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Plunkett Emergency > Environmental emergencies > Flashcards

Environmental emergencies Flashcards

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1
Q

What physical exam findings are noted with drowning?

A 
Bradycardia
Pale MM
Weak femoral pulses
Hypothermic
Cyanosis
Dyspnea
Epistaxis
Moist cough
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2
Q

What lab findings may be seen with salt water ingestion?

A

Hypernatremia
Hypovolemia
Hypoxemia (salt water draws fluid into the alveoli)

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3
Q

What radiograph findings are noted with drowning?

A

Alveolar pattern

Mixed interstitial-bronchial pulmonary pattern

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4
Q

What is the prognosis for drowning?

A

Guarded - 37.5% survive freshwater drowning

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5
Q

What treatments are needed for drowning emergencies

A 
Monitor for 24 hours
Oxygen therapy
Ventilation is Pa02 < 90%
Heat support (warm fluids, heating pads, warm baths and blankets)
Don't give steroids
Can consider giving aminophylline
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6
Q

What is seen with a diving reflex/ when dogs go in cold water?

A

Apnea
Bradycardia
Selective vasoconstriction

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7
Q

Where are electrical burns noted in the mouth?

A

Tongue
Gums
Buccal
Burns appear gray, tan, yellow, may have black borders

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8
Q

What radiograph findings are noted with electricution?

A

Perihilar or caudal lung field pulmonary edema (may not appear for first 18-24 hours)

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9
Q

What is the prognosis for electrocutions?

A

Guarded to poor

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10
Q

What treatment is needed for electrocutions?

A

Oxygen therapy if respiratory distress
Furosemide if pulmonary edema noted
Intubate and ventilate if fulminant pulmonary edema noted
Bronchodilators if pulmonary edema noted (aminophylline, theophylline, terbutaline
Use crystalloids if patient is in shock, but avoid colloids or hypertonic saline in the first 8-10 hours in case pulmonary edema may occur
Ulcer protection for the mouth
Monitor urine output (0.5 - 1 mL/kg/hr for cats)

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11
Q

What are predisposing factors for heat stroke?

A

Excessive exertion
Trapped in dryer or hot area too long
Having an underyling condtion (obesity or heart disease)
High humidity or temperature

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12
Q

What clinical signs are noted with heat stroke?

A 
Hypersalivating
Muscle tremors
Anxiety
Vomting/ diarrhea
Ataxia
Collapse
Seizure
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13
Q

What physical exam findings are noted with heat stroke?

A 
Temp > 104.9 F
Congested mucous membranes
Tachycardia 
Panting 
Hyperdynamic pulses
Can progress to DIC
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14
Q

What are differentials for heat stroke?

A 
Malignant hyperthermia
Strychnine toxicity
Metaldehyde toxicity
Amphetamine ingestion
Macademia nut ingestion
Eclampsia
Seizures
Meningitis
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15
Q

What is the prognosis for heat stroke?

A

Varies

Constant hypogylcemia, DIC, and coma all negative prognostic indicators

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16
Q

What are treatments for heat stroke?

A

Cool water (don’t use ice or rapidly cool as this may predispose DIC), apply this on the jugulars and abdomen
Stop cooling once temp is 103 F
Don’t use NSAIDs or steroids
Monitor bloodwork and clotting times

17
Q

At what point of hypothermia do dogs lose the ability to thermoregulate?

A

< 82 F

Shivering stops at < 87.8 F

18
Q

What is the survival time for mild hypothermia (86-90 F)?

A

24-36 hours

19
Q

What is the survival time for moderate hypothermia (72-77 F)?

A

4-24 hours

20
Q

What is the survival time for severe hypothermia (<60 F)?

A

6 hours

21
Q

What occurs during frost bite (avascular necrosis)?

A

Cold causes destruction of superficial tissues secondary to the disturbance of blood flow through small surface vessels

22
Q

What are the most commonly affected areas of frostbite?

A

Ears
Tail
Genitalia
Foot pads

23
Q

What are acute clinical signs of frost bite?

A

Pale skin
Skin cool to the touch
Hyperthesis
Cyanosis

24
Q

What occurs after thawing from frost bite?

A

Erythematous tissue
Pain
Localized swelling and edema

25
Q

What occurs 20-30 days after frostbite?

A

Alopecia

Sloughing of necrotic tissue

26
Q

What is treatment for hypothermia?

A

Oxygen
Place IV catheter and start warm fluids
Consider warm peritoneal lavage, colonic lavage, or gastric lavage if temp does not raise > 89 F

27
Q

What is treatment for frostbite?

A 
Apply warm compresses to affected area
Gently dry affected area
Antibiotics
No steroids
E-collar to prevent self-excoriation
28
Q

What should be checked for after smoke inhalation?

A

Fluorescein stains for corneal ulcers

Check for laryngeal swelling or carbon monoxide poisoning

29
Q

What is considered a minimal pulmonary injury related to smoke inhalation?

A 
Smell of smoke
Singed whiskers
Normal resp rate
Rare facial burns
Rare pale mucous membranes
Occ discharge
Chest rads are normal
Good prognosis
30
Q

What is considered a slight pulmonary injury related to smoke inhalation?

A 
Smell of smoke
Singed whiskers
Distressed mentation
Mild-moderate resp rate increase
Sometimes facial burns
Rare red mucous membranes
Nasal and ocular discharge
Chest rads are normal
Fair prognosis
31
Q

What is considered a moderate pulmonary injury related to smoke inhalation?

A 
Smell of smoke
Singed whiskers
Distressed mentation
Tachynpnic
Mild-moderate resp rate increase
Facial burns
Red mucous membranes
Nasal and ocular discharge
Chest rads are normal to pulmonary consolidation
Guarded to poor prognosis
32
Q

What is considered a severe pulmonary injury related to smoke inhalation?

A 
Smell of smoke
Singed whiskers
Unconscious, bradycardia, apnic
Tachynpnic
Mild-moderate resp rate increase
Facial burns
Red mucous membranes
Nasal and ocular discharge
Chest rads are normal to pulmonary consolidation
Very poor prognosis
33
Q

What condition can occur secondary to smoke inhalation?

A

Neuro signs ~ 6 days after the event. This occurs from leukoencephalomalacia secondary to hypoxia

34
Q

What radiograph findings are noted with smoke inhalation?

A

Diffuse patchy interstitial infiltrate
Mixed interstitial and alveolar pattern
Alveolar pattern with air bronchogram

35
Q

What effects of blood gas can be seen with carbon monoxide poisoning?

A

Sp02 may be normal

36
Q

How do you treat class I burns?

A

Treat corneal ulcers as needed

Monitor for 24-48 hours

37
Q

How do you treat class II burns?

A

Use low humidity oxygen-rich environment
Place IV cathete, treat as needed for pulmonary edema
Give shock fluids + give fluids in relation to area of body affected by burns
Avoid steroids
Pain meds

38
Q

How do you treat class III - IV burns?

A 
Apply oxygen +/- ventilation
Cool burned areas with water
Apply SSD and clean dressing to wounds
Flush and clean wounds once daily
Can give an epinephrine-saline nebulization (decreases edema, erythema, and exudation)
Bronchodilators
Nutritional support as needed

Plunkett Emergency (8 decks)

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