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PHAR 398: Minor Ailments > First Aid > Flashcards

First Aid Flashcards

1
Q

Describe how to care for minor cuts

A

Apply pressure to stop the bleeding

Clean the wound with cool water

Remove any debris with tweezers

Gently was around the wound with soap and a washcloth

Cover with band-aid

Check daily for infections. Change dressings daily for first few days

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2
Q

When caring for a minor cut, what agents should be used to clean the wound? WHich agents should be avoided?

A

USe fresh, clean water

Do not use idoine, alocohol or hydrogen peroxide

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3
Q

How long does it take for a wound to heal? Symptom while wound is healing? Recommendation for dressings?

A

Wounds may take 2-4 weeks to heal

Patients frequently experience itching after their wounds have appeared to have healed

All wounds normally drain and therefore daily dressing changes are recommended

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4
Q

WHy is hydrogen peroxide not recommended for minor cut care?

A

Hydrogen peroxide can slow healing by dmaging healthy cells

Use mild soap and water instead

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5
Q

Is an anti-septic required for a minor cut? Examples?

A

NOOOOO

Rubbing alcohol
Iodine
Hydrogen Peroxide
Dettol Anti-septic

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6
Q

Describe the manufacturing label of Dettol? Is this our recommendation>

A

Can be used as a gentle antispetic wound cleansing and antiseptic skin cleansing

Not recommended for wounds

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7
Q

Describe the contect for use of rubbing alcohol?

A

Pre-injection –> YES

Post-injury –> NO

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8
Q

What is betadine? Uses?

A

Providone-iodine

Complex of iodine

Not for cuts or wounds; not needed for minor first aid

Pre-surgical –> FAir game as effective for killing bacteria

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9
Q

When caring for a minor cut, should one use a betadine spray directly into the wound?

A

No need to spray directly into the wound

Warm soapy water around the edges is good enough

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10
Q

Describe the overall concept of anti-septic use in caring for a minor wound

A

DO not need to use an anti-septic solution to prevent an infection

Avoid using an antispetic

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11
Q

Regarding polysporin, is there a difference in therapy efficacy between a cream and an ointment?

A

No difference between a cream and ointment

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12
Q

Is polysporin recommended for a clean wound?

A

Decent and clean wound, vast majority of references state that polysporin is not needed

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13
Q

Describe the antibiotic agents in polysporin

A

Gram Positive - Bacitran, Gramcidin

Gram Negative - Polymyxin

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14
Q

Describe the avilable polysporin agents?

A
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15
Q

When selecting a polysporin agent, what is the main considering factor for a pharamcist? Are certain agnets better than others?

A

Just want to have a gram positive and gram negative agent

Lidocaine–> Anasthetic

“One has a pain killer in it, one does not. Which do you want?”

Three ingredients is just as effective as two ingredients

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16
Q

IS polysporin kids any different than the other agents?

A

No - Exact same as Polysporin PAin Relief

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17
Q

How often should polysporin be dosed?

A

Directions state to apply 1-3 times a day

Just go with TID –> Unlikely to have resistance here

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18
Q

Is the polysporin band-aid a more effective agent?

A

No
Just a marketing strategy
Go for simple band-aid instead

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19
Q

Describe the decision process for whether a topical antibiotic is necessary?

A

1) Is one needed? Unlikely –> Go with vaseline
2) Cream or ointment - Do not care
3) Lidocaine needed or not –> Patients decision

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20
Q

Describe the rate of infection of topical antibiotic usage?

A

If wound is dirty assuming you have not washed things out –> 20-30% chance of infx

If wound is “clean” –> 1-5% of infection and alcohol, HP are not needed

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21
Q

Describe caring for a wound in regards to promoting healing and ineffective strategies

A

Promote Healing:

Small cuts and scrapes can be left uncovered but moisture is usally needed to help speed up the healing process

Do not apply a topical antibiotic (vaseline just as effective as antibiotic ointment for non-inf wounds)

Do not douse a minor wound with antispetics

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22
Q

Which is more useful: Vaseline or Topical Antibiotics
What is the risk?

