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EMS > Environmental Injuries > Flashcards

Environmental Injuries Flashcards

1
Q

Heat cramps- EEti

A
  • Hyponatremia- loss of salt

- Replacement of water to replace lost fluids

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2
Q

Heat cramps- Sx

A
  • Muscle spasms in abdomen, thighs and shoulders
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3
Q

Heat cramps- Tx

A
  • Electrolyte solutions

- Saline

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4
Q

Heat exhaustion- Eti

A

Dehydration, prolonged exposure

  • Hypernatremic- inadequate water replacement
  • Hyponatremic- excessive sweating with water replacement
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5
Q

Heat exhaustion- Sx

A
  • HA, N/V
  • Not altered, conscious
  • Tachypnea
  • Malaise
  • Cramps
  • Tachycardia
  • OrthoHTN
  • Dizziness
  • Diaphoresis
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6
Q

Heat exhaustion- Tx

A
  • Salt tablets, saline
  • Rest, cooling measures
  • Check for myoglobinuria- Rhabdo, order CK
  • Hospitalize with comorbid conditions or severe sx
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7
Q

Heat stroke- Eti

A
  • Dysfunction of heat regulation

- Emergency

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8
Q

Heat stroke- Sx

A
  • Elevated body temp > 41C/ 105.8 F
  • AMS!
  • Seizures, delirium and coma
  • Skin hot and dry- Anhidrosis
  • HA, N/V visual disturbances
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9
Q

Heat stroke- Tx

A
  • Rapidly lower core temp
  • ABCs, IV fluids
  • Evaporative cooing
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10
Q

Heat stroke- Dx

A
  • Dx of exclusion, RO drugs, infection, endocrine emergencies
  • Hemoconcentration- loss of fluid
  • BUN and CK for rhabdo
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11
Q

Frost bite- Eti

A
  • 2nd degree injury to tissue due to freezing
  • Limited to exposed skin
  • Classified after rewarming
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12
Q

Frost bite- Sx

A
  • 2nd degree: full thickness freezing
  • Erythema, significant edema
  • Vesicles, blackened eschar
  • Numb, achy and throbbing
  • 3rd degree: full skin and sub freezing
  • Less pain, violates hemorrhagic blisters
  • No sensation progress to shooting pains
  • 4th degree: Most severe, full skin, sub, muscle, tendon and bone
  • No pain, little edema
  • Loss of limb, dry, black and mummified
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13
Q

Frost bite- Tx

A
  • 3-5 weeks to determine extent of injury
  • Deep, rapid rewarming until skin pliable
  • Narcotics
  • ## Debride clear blisters
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14
Q

Frost nip- Eti

A
  • First degree frost bite

- No loss of tissue after rewarming

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15
Q

Frost nip- Sx

A
  • Partial freezing
  • Erythema, edema, hyperemia
  • Stinging, burning and throbbing
  • Desquamation after warming
  • Hyperhydrosis
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16
Q

Frost nip- Tx

A
  • Same as frost bite
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17
Q

Hypothermia- Eti

A
  • Capacity to produce heat overwhelmed by external temp

- More common with comorbid- CNS depressants, ETOH

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18
Q

Hypothermia- Sx

A
  • Mild: Retal temp of 90-95
  • Normal consciousness and shivering
  • Profound: Retal temp below 90
  • Marked AMS
  • Shivering stops at 87.8
  • Hypotension, ventilation, bradycardia
  • EKG: Osborne/ J wave- unusual QRS elevations
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19
Q

Hypothermia- Tx

A
  • Hospitalize
  • Rewarming- may be dangerous due to vasodilation
  • Cardiopulm resus
  • Correct fluids and lytes
  • Abx if coma
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20
Q

Chilblains- Eti

A
  • Women (15-30), children, PV dz

- Chronic, intermittent exposure to damp, nonfreezing temps

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21
Q

Chilblains- Sx

A
  • Painful, inflamed lesion of hands, ears and lower extremities
  • Erythema, edema, vesicles, nodules and ulcerations
  • Paresthesias and pruritus
22
Q

Chilblains- Tx

A
  • Elevate
  • Warm at room temp
  • Protect from further trauma
23
Q

Immersion foot- Eti

A
  • Prolonged clod water immersion
  • Hours to days to develop
  • Alternating vasospasm and dilation
24
Q

