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Back to Basics - Critical Care Transport Review > Environmental/Toxicology > Flashcards

Environmental/Toxicology Flashcards

1
Q

Normal body temperature

A
  1. 0 C

98. 6 F

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2
Q

Mild hypothermia temperature (C), common signs

A

32-36 C

slowing heart rate, shivering

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3
Q

Moderate hypothermia temperature (C), common signs

A

28-32 C

loss of shivering, altered LoC, reduced drug metabolism

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4
Q

Severe hypothermia temperature (C), common signs

A
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5
Q

Two major causes of heat loss

A

evaporation, radiation

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6
Q

Thermoregulation ceases at what temp

A

28 C

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7
Q

What is the appropriate and inappropriate drug for treating stimulant overdose (cocaine, meth)?

A

Appropriate: benzodiazepines, nitro
Inappropriate: B-blockers

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8
Q

Signs of digoxin toxicity

A

Blurry vision, including green/yellow halos
Abnormal EKG, prolonged PR

“Dig-dip” is not sign of toxicity, only that PT is on digoxin

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9
Q

Acetaminophen overdose proceeds in how many distinct stages? Each lasting about how long?

A

4 stages

24 hrs

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10
Q

The most common drug overdose in the USA is:

A

Acetaminophen - responsible for the most ED visits and most admissions to ICU

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11
Q

Describe stage 1 of acetaminophen overdose

A 
0-24hrs
GI upset (N/V), may be asymptomatic
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12
Q

Describe stage 2 of acetaminophen overdose

A

24-48 hrs

N/V, RUQ pain, elevation of liver enzymes

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13
Q

Describe stage 3 of acetaminophen overdose

A

48-96 hrs

Acute liver failure (jaundice, abnormal coags, encephalopathy)

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14
Q

Describe stage 4 of acetaminophen overdose

A

> 96 hrs

Death from liver failure or recovery (full recovery up to 3 months)

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15
Q

Describe the initial presentation of acetylsalicylic acid (aspirin) overdose

A

N/V, headache, tinnitus, tachypnea

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16
Q

Tylenol overdose is any ingestion greater than

A

200mg/kg

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17
Q

Aspirin overdose is any ingestion greater than

A

approx 150mg/kg

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18
Q

The antidote for tylenol overdose is

A

N-acetylcysteine (NAC aka Mucomyst)

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19
Q

Defibrillation of a hypothermia PT is often not effective until body temperature is

A

30 degC

20
Q

Define afterdrop in the hypothermic patient

A

Prehospital external warming results in cold blood returning to core, increased risk of dysrhythmia

21
Q

What transfusion reaction occurs within minutes of administration?

A

Acute hemolytic reaction - donor blood rapidly destroyed by host antibodies, usually caused by ABO type incompatibility

22
Q

Anaphylactic reaction to blood transfusion most often occurs after how long

A

> 30 minutes

23
Q

The antidote for coumadin toxicity is

A

Vitamin K, FFP

24
Q

Treatment for digitalis toxicity includes

A

Digibind, pacing for severe bradycardia

25
Q

The antidote for malignant hyperthermia is

A

Dantroline

26
Q

What are the signs of malignant hyperthermia in the vented patient?

A

Recent administration of succinylcholine or anesthetic gas
Rapid, uncorrectable elevation of ETCO2
May see elevated temp, muscle rigidity

27
Q

The most critical, life-saving treatment for heat stroke is

A

Rapid, active external cooling (submersion, ice sheets)

28
Q

The most common type of decompression injury from diving is

A

Pulmonary (the “chokes”) - presents like PE

May also cause neuro symptoms

29
Q

How can arterial gas embolism (AGE) may be differentiated from decompression illness (DCI)?

A

AGE is rapid onset (

30
Q

Two types of decompression illness are:

A

The “bends” - severe joint pain

The “chokes” - respiratory or neuro symptoms

31
Q

What gas law describes how gases in the lungs expand when a scuba diver ascends?

A

Boyle’s Law (P = 1/V)

32
Q

Describe hypoxic hypoxia

A

Reduced alveolar oxygen exchange (low FiO2, APE, lung disease)

33
Q

Describe hypemic hypoxia

A

Reduced oxygen carrying capacity of the blood (anemia, CO poisoning, sulfa/nitrate drug use)

34
Q

Describe stagnant hypoxia

A

Reduced cardiac output (PPV, PE, heart failure)

35
Q

Describe histotoxic hypoxia

A

Poisoning of cytochrome oxidase system, resulting in metabolic disorder (CN/CO/EtOH toxicity)

36
Q

Hallucinations are most common with what street drug poisonings?

A

PCP, LSD

37
Q

Treatment of organophosphate poisoning includes

A

Atropine, Pralidoxime

Benzodiazepines (for seizures)

38
Q

The antidote for benzodiazepine overdose is

A

Romazicon

39
Q

The antidote for ethanol toxicity is

A

Fomepizole

40
Q

The antidote for B-blocker overdose is

A

Glucagon

41
Q

A patient with ethylene glycol ingestion would initially present with

A

Nystagmus, headache, elevated anion gap, confusion

42
Q

The antidote for heparin overdose is

A

Protamine sulfate

43
Q

What is the antidote for iron overdose? How do you know treatment is effective?

A

Deferoxamine

Pink urine

44
Q

An elevated BUN may indicate

A

Dehydration, Renal failure, Intra-abdominal hemorrhage

45
Q

The antidote for carbon monoxide poisoning is

A

High FiO2, hyperbaric chamber

46
Q

The antidotes for cyanide poisoning are

A

Cyanokit (Amyl nitrate, sodium nitrite, sodium thiosulfate)

Hydroxycobalamin

Back to Basics - Critical Care Transport Review (10 decks)

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