A

Topical ointments with antibiotics in them do not prevent infections any better than vaseline

More expesnive and risk of dermatitis rxn and allergic rxn

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23
Q

Describe the best way to heal a minor cut? What is the benefit? Is a bandaid needed?

A

Moist healing is the way to go

Moist healing can help prevent scars

Moist healing promoted greater rate of revascularization leading to:

Less necrosis, faster healing, and better quality of healing

A bandaid on a wound is not better than off a wound - Do not require oxygen for wound healing

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24
Q

Describe the benefit of vaseline in minor cuts

A

Use vasleine to help the injured skin heal and keep the wound moist

Vaseline helps prevent the wound from drying out and froming a scab

Wounds that form scabs take longer to heal

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25
Q

Describe the agents that can be sued to help create a moist environment for a wound?

A

Band-Aid Non-Stick Pads
–> Protection, but minimal occlusion

Opsite
–> Sure

Vaseline
–> Yes but put on top of the wound; not driving it into the wound

Polysporin Ointment
–> Ointment so occlusive but the antibiotic aspect is not required

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26
Q

Describe how vaseline should be applied to a wound?

A

Do not drive the vaseline into the wound; going only over top of the wound

Do not slather the wound with vaseline

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27
Q

When should vaseline be added to a minor wound? Is this factual? If not, what do we do?

A

It is best to let the the cut clot for half and hour to let the film (scab) form
–> 2-3 minutes after a cut is enough, clots happen fast

Clean it if needed

After that it can be beneficial to add vaseline

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28
Q

How should vaseline be applied to a minor cut?

A

Vaseline is not jammed into the cut

Get the wound mostly closed then add the vaseline on top

Can put vaseline on a band-aid, then use that to close the wound

Change once a day and check for infection

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29
Q

Describe the use of honey as a wound treatment?

A

USed since ancient times

ANtispetic

Promotes healing

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30
Q

Describe the properties of honey

A

Honey has specific physiochemica; properties that favour its use as a therapeutic agent to combat several microbial infections

These properties of honey are also associated with its wound healing effect, anti-inflammatory potency, anti-oxidant and free radical scavenging ability

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31
Q

What types of wounds is honey commonly used for?

A

Leg Ulcers
Burns
Pressure Ulcers
Infected Wounds (via injury or surgery)
Diabetic foot ulcers

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32
Q

Describe MEDIHONEY

A

Medical Grade Honey

Broad Spectrum of antimicrobial efficacy

Hospital Territory

Not the honey in the pantry

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33
Q

Describe the criteria that MEDIHONEY must meet:

A
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34
Q

Describe the indication of MEDIHONEY

A

2nd or 3rd line after debridement of the wound

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35
Q

Is manuka honey useful for first aid? Is it the same as regular honey?

A

NOT THE SAME AS REGULAR HONEY –> Do not use regular honey on wounds –> MUST BE MEDICAL GRADE

Can be effective for treating serious infx, ranging from skin rashes, boiled and scalded skin

Do not attempt to use regular honey as an option for wound care

The high fructose corn syrup in regular honey is more likely to make the infection spread

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36
Q

What type of honey can be sued for first aid?

A

MEDICAL GRADE HONEY
- Specilaly sterilized and prepared as a dressing

Manuka honey in the pantry should not be used

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37
Q

How should honey be applied in a minor cut first aid? What type of honey?

A

Apply honey to a clean dressing first - reduces mess of application

MEDICAL GRADE HONEY

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38
Q

How can a pharmacist be involved in tattoo and piercing care? Examples?

A

Get them whatever is on the page they bring in

Vitamin A and D ointment –> No anti-septic properties, just use vaseline (ointment base)

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39
Q

Describe the assessment for a need of a dressing in the pharmacy

A
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40
Q

What are some signs that a wound is infected?

A

Redness and swelling

Worsening PAin

Pus or fluids coming out of the wound

Wounded area feels hot

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41
Q

When selecting a BAND-AID, how should a pharmacist decide?

