More stuff Flashcards
Anaphylaxis is defined by?
airway compromise or hypotension
Triggers?
(1) Drugs (Antibiotics, NSAIDs; ANY DRUG)
(2) Foods (nuts, shellfish, soy, eggs)
(3) Additives (sulfites)
(4) Toxins (insect stings, venom)
(5) Chemicals (contrast dye, latex)
Classic presentation?
- pruritis
- flushing
- urticaria
Progression of anaphylaxis?
(a) Throat fullness (lump sensation)
(b) Anxiety
(c) Chest tightness, SOB, Lightheadedness
Severe Reaction of anaphylaxis?
(a) Loss of consciousness
(b) Cardiorespiratory arrest
The faster the onset the…
severe the reaciton
Within what timeline does anaphylaxis occur?
60 min
Tx for anaphylaxis
- ** Rapid admin of EPI 0.5mg IM
- Remove agent
- C - A - B
2nd line therapies for anaphylaxis?
- Solumedrol 125mg IM/IV
- Antihistamine (IV Benadryl preferred)
- Nebulized albuterol
Initial approach to any toxic inhalation?
- Scene safety
How do Inhaled agents manifest their toxic effects by?
1) physical particulates
2) simple asphyxiants
3) chemical irritants
4) chemical asphyxiants.
What may act as a vehicle that carries toxic chemicals thru the respiratory system?
Physical particulates
When is physical particulates most commonly encountered?
with cases of smoke inhalation.
Tx for particulate inhalation exposure?
- Remove from source
- O2
- Albuterol if needed
How do simple asphyxiants works?
cause injury by merely being present in an environment and displacing the normal levels of atmospheric oxygen
What are the gases involved in simple asphyxiants
1) carbon dioxide (CO2),
2) Nitrogen,
3) Methane,
4) Natural gas.
What do simple asphyxiants effect?
Cause hypoxia, no other effects on body’s cells
How will patients present if the simple asphyxiant is CO2?
narcotic-like sleepiness as the initial effect of exposure.
Tx for simple asphyxiants?
(b) Administration of High-concentration oxygen
(c) cardiopulmonary support as indicated.
What do chemical irritants interact with?
chemical reaction with the mucus membranes of the eyes and respiratory system.
What are hydrophilic chemical irritants?
Chemical irritants that are highly reactive with water
What is significant about hydrophilic chemical irritants?
react quickly with the moist membranes of the eyes and the upper respiratory tree, causing immediate intense burning and pain.
What is significant about non-hydrophilic chemical irritants?
can pass more
deeply into the lungs and cause direct lung injury
Common non-hydrophilic chemical irritants?
phosgene gas, a major chemical used to make plastics and pesticides
How do chemical asphyxiants work?
cause injury by asphyxiating patients at the cellular level by massively deranging normal cellular utilization of oxygen.
Most common example of chemical asphyxiants?
carbon monoxide (CO)
Other examples of chemical asphyxiants?
cyanide gas (HCN) and Hydrogen Sulfide (H2S).
What gas comes from Industrial activities that include petroleum/natural gas drilling and refining, wastewater treatment, coke ovens, tanneries, and Kraft paper mills.
Hydrogen sulfide
How do the symptoms present for H2S and HCN
Rapid onset
Tx for CO poising?
supportive care with high-flow oxygen via a non- rebreather mask or ET tube for the comatose patient
candidates for hyperbaric oxygen therapy for CO poisoning?
high blood levels of COHgb or those
who are pregnant, have signs of cardiac ischemia or have a loss
consciousness
What is characteristic of H2S poisoning?
rotten egg smell
What is also significant of H2S poisoning
possesses both chemical asphyxiant and chemical irritant properties, resulting in eye and
upper airway irritation and burning.
How fast does death occur with H2S?
Can be as few as a couple breaths
Can the patient actually breathe off H2S?
Yes, so be careful
Tx for H2S?
use of the nitrite component of the standard cyanide kit and hyperbaric oxygen therapy.
What is the final major chemical asphyxiant?
Cyanide posining
Classical presentation of cyanide poisoning?
unresponsiveness, hyperventilation and hypotension without evident cyanosis.
How is cyanide treated?
immediately initiate cyanide antidote therapy.
What’s in the cyandie kit?
(1 inhaled amyl nitrite,
(2 IV sodium nitrite and
(3 IV sodium thiosulfate.
Example of hydrophilic chemical irritants?
hydrochloric acid
ammonia
