Exam 5 Study Guide Flashcards
Near Drowning
A patient who survives, at least temporarily for 24 hours, after suffocation in water or other liquids.
Lightning Strikes DO NOT cause full thickness burns - WHY?
Because the duration of the lightning strike is SHORT.
Loss of body heat primarily happens where?
Cold Environments
Radiation
The Head
Hypothermia
MILD 95-90F with CBT 95-93F
Signs and Symptoms
Shivering and Foot Stamping
Constricted Blood Vessels and Rapid Breathing
Withdrawn
Hypothermia
Moderate 90-82F with CBT 92-89F
Signs and Symptoms
Loss of coordination and muscle stiffness
Slowing respirations and slow pulse
Confused, lethargic and Sleepy
Shivering Stops
Hypothermia
Moderate CBT 88-80F
Signs and Symptoms
Coma
Weak Pulse, dysrhythmias, very slow respirations
Unresponsive
PT may try to remove clothes
Poor coordination and memory loss
Reduced or complete loss of sensation to touch
Mood Changes
Impaired Judgements
Hypothermia
Severe Less than 82F with CBT Less than 80F
Signs and Symptoms
Apparent Death
Cardiac Arrest
Unresponsive
What causes lethal Cardiac Dysrhythmias in hypothermic patients?
May occur as a direct effect of cold as cardiac tissues become more irritable or as the blood pressure decreases.
Definition
Thermogenesis
The physiologic process of heat production in the body
Definition
Thermolysis
The process of heat loss
Inadequate thermolysis causes reduced heat which will then cause what?
Hyperthermia
Definition
Heat Stroke
A life threatening condition of severe hyperthermia caused by exposure to excessive natural or artificial heat.
Marked by warm, dry skin, severely altered mental status and often irreversible coma.
Signs and Symptoms
Heat Stroke
- Warm Dry Skin
- Severely Altered Mental Status
- May still be sweating if caught early
- AMS that can develop to Coma
- Seizure may be present
- Pulse may start rapid and strong, but as severity worsens it may weaken and the BP may drop
- Increases RR.
What causes heat cramps?
The exact cause is not fully understood, but is probably due to loss of electrolytes, imbalance of electrolytes, or dehydration.
Most Common Routes for Poisonings?
- Ingestion
- Inhalation
- Absorption
- Injection
Definition
Substance Abuse
Self administration of licit or elicit substances in a manner not in accordance with the approved medical or social practice.
Signs and Symptoms
Cyanide Poison
- AMS
If NOT Altered PT may report.
- Headache
- Palpitations
- Dyspnea - Bitter almond odor on breath
- Initially rapid and labored respirations as deterioration continues, respirations can become slow and gasping.
- Rapid and thready pulse
- Vomit
- Seizures
- Coma
Why should an extremity never be rewarmed?
Gangrene or Amputation may occur if they are rewarmed under uncontrolled circumstances.
Rewarming to quickly can cause vasodilation, leading to more cold exposure to the core.
Rewarming techniques for:
MILD Hypothermia
Passive rewarming.
Take to a warm environment
Remove wet clothing
Place heat packs
Rewarming techniques for:
Moderate to Severe Hypothermia
Lavage with warm fluids
Extracorporeal rewarming
Signs of Frostbite
- Hard Waxy Feeling of the Tissue
- Firm Frozen Feeling upon touch
- If only skin-may feel hard or leathery to the touch.
- Blisters may appear
- Mottled or Cyanotic Skin
Heat Exhaustion
Signs & Symptoms
- Hypovolemia
- Cold Clammy Skim with Ashen Pallor
- Dry Tongue and Thirst
- Dizziness, Weakness, Or Faintness with accompanying nausea or headache.
- Muscle and Abdominal Cramping
- Normal Vitals with Rapid Pulse and low BP
- Normal or Slightly elevated body temp.
Heat Stroke
Signs & Symptoms
- Hot, Dry and Flushed Skin
- Rapid and Strong Pulse at first, as deterioration continues, pulse may become weaker and BP Falls
- No longer has perspirations, however skin may still be moist if caught early.
- AMS to Unresponsiveness
- Increased RR
- Seizure may be noted.
Reverse Triage
Definition
A triage process in which efforts are focused on those who are in respiratory or cardiac arrest.
Different from conventional triage where such patients would be classified as decreased.
Used in triaging victims of a lightning strike.
Percentage of drownings that include alcohol?
Approximately 70% of all teenage and adult drownings are associated with alcohol abuse.