A

Do not waste time in this area

Go with the regular one

Children –> Go with favourite character

Silver and Cooper - has antibacterial properties but do not recommend unless someone is asking for these agenrs

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42
Q

Are the hydroseal bandages more effective than regular bandages?

A

NO
Go for the regular ones
Save money

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43
Q

What is a new trend that band-aid companies are hoping onto?

A

Mositure Seal

Hydrocolloid Adhesive Pads

Just regular bandaids here

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44
Q

Is a silver bandaid more effective than other bandaids?

A

NO

Silver is anti-septic

Expensive here

Just keep it clean and regular bandaid

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45
Q

How can one banadage the knuckles,, heels and fingers?

A

Difficult to banadage

Keep them clean and free of dirt

Banadages that are hourglass shaped or notched can prevent folds and bunching

Go with nexcare instead (liquid banadage)

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46
Q

Describe the agent nexcare: Application S/E, Indication and Duration of use

A

Should not sting on contact

Waterproof

For larger scapres and abrasions that are difficult to cover with traditional bandages

Not for large, deep punctures

Lasts about 5 days

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47
Q

What is OPsite? Indication?

A

Transparent adhesive film

For superificial wounds (sllow pressure sores, minor burns, cuts and abrasions)

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48
Q

Describe the critical benefit of OPSITE?

A

Mosisture-vapor permeable (allows excess exudate to evaporate to prevent skin maceration)

Provides a moist environment for healing

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49
Q

Describe the benefical reasons of OPSITE for the patient? When is it changed?

A

Waterproof –> Allows patient to bathe and aids in prevention of bacterial contamination

Easily cut into strip[s for awkward areas

Dressing can be left for 7 days. Minimizes interference at the wound site

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50
Q

Where is opsite more commonly used?

A

Nursing/medical care on more significant wounds

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51
Q

What is a tegaderm?

A

Same idea as opsite
Protects minor wounds (cuts and scrapes)
ALlows the skin to breathe
Can be left on for 7 days

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52
Q

When would we choose ceratin nexcare tegarderm products?

A

If only need protection, Nexcare Tegaderm

If oozing and bleeding, Nexcare Tegaderm + Pad

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53
Q

What type of gauze is used for protecting wounds?

A

Telfa

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54
Q

Describe the layers of Telfa

A

Outside LAyer: Covers the wound, pad won’t stick
- Protects and helps keep out water, dirt and germs

Middle layer –> Absorbent

TEFLA pad should be placed at the site of the wound

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55
Q

What is Tefla used for? Benefit?

A

Used for covering wounds and controlling blood or fluid leaking from them

Non-stick surface allows for easier removal during dressing changes

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56
Q

How is TEFLA applied?

A

TEFLA First

Then back up with guaze then wrap the bandage with tape or clip

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57
Q

Describe the sue of GAuze pads in first adi?

A

No covering on these gauze pads

Used for cleaning a wound or ‘packing’ a dressing

Catches some fluids

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58
Q

Gauze pads or Tefla

A

Tefla

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59
Q

When does a cut not require stsitches?

A

Lacerations that are:

Superficial (do not involve fat or muscle tissue)
Are not bleeding heavily
Les sthan 1/2 inch long
Do not involve the face

CAn be managed ta home without stitches

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60
Q

When would a butterfly bandage be appropriate?

A

Edges of a cut are seperated but will move together

Can use butterlfy banadage to help close the wound

Placed across the cut long its length

If wound is long more than on emay be required

Takes the place of a sticth

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61
Q

When would a butterfly banadage not be appropriate?

A

Cuts that are gaping, longer than half an inch or do not stop bleeding after 15 minutes

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62
Q

How long after a cut can a wound be stistched?

A

Most wound sthat require closure should be sticthed, stapled or closed with a skin adhesive within 6 to 8 hours after the injury

Some wounds can be closed as long as 24 hours after the injury

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63
Q

When do certain wounds get closed via stictches?