Immersion foot- Sx

A
  • Tingling, numbness with pale mottled appearance
  • Hyperemic- burning
  • Edema and bullae
  • Anesthesia
  • Hyperhydrosis, cold sensitivity and gangrene
25
Q

Immersion foot- Tx

A
  • Change shoes and wet socks
26
Q

Electrical/ lightening injuries- Eti

A
  • Electrical current on cells
  • Heat generated due to resistance of tissues
  • Energy greatest at point of contact
27
Q

Electrical/ lightening injuries- Sx

A
  • Linear, thermal burns
  • AMS, dazed or unconscious
  • Rhythm disturbances
  • MS trauma- crush injuries
  • Damage to vessels, muscles and nerves
  • Exit wound larger than entrance
28
Q

Electrical/ lightening injuries- Dx

A
  • UA for myoglobin
  • ECG
  • CT for head trauma
29
Q

Electrical/ lightening injuries- Tx

A
  • High flow O2
  • ACLS for systole of ventricular dysrhythmia
  • Crystalloid fluids
30
Q

Barotrauma- Eti

A
  • Most common

- Squeeze on descent in air filled body space

31
Q

Barotrauma- Sx

A
  • Sinus and dental barotrauma
  • ## Pulm barotrauma leading to gas
32
Q

Barotrauma- Tx

A

-

33
Q

Decompression sickness- Eti

A
  • Increased Atm pressure increases gas dissolved in plasma
  • Due to rapid ascent
  • 75% develop sx within 1 hr
  • Wait 12-48 hrs before flying
34
Q

Decompression sickness- Sx

A
  • Type 1: Mild
  • MS joint pain, elbow and shoulder
  • Pruritus, erythema, cyanosis
  • Peau d’orange, adénopathie
  • Type II: NS involvement
  • Paresthesia, weakness, paraplegia, venous gas embolism
35
Q

Decompression sickness- Tx

A
  • O2, analgesics, crystalloid fluids

- Hyperbaric chamber

36
Q

Arterial gas embolism- Eti

A
  • Due to pulmonary barotrauma
37
Q

Arterial gas embolism- Sx

A

-

38
Q

Arterial gas embolism- Tx

A

-

39
Q

Acute mountain sickness- Eti

A
  • Rapid ascent over 6600 ft
  • Phys changes to resp, circ, hematopoietic, renal sx
  • 6-24 hrs after arrival at altitude
40
Q

Acute mountain sickness- Sx

A
  • HA, N
  • Palpitation
  • Drowsiness, weakness and fatigue
  • Worse on day 2-3, better by day 7
41
Q

Acute mountain sickness- Tx

A
  • Descent
  • Antiemetics, analgesics
  • O2
  • Dexamethasone if progression
  • Prevent with acetazolamide
42
Q

High altitude pulm edema- Eti

A
  • Severe AMS
  • Rapid ascent > 8000 ft
  • Young and healthy
  • Salt intake, cold, sleeping exposure increase risk
43
Q

High altitude pulm edema- Sx

A
  • Cough, dyspnea at rest
  • Pink, frothy sputum
  • Weak and drowsy
44
Q

High altitude pulm edema- Tx

A
  • Rest and O2
  • Postive pressure vent
  • Descend
  • Acetazolamide
  • Nifedipine to lower pulm pressure
45
Q

High altitude cerebral edema- Eti

A
  • Rapid ascent > 8000 ft

- Hypoxia

46
Q

High altitude cerebral edema- Sx

A
  • HA
  • AMS and coma
  • Papilledema
  • Global encephalopathy
    May lead to brainstem herniation
47
Q

High altitude cerebral edema- Tx

A
  • O2

- Rapid descent

48
Q

Drowning/ Near drowning- Eti

A
  • Oregon 10th highest

-

49
Q

Drowning/ Near drowning- Sx

A
  • Wet drowning- fluid in lungs
  • Dry drowning- Laryngospasm due to inhalation of water, no water in lungs
  • Resp impairment due to submersion in liquid
  • Panic, loss of breathing
  • Inspiration reflex
50
Q

Drowning/ Near drowning- Tx

A
  • Resuscitation in 2 min
  • Breaths before compressions
  • O2 > 94%
  • CPAP
  • Hospitalize! Sx within 7 hrs
  • C-spine immobilization

EMS (19 decks)

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