Scorpion Strings
Signs & Symptoms
- Usually very painful but not dangerous
- Causes localized swelling and discoloration
- Centruoides Sculpturats
Scorpion Stings
Venom Produces Severe Systemic Reaction
Describe the Symptoms
- Circulatory Collapse
- Severe Muscle Contractions
- Excessive Salivation
- Hypertension
- Seizures
- Circulatory Collapse
- Antivenin can be administered by Physician
Biggest SCUBA Diving Emergency?
Air Embolism
Most Common Heat Emergency?
Heat Exhaustion
Rocky Mountain Spotted Fever
Signs & Symptoms
- Occurs 7-10 Days Following Tick Exposure
- Nausea
- Vomiting
- Headache
- Weakness
- Paralysis
- Possible Cardiorespiratory Collapse
Lyme Disease
Signs & Symptoms
- Fever
- Flu Like Symptoms
- Rash that may spread to several parts of the body occurring within 3 days of exposure.
- Rash may resemble a bullseye target in 1/3 of patients
- After a few days or weeks, painful swelling of the joints, particularly in the knees may occur, may be misdiagnosed as rheumatoid arthritis.
Pale moist skin in heat emergencies means what?
Exertional Heatstroke
Rattlesnake Bites
Signs & Symptoms
- Severe Burning Pain at the site.
- Swelling.
- In light skin people, ecchymosis may be present in the skin.
- Destroy tissues locally.
- May interfere with the blood clotting system and cause bleeding at distal sites.
- Weakness
- Nausea & Vomiting
- Seizures
- Sweating & Fainting
- Change in level of consciousness
- Shock
Brown Recluse Spider Bite
Sign & Symptoms
- Dull and Brown
- 1 inch
- Violin Shaped Brown or Yellow Mark on Back
- Cytotoxic
- Not Painful at first but will become painful within hours.
- Bite area becomes swollen and tender - develops a pale, mottled, cyanotic center and possible a small blister.
- Over the next several days, a scab or dead skin, fat, and debris will form and dig into the skin producing a large ulcer that may not heal unless properly treated.
Black Widow Spider Bite
Signs & Symptoms
About the Spider:
1. 2 Inches Long
2. Black with a distinctive bright red-orange hourglass on its abdomen.
3. Female is larger and more toxic than the male.
4. Dry Dim Places in woodpiles and debris
Signs:
5. The site causes immediate localized pain and symptoms including agonizing muscle spasms
6. Neurotoxic
7.Dizziness
8. Sweating
9. N/V
10. Rashes
11. Tightness in the chest within 24 hours
12. Sever Cramps with boarlike rigidity of abdominal muscles
13. Physician can administer antivein
14. Benzos used to treat muscle spasm
15. Symptoms usually resolve in 48 hours.
Black Widow Spider Bite
Signs & Symptoms
About the Spider:
1. 2 Inches Long
2. Black with a distinctive bright red-orange hourglass on its abdomen.
3. Female is larger and more toxic than the male.
4. Dry Dim Places in woodpiles and debris
Signs:
5. The site causes immediate localized pain and symptoms including agonizing muscle spasms
6. Neurotoxic
7.Dizziness
8. Sweating
9. N/V
10. Rashes
11. Tightness in the chest within 24 hours
12. Sever Cramps with boarlike rigidity of abdominal muscles
13. Physician can administer antivein
14. Benzos used to treat muscle spasm
15. Symptoms usually resolve in 48 hours.
Opioid Overdose
Signs & Symptoms
- Hypotension
- Respiratory Depression
- Pinpoint Pupils
- N/V
- Constipation
- Coma
- Seizures
- Cardiac Arrest
Treat: Ventilations & Narcan
Tricyclic Antidepressant Overdose
Signs & Symptoms
- AMS
- Dysrhythnias
- Dry Mouth
- Blurred Vision
- Dilated Pupils
- Urinary Retention
- Constipation
- Pulmonary Edema
- Respiratory Depression
- Seizures
Activated Charcoal indications and dosage?
Ingestion of poison when the patient is alert enough to maintain their own airway.
Not indicated for acids or alkaline or petroleum products
1g per kg of body weight.
4 Types of Food Poisonings
- Salmonella 28%
- Toxoplasma 24%
- Listeria 19%
- Norovirus 11%
Anticholinergic Substance Exposure
Sign & Symptoms
- Tachycardia
- Hyperthermia
- Dry Skin and Mucous Membranes
- Dilated Pupils
- Blurred Vision
- Sedation
- Agitation
- Seizures
- Coma
- Delirium
Benzo Overdose
Signs & Symptoms
- AMS
- Drowsiness
- Confusion
- Slurred Speech
- Ataxia
- General Incoordination
Why is carbon monoxide so toxic?