A

Wounds that have an increased risk of infection (dirty cuts, crush injuries) are usually closed within 6 hours after injury

Occasionally a wound that has an incraesed risk of infection will not be closed until 24 hours, or not at all, so that adequate clenaing and antibiotic treatment can be done to initially prevent infection

64
Q

What are some other options besides stitches for minor cuts?

A

Krazy Glue - Slightly more irritating but well tolerated; no industrial chemicals here

Dermabond (not oTC in CAnada)
- Allows it to be done without stitches, one less chemical than Krazy Glue

65
Q

Is alcohol (such as vodka) recommended for cuts?

A

NOOOO

66
Q

How to treat a burn in general?

A

COOL WATER FIRST

If an ointment or cream is used, wait a few hours first

67
Q

How should stitches be cared for?

A

Keep the stitches completly dry

Likely leave the hospital or clinic with stitches covered; leave the dressing on for 2-3 days. Avoid getting the dressing wet.

Once you remove the dressing, likely do not need to put anything on the sticthes such as vaseline or HP

Stitches may become itchy as healing is occuring

68
Q

Describe the difference between a scar and a keloid

A

A cut that is kept moist is less likely to have a visible scar

Scar removal products are really keloid products

Keloids are ana reaction to the area of cuts that people get and is hyper-kerototic tissue
–> Purplish/blue lesions on people

69
Q

How can keloid be treated?

A

Injection of a steroid into the keloid can help bring down inflammation

70
Q

What are some ways to minimize a scar from forming?

A

Use vaseline to keep the wound moist
- New reference –> Wait 30 min to apply it (as in allow clot to form first)

As long as wound is cleaned daily, no necessary to use bacterial ointments

After cleaning teh wound and applying petroleum jelly, cover the skin with an adhesive banadage

Change the bandage daily

71
Q

What is the difference between aquaphor and vaseline?

A

Aquaphor is an emulsion and therefore has a little water in it

Totally fine to use for cuts

72
Q

When should one stop applying vaseline to a wound?

A

Continue applying until teh wound has completly healed

A large wound can take 4 weeks to heal

A dressing can be applied toprotect teh wound and keep it clean

73
Q

Describe the treatment options for reducing scars? Are these effective agents? Recommendation?

A

Silicone Sheet
- TX for keloid; 18 months of tx to bring down the keloid

Mederna
- USe befpre to prevent a keloid or placed on top of already formed keloid (unlikely)

Vaseline and Aquaphor is likely to be good enough for treatment here

74
Q

Are silicone sheets effective for keloids? ANy treatment of keloids?

A

Keloid scars are difficult to treat

Uncertain whether use of silicone sheets comapred with no tx, treatment with non-silicone sheets or intralesional injections with traiamcinolone acetonide makes any difference in the treatment of keloid scars

75
Q

How to use the Elastoplast Scar reducer patch?

A

Keloid front of therapy here

More effective for older scars

76
Q

Describe the different types of burns

A

1st Degree Burns: Red and Painful; tend to swell slightly and turn white when apply pressure to skin

2nd –> Produc blisters, thicker, very painful, skin may turn red, splotchy, or swollen

3rd degree - Skin is white or charred, may cause little or no pain (damage to nerves)

77
Q

Describe the pathology of 1st degree burns

A

Surface of the skin is damage but epidermis is still intact
Can perform its fucntions such as control temp, protect from injury or infection

78
Q

What types of burns are the most painful? Common sign?

A

2nd degree are the most painful

Blisters are the first sign

Loss of skin fucntion here

79
Q

What is a concern with 3rd degree burns?

A

Trouble with fluid loss, heat loss and infection

May not be able to feel anything in the burned area

80
Q

What are the different classificiations of burns?

A

Thermal
Chemical
Radiation
Electrical

81
Q

What is the most common type of radiation burn?

A

Radiation from the sun

82
Q

How are burn degreess determined?

A

Depth of skin that is impacted

83
Q

Describe a first degree sunburn. Treatment?

A

Red, irritated and dry

No blister

Cool compress, aloe vera (just a cooling effect on the skin - evaporating off the skin)

84
Q

When a burn blisters, what degree is it?

