Physical Medicine Flashcards
Drowning
describe water rescue
someone gets immersed and then removed without evidence of respiratory impairment
Drowning
describe non-fatal drowning
someone get simmersed, has respiratory impairment, but doesn’t die
Drowning
describe fatal drowning
someone gets immersed, has respiratory impairment, and dies
Drowning
when to discharge?
3
- no increased work of breathing
- no decreased sats
- little to no rales
Drowning
generally describe the mammalian dive reflex
metabolism slows when immersed in cold water
Drowning
who is the mammalian dive reflex more pronounced in?
children
Drowning
describe shock related to drowning?
not common- look for other causes (hemorrhagic/neurogenic)
Drowning
describe resuscitation in nonfatal/fatal drowning
- adults: aggressive resuscitation for < 60 min drowning
- children: aggressive resuscitation even if over 60 min
Scuba- Barotitis
what is barotitis
pressure inflaming the ear
Scuba- Barotitis
describe mild vs mod/severe sx
- mild: pain
- mod/severe: TM rupture, vertigo, n/v, sensorineural hearing loss
Scuba- Barotitis
tx
- decongestants
- pressure equalization (pinched nose valsalva)
- vertigo meds (meclizine, benzos)
- analgesics
Scuba- Barotitis
what to consider if TM is inflamed but intact?
2% lido
Scuba- Barotitis
when to refer to ENT?
if mod/severe
Scuba- Nitrogen Narcosis
cause
neurotoxic levels of nitrogen in the blood
Scuba- Nitrogen Narcosis
sx
2
- AMS
- poor coordination at depth
Scuba- Nitrogen Narcosis
tx
controlled ascent to decrease blood nitrogen
Scuba- Decompression Sickness
how does this occur
- dissolved nitrogen forms bubbles in blood, tissue whend ascending too quickly
- 98% have sx w/in 24hrs, 100% have sx w/in 48 hrs
Scuba- Decompression Sickness
describe Type I
- Systems: MSK, skin, Lymph
- Sx: joint pain, rash, itching
Scuba- Decompression Sickness
describe Type II
- Systems: Neuro, CNS
- Sx: gradual neuro sx like paresthesia, numbness, weakness, AMS