It binds to the hemoglobin more regularly, displacing O2 and causing false SPO2 readings
Aspirin Overdose
Signs & Symptoms
- N/V
- Abdominal Pain
- Diaphoresis
- Ringing in the Ears
- Hyperpnea
- Pulmonary Edema
- Acid Base Disorders
Hypertensive Crisis occurs when you mix what?
MAOIs and tyramine containing foods.
Behavior Crisis
Definition
The point at which a persons reactions to events interfere activities of daily living.
Psychiatric Emergency
Definition
A person who is no longer able to respond appropriately to the environment.
Types of Mental Illnesses
Organic Brain Syndrome
- Organic brain syndrome – Temporary or permanent dysfunction of the brain, caused by a disturbance in the physical or physiological function of the brain tissue.
Types of Mental Illness
Functional Disorder
- Functional Disorder – A disorder in which there is no known physiologic reason for the abnormal functioning of an organ or organ system.
Types of Mental Illness
Schizophrenia
- Schizophrenia – A complex difficult-to-identify mental disorder with typical onset occurring during early adulthood. Dysfunctional symptosm typically become more prominent over time and include delusions, hallucinations, apathy, mutism, flat affect, a lack of interest in pleasure, erratic speech, emotional responses, and motor behavior.
Types of Mental Illness
Psychosis
- Psychosis – A mental disorder characterized by the loss of contact with reality.
Types of Mental Illness
Agitated Delirium
- Agitated Delirium – An acute confrontational state characterized by global impairment of thinking, perception, judgment, and memory.
Types of Mental Illness
Dementia
- Dementia – The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function.
Types of Mental Illness
Mood Disorders
- Mood Disorders – Disorders in which the disturbances of mood is accompanied by full or partial manic or depressive syndrome.
Types of Mental Illness
Bipolar Disorder
- Bipolar Disorder – A disorder in which a person alternates between mania and depression.
Types of Mental Illness
Mania
- Mania – A mental disorder characterized by abnormally exaggerated happiness, joy, or euphoria with hyperactivity, insomnia, and grandiose ideas.
Types of Mental Illness
Depression
- Depression – A mental health disorder characterized by a persistent mood of sadness, despair, and discouragement.
Types of Mental Illness
Neurotic Disorders
- Neurotic Disorders – A collection of mental disorders without psychotic symptoms and lacking the intense psychopathology of other mood disorders; including anxiety disorders, phobias, and panic disorder.
Types of Mental Illness
Anxiety Disorders
- Anxiety Disorders – Mental disorders in which the dominant mood is fear and apprehension.
Types of Mental Illness
Generalized Anxiety Disorders
- Generalized Anxiety Disorders – A disorder in which a person worries about everything for no particular reason, or the worrying is unproductive and the person cannot decide what to do about an upcoming situation.
Types of Mental Illness
Simple Phobias
- Simple Phobias – A fear that is focused on one class of objects.
Types of Mental Illness
Panic Disorder
- Panic Disorder – A disorder characterized by sudden, usually unexpected, and overwhelming feelings of fear and dread, accompanied by a variety of other symptoms produced by a massive activation of the autonomic nervous system.
Normal Behavior
Definition
Whatever behavior society accepts.
Alzheimer Disease
Definition
- Primary progressive dementia
- Cortical atrophy and loss of neurons in the frontal or temporal lobes of the brain.
- Progressive
- AMS and disorientation
- Loss of brain function
COASTMAP
Signs and Symptoms
- S/S of a psychotic episode
- Consciousness – Awake and alert but easily distracted
- Orientation – Common in organic brain syndrome
- Activity
- Speech
- Thought
o Flight of ideas
o Loosening of associations
o Delusions of persecution
o Thought broadcasting
o Thought insertion - Memory
- Affect and mood
- Perception – Hallucinations
GASPIPES
Signs and Symptoms
- GAS PIPES for depression
- Guilt
- Appetite
- Sleep
- Paying attention
- Interest
- Psychomotor abnormalities
- Energy
- Suicidal thoughts
Suicide Contributions
- Alcohol or substance abuse
- Hopelessness
- Impulsive and/or aggressive tendencies
- History of trauma or abuse
- Major physical illness
- Previous suicide attempt
- Family history of suicide
- Job or financial loss
- Loss of relationships
- Easy access to lethal means
- Local clusters of suicides
- Lack of social support and sense of isolation
- Stigma associated with asking for help
- Lack of healthcare
- Cultural and religious beliefs
- Exposure to other suicides
Types of Consent ?
- Expressed
- Implied
- Minor
- Involuntary
Which of the following is recognized as a biologic attempt to release nervous tension, which may result in sudden, unpredictable physical actions in the patient?