A

2nd Degree

Shallow Second Degree burn

85
Q

Describe a third degree burn? Concerns?

A

Full thickness burn

Damage has completly destroyed the thick layer of skin and reached fatty tissue underneath

No way to tell outside a hospital

Once top layer of skin falls off, bacteria and fluid can leak out

Risk of infection here =–> COVERRRR

86
Q

How should one care for a burn?

A

1) FLush the burned area with cool running water for 10 min if possible to extract the heat

2) CAll 911 for a svere burn

3) Apply a burn ointment or spray for pain

4) Take ibuprofen or acet for pain releief if necessary

87
Q

Describe the initial step for burn management

A

Run cool water over the area for atleast 10 min if possible

Cold water or a cool compress

88
Q

What should be avoided in cooling a burn?

A

Do not use an ice pack to cool a burn

Can cause frostbite quickly as skin already damaged

89
Q

Describe the care for burns? What agents should not be used? What is one instruction that is up for debate?

A

RInse the area with cool water as this keeps the skin from holding heat and continuing to burn

Never use butter, grease or powder on a burn

Leave any blisters that form ALONE

Cover the burn with a thin layer of antibiotic ointment (some suggest not to do this)

90
Q

Should an ointment be used on a burn? COntroversy?

A

One reference suggests Ointments should be water soluble

Oils will trap heat and make the burn deeper over time

Ointments and oils are the same thing

Both oil and ointments will hold heat in

91
Q

How should one bandage a burn?

A

If the burned skin or blisters have not broken open, a bandage may not be necessary

If broken open, apply a clean banadage whenever bandage gets wet or soiled

If banadage is stcuk to a burn, soak in warm water to make it easier to remove.

If available, use a non-stick dressing

92
Q

Describe the overall cocnept of ointments on burns

A

Can use petroleum jelly (vaseline) but depends on the timing

–> Want to delay use

–> 20 minutes of cooling and wait until the burn is completly cooled

Do not put it on a fresh burn as will trap in heat and cause further damage

Wait until burn is completly cooled before applying a dressing

Not a lot of therapeutic gain with vaseline here –> keeps the area supple

93
Q

How often can vaseline be applied to a burn?

A

Apply vaseline two to three times daily (up to 3 times daily)

94
Q

When are antibiotics required for a burn?

A

Antibiotics are addition

Consider if wound is open/broken

95
Q

What if the sun burn is a big area or on the back?

A

Go with a cream (cooling) or a lotion

96
Q

What other agents can be used for a burn? Are they effective?

A

1) Ozonol - Non-stinging Ointment
- Phenol, Zinc oxide
No compelling need for this agent
- VAseline is fine (or any un-medicated cream)
- Just thicker than vaseline

2) Mecca
- Phenol 0.5%, Camphor 0.5%, Zinc Oxide 1.25%
- Thick agent
- Same as ozonol
- Go for vaseline

97
Q

What are some options for treatment of a first degree burn or sun burn? What agent should not be used?

A

Soak a facecloth in water to make a cool compress

Use a moisturizer to smooth areas where skin rubs against skin to prevent chaffing

Do not use a light powder on a burn

Do not use calamine lotion for itching as dries the skin

98
Q

What is heat rash also known as? Pathology?

A

Also known as prickly heat

Salt trapped in the pores leading to occlusion

Sweat glands become blocked and trapped sweat irritates the skin and produces a rash

99
Q

How is prickly heat treated?

A

Same excat treatment as a sunburn

Looks the excat same as a sun burn

100
Q

When does prickly heat occur?

A

Hot day (sweaty)

Infanats with too many blankets

101
Q

What are some symptoms of heat rash (prickly heat). Do the sx change between adults and children?

A

Small, raised spots
An itchy, prickly feeling
Mild swelling

Rash looks red or white on skin

Sx same in adults and children

102
Q

Describe the specific treatment of prickly heat?

A

Apply something cool such as a damp cloth or gel pack (fridge) for up to 20 mins

  • Cold and ice pack here are overkill

Cold shower or bathe

Tap or pat the rash instead of cratching it

Unlikely:

Calamine lotion or HC cream

103
Q

What are some causes of fainting?

