Environmental/Overdoses/Infectious/Abdominal

Question 1

Stages of a thermal burns

Answer 1

Emergent, fluid shift phase, hypermetabolic phase, resolution

Question 2

What is the emergent phase of burns

Answer 2

Release of catecholamines in response to pain. Can be fatal on its own, elderly most at risk

Question 3

What is the fluid shift phase

Answer 3

Shift of intravascular to extravascular space surrounding the tissue

Question 4

When does volume loss peak?

Answer 4

At 8 hr but continues for up to 24hr. Hypotension after several hours therefore need to start bolus earlier

Question 5

What is the hypermetabolic phase

Answer 5

Large increase in body’s demand for nutrients as it begins healing. Increases hr &bp

Question 6

Equation of death

Answer 6

Age of pt + TBSA burns = 100< = pt death

Question 7

What is the resolution phase

Answer 7

Formation of scar tissue and return to normal function around area

Question 8

Electrical Burns

Answer 8

Disturb normal electrical conduction in body, damage to internal organs w no outward appearance

Question 9

Acids vc Alkali burns

Answer 9

Acids- coagulation necrosis (melt tissue on surface of skin only)
Alkali- no coagulation layer, liquification necrosis

Question 10

Types of burns

Answer 10

Thermal, electrical, chemical, radiation, inhalation

Question 11

Rule of nine’s adult vs child

Answer 11

Differences in head and legs. Adult leg = 18, child 13.5. Head adult=9, child 18.

Question 12

What is a complex burn

Answer 12

Any electrical, chemical, inhalation burn, eye, face, entire hand or foot, circumferential burn, perineum, pts with fxs, elderly, immunosuppressed.

Question 13

Cyanokit (Hydroxocobalamin)

Answer 13

18> 70mg/kg over 30 mins max 5g
18<= 5g over 15-30min 5g max

Question 14

Parkland burn formula

Answer 14

4ml x weight (kg) x TBSA = ml infused. Infuse 1/2 amount in first 8 hr, other 1/2 over following 16 hr

Question 15

What is rhabdomyolysis

Answer 15

Extensive muscle necrosis and release of intracellular muscle components into circulation

Question 16

Temps for moderate and severe hypothermia

Answer 16

Moderate 32< Severe 32>=

Question 17

Drowning defenition

Answer 17

Death from submersion w/i 24 hrs of submersion

Question 18

Near drowning defenition

Answer 18

Death does not occur after submersion or death after 24 hrs of subermsion

Question 19

Fresh water drowning

Answer 19

Hypotonic water goes through bronchioles into alveoli crossing to vascular space. Fluid in vasc space moves into RBCs and explode. Washes away lung surfactant. Vasodilation due to toxins

Question 20

Salt Water

Answer 20

Hypertonic- water flows from bloodstream into lungs. Draws fluid into alveoli from vasc space via osmosis. Pulm edema,

Question 21

Dive emergencies (descent)

Answer 21

Increase intrathoracic pressure (barotrauma) where air is forced from lungs to vasc space. Pulm air embolism, severe pn, bleeding in sinuses/ears/eyes

Question 22

Dive emergencies of ascent

Answer 22

Nitrogen bubbles form in arterial blood supply and travel to lung. Pulm and cerebral a/e. The “bends” migrate to tissues/joints etc

Question 23

Cholinergic overdoses

Answer 23

Kills pests/plants, stimulate parasym ns

Question 24

SLUDGE (Cholinergic)

Answer 24

Salivation, lacrimation, urination, defecation, gastro distress, emesis

Question 25

Reversal agent for cholinergic od

Answer 25

Atropine

Question 26

Anti-Cholinergic examples

Answer 26

TCAs, antihistamines, atropine

Question 27

Anti-Cholinergic mneumonic

Answer 27

Mad as a hatter, blind as a bat, dry as a bone, red as a beet, hot as hell

Question 28

Sympathomimetic examples

Answer 28

Epi, dopamine, cocaine, meth, ritalin

Question 29

Sympathomimetic sym

Answer 29

CNS excitation (tachycardia, ht, lethal tachydysrhythmias)

Question 30

Sympatholytic moa

Answer 30

Blocks stim of alpha 1, beta 1 &2

Question 31

Sympatholytic symptoms

Answer 31

CNS depression, syncope, bradycardia, hypotension, may cause bronchoconstriction, pulm edema