Agitation
Scene Safety is Always #1 ? True or False
TRUE
Reasons a patient would need transportation by Association of Air Medical Services (AAMS) trauma criteria ?
- Extended period of time to access or extricate pt
- Distance to trauma center greater than 20-25 miles
- Need for ALS with no ALS ground unit available
- Traffic conditions cause a delay to care
- Multiple patients that will overwhelm the nearest trauma center
- Systems may require the pt to be brought to the nearest hospital resulting in delay to definitive care
- MCI
Points of impact and associated injuries (windshield= head trauma)
Signs and Symptoms
- Deformed front end and cracked windshield – bruised or lacerated head or face
- Deformed steering column – bruised neck, bruised chest
- Deformed dashboard – bruised abdomen, bruised knee, dislocated patella
- Deformed side of vehicle – bruised shoulder
- Door smashed in – bruised shoulder or pelvis
- B pillar deformed – bruised temple
- Broken door or window handles – bruised or deformed arms
- Broken window glass – dicing lacerations
- Posterior deformity of the vehicle – secondary anterior injuries especially if the patient was unrestrained
- Headrest not adjusted – none detected
GCS SCALE
See Book to Reference
Phases of a Blast injury?
- Primary – Due to blast wave itself
- Secondary – Flying debris
- Tertiary – Impact of body with another object
- Quaternary – Collateral injuries due to the blast
- Quinary – Long term damage from biologic, chemical, or radioactive components added to explosive
Types of car crashes and the possible injuries with each
* Frontal
o Up and Over
Head, spine, and chest injuries
* Rib fractures or flail chest
* Pneumothorax
* Hemothorax
* Contusions
* Great vessel injury
Venae cava, aorta, abdominal injuries
* Solid organs
* Hollow organs
* Diaphragm
Fractured pelvis
Types of car crashes and the possible injuries with each
o Down and under
Posterior knee and hip locations
Femur fractures
Lower extremity fractures
Pelvic and antecubital fractures
Types of car crashes and the possible injuries with each
* Chest Injuries with impact to steering wheel
o Facial injuries
o Soft tissue neck trauma
o Fractured sternum
o Myocardial contusion
o Pericardial tamponade
o Pulmonary contusion
o Pneumothorax
o Hemothorax
o Rib fractures
o Flail chest
o Ruptured aorta
o Intra-abdominal injuries
Types of car crashes and the possible injuries with each
* Rear end crashes
o Whiplash injuries when no headrest
o Acceleration injury to the brain
o Unrestrained passenger may hit dash
o Spinal or pelvic injuries
Types of car crashes and the possible injuries with each
Lateral
o Common cauase of death
o Lateral whiplash
o Shoulder, thorax, upper extremity, and skull injury
o Rotation of the neck, lateral flexion, or both
Types of car crashes and the possible injuries with each
Rollover
o Multi system trauma
o Unpredictable
o Ejection or partial ejection
Types of car crashes and the possible injuries with each
Rotational
o Multiple impacts
o Multisystem trauma
Fall Details: What we need to know
- Height
- Surface landed on
- Part of body that hit first
- Area that the force was distributed on
What is the definitive treatment for any trauma pt?
Surgery
Most injuries occur in which kind of MVC
- Lateral (I’m not sure about this)
Intrusion and how it fits on the trauma criteria
- Intrusion of more than 12 in where passengers are and greater than 18 in any site, transport to trauma center
Kinetic Energy
Definition
- Kinetic – The energy of a moving object.
Potential Energy
Definition
- Potential – The product of mass, gravity, and height that is converted into kinetic energy that results in injury such as a fall.
What is work when it comes to energy?
Force X Difference
How is the c spine protected from whip lash injuries ?
Headrest
What is index of suspicion ?
- Awareness that unseen serious and/or life-threatening injuries may exist when determining the MOI.
How to remove a drowning or near drowning victim?
- Reach, throw, row, go
What increases the risk of infection or gangrene of a frost-bitten ?
- Rewarming a frozen extremity
Pit viper venom causes what?
Signs and Symptoms
- Severe burning pain at the site
- Swelling
- In light-skinned people, eccymosis may be present in the skin
- Destroy tissues locally
- May interfere with the blood clotting system and cause bleeding at distal sites
- Weakness
- n/v
- vision problems
- seizures
- sweating fainting
- Change in level of consciousness
- Shock
Laryngeal spasms
Definition
- The spasmodic contraction of the vocal cords, accompanied by an enfolding of the arytenoid and aryepiglottic folds.
- Occurs when water enters into the lungs
Thermolysis
Definition
- The process of heat loss.
Decompression sickness treatment
- BLS, O2 administration, monitor and transport, hyperbaric chamber