A

Drop in BLood pressure
Low blood sugar
Standing in one position for too long

104
Q

How to manage fainting?

A

1) Lay the person on back
2) Elevate legs to restore blood flow to the brain
3) Loosen tight clothing
4) try to awaken individual - Shake or yell
5) No response - call 911
6) Not breathing - CPR

105
Q

What to not do if someone has fainted?

A

Give person any food or drink
Slap face or splash water to try and wake individua;l
Leve the person alone

106
Q

Why are puncture wounds a concern? Is it our call as pharamcists?

A

Tetanus:

Clostridium Tetanti (spores) - found in dirt, rusty nails
- Deep narrow wound sincraeses the risk

Can lead to lock jaw

Not our call

107
Q

Tetanus Therapy

A

DTP vaccine (diphtheria, tetanus, pertussis)

Series of 5 shots till age 6, booster at 16, then q10 years

Tetanus Booster every 5-10 years

Puncture WOund - Tetanus vaccine right away

108
Q

What is a myth for management of nose bleeds that should not be done?

A

Do not tilt the head backwards

Leads to clots and gag risk

109
Q

How should nose bleeds be handled?

A

1) Lean forward slightly with the head tilted forward (tilting back can make blood run back into throat and cause gagging)

2) Spit out any blood that collects in mouth or throat

3) Gently blow any blood clotting out of the nose. Nosebleed may worsen slightly when you do this, but this is expected

4) Pinch all the soft parts of the nose together between thumb and index finger

5) Hold nose like that for atleast 5 mins (judgement call - likely 10 mins). Repeat as necessary until bleeding has stopped.

6) DO not lay plat or put head between legs.

7) Apply ice (warapped in towel) to nose and cheeks afterwards)

8) Stuffing cotton or tissue into the nsoe is not recommended

110
Q

Describe the difference between a wasp and a bee sting

A

Bee’s leave the stinger in the skin; wasps do not

111
Q

What is the first step in managing a bee sting?

A

get the stinger out of teh skin

112
Q

How can one get a bee stinger out of the skin?

A

Use tweezers to remove the stinger
- CAre to not squeeze the exposed end of the stinger as will release more venom (almost impossible to not squeeze venom sac)

USe a flat card (e.g. credit card) and scarpe across the stinger - prevents venom sack from releasing more venom

113
Q

Treatment for bites and stings

A

Use second generation anti-histamines for itch and inflammation
Benadryl is not any better for skin itch (not fdaster acting or better)

Local anasthetics (Benzocaine, lidocaine, pramoxine)
And
Conuter-irritants (Camphor, menthol)
And
Atringents (Ammonia/baking soda)

Provid eonly minor relief

Topical diphenyhydreamine is not recommended for relief of itching

Corticosteroids:
- HC is not enough here (not strong enough)
- Go with spectro ecezema
- Safe –> No steroid effects

114
Q

What OTC topical astringent agents are recommended for bug bites? WHich to avoid?

A

Afterbite and topical benadryl are all the same –> Astringents

Afterbite. (any one) is fine but rather other agent

Topical Benadryl –> NOOOO

Calamine –> Cheap, just a few dabs can help

115
Q

Describe the differences between angiodema and hives. Epi-Pen?

A

Angiodeema –> Swelling of the face, lips, mouth, eyes
–> GIVE EPI-PEN

Hives -> Localized reaction that is sometimes allergic nature
“Cusp of analphylaxis” - If only one system ivolved, not worried (e.g. hives on back). If moves to anotehr system (face), give EPI-PEN
–> Likely will give EPI-PEN and not take the. chance

116
Q

What are the two common signs of a severe allergic reaction?

A

Hives/Welts (same thing)

Plus:

Swealling of throat, lips, tongue, or arpound the eyes
Difficulty breathing or swallowing

SECOND SYSTEM INVOLVEMENT

117
Q

What are hives?

