  • Whole IgG, equine origin
53
Q

A snake bite can be considered dry if no signs are seen after _____?

A

1 hour

54
Q

What snake family “chews” to inject venom?

A

Corals - they have short, fixed front fangs and a relatively poor venom delivery system

55
Q

How do the hemotoxic venoms exert their effect?

A
  • The proteins break down tissue and allow penetration of venom into patient’s systemic circulation
  • It destroys RBC, inhibits coagulation, breaks down fibrinogen proteins
  • Destroys vascular walls, which allows leakage of RBC and plasma into extravascular spaces
56
Q

How can the venomous coral snakes be distinguished from non venemous?

A

“Red on yellow, kill a fellow. Red on black, venom lack”

57
Q

How does neurotoxic venom exert its effect?

A
  • Neurotoxic venom is chemically similar to non depolarizing neuromuscular blocking agents
  • Mixture of polypeptides including cholinesterase & acetylcholine
  • This nondepolarizing blocking of acetylcholine receptor sites has a slow onset and markedly prolonged duration
  • Clinical signs: muscle fasciculations, spasms, paralysis, resp failure
58
Q

What is the origin of coral snake antivenom?

A

Equine antibodies

59
Q

Black widow snakes reside in every state except for?

A

Alaska

60
Q

Which species is extremely susceptible to black widow bites?

A

Cats - painful vocalization can progress to ataxia and paralytic signs +/- death

61
Q

What are the clinical signs of black widow bites?

A
  • Nearly painless bite followed by severe pain
  • Can see muscle spasms, cramping, and abdo rigidity are thought to be due to massive release of neurotransmitters
62
Q

What type of toxin does the black widow spider have?

A

A potent neurotoxin, alpha latroxin, that initially stimualtes secretion of neurotransmitters, then inhibits uptake

63
Q

Black widow bite treatment

A
  • Calcium gluconate lessens signs, but antivenom is highly effective in cats.
  • Antivenom: Derived from horse serum, standardized by a biologic assay in mice, and
    administered intravenously. Rapid reversal of symptoms noted within hours
  • Supportive therapies: Morphine, barbiturates, and glucocorticoids
64
Q

What spider species has a violin shaped icon on dorsum?

A

Brown spider

65
Q

What effect does brown spider venom have?

A

Highly toxic to tissues by interfering with leukocytes and causing dermal necrosis
- Renal injury can result from the Loxosceles toxins binding to glomerular and tubule cells

66
Q

Is there antivenom available for brown spider bites?

A

No

67
Q

Do spider bites cause infection or transmit communicable disease?

A

No

68
Q

What spider bite causes a bullseye/target sign?

A

Brown spider

69
Q

What scorpion is of concern to companion animals?

A

Bark scorpion (Centruroides exilicauda)

70
Q

What effect does bark scorpion venom have?

A

Blocks voltage-gated potassium and sodium channels; causes systemic symptoms like nystagmus, paraesthesia, excessive salivation, tachycardia, and myoclonus.

71
Q

What is the treatment for bark scorpion bites?

A
  • Symptomatic care includes high doses of benzodiazepines and opioids.
  • Anascorp antivenom, derived from horse plasma, neutralizes venom toxins but has no veterinary literature on its use in animals

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