Environmental emergencies Flashcards by Jacob Quin

What physical exam findings are noted with drowning?

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

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What lab findings may be seen with salt water ingestion?

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

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What radiograph findings are noted with drowning?

Alveolar pattern

Mixed interstitial-bronchial pulmonary pattern

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What is the prognosis for drowning?

Guarded - 37.5% survive freshwater drowning

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What treatments are needed for drowning emergencies

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

Apnea
Bradycardia
Selective vasoconstriction

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Where are electrical burns noted in the mouth?

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

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What radiograph findings are noted with electricution?

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

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What is the prognosis for electrocutions?

Guarded to poor

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What treatment is needed for electrocutions?

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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What are predisposing factors for heat stroke?

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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What clinical signs are noted with heat stroke?

Hypersalivating
Muscle tremors
Anxiety
Vomting/ diarrhea
Ataxia
Collapse
Seizure

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What physical exam findings are noted with heat stroke?

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

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What are differentials for heat stroke?

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

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What is the prognosis for heat stroke?

Varies

Constant hypogylcemia, DIC, and coma all negative prognostic indicators

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What are treatments for heat stroke?

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

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

< 82 F

Shivering stops at < 87.8 F

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

24-36 hours

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

4-24 hours

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

6 hours

What occurs during frost bite (avascular necrosis)?

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

What are the most commonly affected areas of frostbite?

Ears
Tail
Genitalia
Foot pads

What are acute clinical signs of frost bite?

Pale skin
Skin cool to the touch
Hyperthesis
Cyanosis

What occurs after thawing from frost bite?

Erythematous tissue
Pain
Localized swelling and edema

What occurs 20-30 days after frostbite?

Alopecia | Sloughing of necrotic tissue

What is treatment for hypothermia?

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

What is treatment for frostbite?

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

What should be checked for after smoke inhalation?

Fluorescein stains for corneal ulcers | Check for laryngeal swelling or carbon monoxide poisoning

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

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

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

``` 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 ```

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

``` 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 ```

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

``` 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 ```

What condition can occur secondary to smoke inhalation?

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

What radiograph findings are noted with smoke inhalation?

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

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

Sp02 may be normal

How do you treat class I burns?

Treat corneal ulcers as needed | Monitor for 24-48 hours

How do you treat class II burns?

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

How do you treat class III - IV burns?

``` 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 ```