A

Not raised
Move around the body
Extremly itchy
Hard to treat topically

118
Q

TX of Hives

A

Second Gen NAti-histamines are the DOC

Can increase the dose

e.g. 40 mg of Claritin (loratidine)

119
Q

Does the risk of local skin reactions such as hives leading to anaphylaxis related to size of reaction?

Examples:

A

Local reactions “even big ones” are not anaphylaxis

Must see the local reaction jumpt to a 2nd system (like changes to breathing) to worry about anaphylaxis and use an epi-pen

Local reactions are just that, no matter how severe they get

e.g. Angioedema, rhinitis/cough + rash –> 2 systems

Donot worry about rash if it becomes large if no other system induced

120
Q

How is an EPi-pen used?

A

Blue to the sky, orange to the thigh

Hold firmly
Swing and push orange tip firmly into mid-outer thigh until hear a click

Call 911 after using (*****)

121
Q

What is the main cocnept regarding epi-pen usage?

A

When in doubt, give it

120 kids die yearly via anaphylaxis
Zero incorrect EpiPen usage

122
Q

Describe expiry of Epi-Pens and usage. Is this a legal recommendation?

A

Ones sold by pharamcy should have about a year expiry date

Made to go through clothes/denim, but open skin is ideal

Does not reduce in potency after expiry

If looks okay, ok to use (not a legal recommendation)

123
Q

If in doubt, what to do regarding epi-pen?

A

When in doubt, give the shot
Especially if they have an epi-pen and allergen is present

124
Q

Different types of Epi-Pen dosages

A
125
Q

Describe anaphylaxis and treatment

A

Anaphylaxis is a severe allergic reaction

Sx occur within minutes

Give epinephrine as soon as possible

Transport patient to the hospital immeditaely

A second dose of epinephrine should be adminstered within 5-20 minutes if patient has not reponded adequately

Up to 20% of insect bite anaphylatic reactions are biphasic

Oral anti-histamines should not be used as first line tehrapy in emergency situations
–> Considered a secondary med to help with hives and itching

126
Q

Descriibe the anaphylaxis reaction regarding timing and antigen exposure

A

iphasic reaction

Call 911 after EpiPen (even if two shots)

127
Q

New epinephrine agents

A
128
Q

Is an anti-histamine required in the anaphylaxis process?

A

Epi-Pen is KEY

ANti-hist is unecessary

Do not give anti-histamine prophylatically - unsure what the allergen is

129
Q

What used to be sued histrocially for anphlaxis in the uSA?

A

Ana-kit

Epinephrine

Chlorpheniramine

130
Q

Anti-hsitamine Indication and Anaphylaxis recommendation

A

Anti-histamines are intended for mild or early allergic sx such as hives –> Go with cetirizine

No necessary for anaphylaxis

If no epi-pen present, take anti-histamine if new allergic reaction

Anphylaxis - Epi-pen every time

131
Q

What is the charcteristic symptom of LYme’s Disease?

A

Bull’s Eye RAsh develops at the site of tick bite
- 70-80% of individuals

132
Q

Rsik of Lyme’s disease in SK

A

Low but not zero

96% - american dog tick - Not capable of transmitting Lymes DX

Rocky Mountain and WInter tick(moose tick) also in SK

Black-legged ticks are the ones that can carry Lyme’s disease; however, not all of them carruy the bacetria responsible for lymes dx

133
Q

Lyme Disease Prevention - Nova Scotia

A

Have a tick - pharamcist can assess need for tx to help prevent Lyme’s Dx
- Dtermine whether a prevtative antibiotic is necessary

134
Q

How can frost bite be managed initially?

A

Get out of cold and seek tx ASAP

If unable to get out of the cold, do not try rewraming the area if its in danger of re-freezing

Freeze-thaw-freeze cycle causes more damage

Leave alone if cant get to care or warmth

135
Q

Tx of Frost-Bite

A

Rewram the area by submerging it into warm water

Submerge for 30 mins

Water should feel very warm

Do not re-warm the area for less than 15-30 minutes

As the area unthaws, you may experience severe pain (pain signals kick in). However continue to important to continue rewarming

If stop rewarming too early, could cause further damage

136
Q

Describe some recommendations of the rewarming process for frost bite

A

Thawing takes 20-40 minutes for superfifical frost bite and as long as 1 hour for deep injuries

Encourage gentle moving of the frostbitten area during re-warming

137
Q

What should be avoided in re-warming of frost-bite?

A

Massaging the area by hand or with ice are detrimental to viable tissue and should be avoided

Direct dry heat (a fire or heater) can lead to burns and hsould be avoided

138
Q

Common Mistake in rewarming of frostbite

A

A common mistake during rewraming is too stop to soon

Pt’s will start to complain of re-perfusion pain

139
Q

Risk of frost bite injuries

A

Forstbite injuries that result in blisters are prone to tetanus and thus tetanus prohylaxis is indicated

140
Q

Can a sprain and a broken ankle be easily distingiuisable?

A

Often hard tpo tell the difference

141
Q

Describe the difference in signs between an ankle fracture and an ankle sprain

A

Unable to [put weight in it is likely both

142
Q

What is the new acronym for injury management?

A

No longer RICE
Moevemnt towards MHCE

Movement, Heat, Compression, Elevation
(DO NOT ICE)

143
Q

Why is there a ovement away from RICE?

A

MICE Now

Rest replaced with movement

Once a fracture or catastrophic injury is excluded, movement is best and not rest

Immediate but gentle restoration of acttive range of motion

Remodelling is better with light movement

Ice is also wrong and delays healing as it inhibits the inflammatory response needed to intitate healing

144
Q

Are anti-inflammatory medications useful in ankle sprains?

A

NSAIDs > Acet for joints and nati-inflamm

Ibu –> 400 mg –> Cieling of pain
600 mg required for anti-inflamm

Topical diclofenca has been comsistently demonstrated to be an effective agent

Improve pain; but want inflammation to help remodel the joint

145
Q

Describe the differences in tennis elbow and golders elbow? Where is the pain?

A

Tennis –> Back Hand

146
Q

Describe the treatment of tennis/golfers elbow?

A

Brace Band
- 2 fingers ahead of the elbow (forarm)
- Moves the pressure to help with relief
- Counterforce brace compressees muscles to prevent pulling on pain location

Can alternatively use volatren
- inflammation is not being useful here (such as seen in an ankle sprain)

147
Q

Which knee brace should be choosen and why?

A

OPEN PATELLA - Daily SUe

Check for fit and comfort

Less pressure on the patella than closed (compresses patella agaist thigh bone)

Knit material in patella spot is still considered open

Cutout behind the knee can help prevent sleeve from bunching

148
Q

What is CArpal Tunnel?

A

Tingling and numbness in the fingers
Decraesed grip strength

Nerve compression in the hand so try to decraese the pressure

149
Q

Tx of CArpal Tunnel. Use, duration, and fit?

A

Wrist Splints

  • Keep the wrist neutral
    Can use 24/7 or just HS (more common)
    6-8 weeks of use is common

Fit the device for comfort
Ice pack/NSAIDs are tried too

MD assess after 6 months

150
Q

What is kep for wrist guards for carpal tunnel?

A

Need the metal bar to keep the hand in the correct position

151
Q

Are pre-made first aid kits useful?

A

No - MAke your own

152
Q

What to do if someone has a seizure?

A

Protect their head and protect them from hurting themselves

Do not put a spoon in mouth or pull the tongue

153
Q

Choking management

A
154
Q

In a road accident, should you move the person?

A

Do not pull a road accident victim from the cat or help them move into a more comfortable position

neck and spine injuries –> Slightest movement may kill them or render them paralyzed

155
Q

Tourniquet and first aid

A

An incorrect tourniquet can stop blood flow and lead to necrosis

Applyiong pressure with gauze or clothe to the ount and pressing tightly should be enough until ambulance arrives

156
Q

Should you drive someone to the hospital?

A

Call an ambulance if multiple hospitals - operator will tell you where to go

Still likely to drive in a small town

PHAR 398: Minor Ailments (9 decks)

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