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Mike and Nate's > Submersion/Environmental (1305) > Flashcards

Submersion/Environmental (1305) Flashcards

1
Q

What population is predominantly impacted with drowning?

A

Children <5 or youth ages
Males
Alcohol & drug intoxication
Disorders that can cause LOC (seizure)

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2
Q

What is drowning defined as?

A

Respiratory failure due to submersion (airway below liquid) or immersion (airway above liquid)

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3
Q

Patho of drowning?

A
  • Starts with breath holding. Hypercapnia overrides voluntary urge to hold your breath (55 mmHg)
  • Coughing occurs, causing swallowing large amounts of water
  • Gasping due to LOC occurs
  • Once water enters pharynx and/or trachea, victim will suffer laryngospasm (can be perm or temp)
  • Spasm permanent? No aspiration
  • Spasm temporary? Fluid enters lungs; increases hypercapnia and hypoxia - arrest
  • Progression is tachy, brady, PEA, asystole
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4
Q

Saltwater vs Freshwater?

A

Fresh water has lower osmolarity. If large amounts consumed, blood volumes increase causing breakdown of RBC’s.

Does NOT occur with salt water cause osmolarity is relatively equal.

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5
Q

What happens if water is polluted/sewage is present?

A

Patient will need antibiotics for pulmonary infections

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6
Q

What is cold water drowning?

A

When the mammalian diving reflex is triggered.

  • Causes bradycardia, peripheral vasoconstriction, and reduced O2 demand.
  • Reflex is more pronounced in pediatrics
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7
Q

What is secondary drowning?

A

When small amounts of aspirated water are either reabsorbed in vasculature or decreases lung compliance. This results in loss of surfactant, atelectasis, and hypoxia.

Can be immediate or delayed 4-8 hours

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8
Q

What is ARDS?

A

Impacts alveoli/capillaries causing increased capillary permeability.

  • Leads to non-cardiogenic pulmonary edema
  • Eventually transitions to atelectasis (collapse of lung), decreased lung capacity, V/Q mismatch and hypoxia
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9
Q

Drowning management?

A

Manage ABC’s and treat as medical cardiac arrest (UNLESS HYPOTHERMIC)

  • Get a GOOD history gathering. Condition of water, temperature of water, duration of submersion, etc
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10
Q

What is barotrauma?

A

Injury to the body due to changes in barometric (air) or water pressure

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11
Q

How much is ATA?

A

Atmosphere absolute?

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12
Q

How much does depth increase when you increase ATA in increments of 1?

A

33

(ex: 2 ATA = 33 feet, 3 ATA = 66 feet)

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13
Q

What is Boyle’s Law?

A

Pressure of gas has an inverse relationship with its volume

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14
Q

What is Dalton’s Law?

A

Total pressure of gas equals sum of partial pressures of ALL gases

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15
Q

What is Henry’s Law?

A

Amount of dissolved gas in liquid is proportional to the partial pressure ABOVE liquid when temperature is kept constant

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16
Q

What should you consider with a diver who just resurfaced 10 minutes ago and is now experiencing LOC?

A

Air embolism

17
Q

What is Pulmonary Overpressurization Syndrome (POPS)?

A

When air becomes trapped within lungs from breath holding, bronchospasm, or mucus plugs which all cause alveolar rupture. Happens when a diver makes ascent

18
Q

What is Decompression SIckness (The Bends)?

A

When nitrogen compressed in tissues/blood (due to pressure underwater) turns back into gas bubbles when surfacing (Henry’s Law)

These people need hyperbaric chamber and high flow O2 ASAP

19
Q

What is Nitrogen Narcosis?

A

When nitrogen becomes dissolved in blood and passes through blood brain barrier

Similar to being drunk off alcohol

20
Q

What is Thermogenesis?

A

Production of heat for body via sympathetic nervous system

  • Body shunts blood to core via vasoconstriction; causes piloerection
  • This traps more air increasing insulation; closes skin pores limiting sweating
  • When maximum vasoconstriction has occured, body will start involuntarily shaking
  • Lastly, thyroid release hormones to increase metabolic rate in celss (brown fat - only plays a role in very young people)
21
Q

What is Thermolysis?

A

Release of stored heat from body via parasympathetic nervous system

  • Vasodilation occurs, releasing heat and causes diaphoresis
  • Decreases demand from thyroid and adrenals
22
Q

4 Main Types of Heat Related Injuries?

A

Heat Syncope, Cramps, Exhaustion, Stroke

23
Q

What is Heat Syncope?

A

Result of hypovolemia from volume depletion and vasodilation.

  • Compounded by medications
  • Occurs to people who are unacclimated to heat or elderly
  • Orthostatic hypotension
24
Q

What are Heat Cramps?

A

Mild to severe muscle cramps that are fatigued.

  • Imbalance between Na and water loss
  • Get electrolytes in these patients asap
  • Will present with hot flushed skin, diaphoresis, tachycardia
25
Q

What is Heat Exhaustion?

A

More serious than heat cramps. Patients will be hyperthermic (<39 C)

  • Patients complain of dizziness, headache, nausea, etc
  • Remove from hot environment and supportive care with fluid replacement
26
Q

What are Heat Strokes?

A

Most dangerous, temperature >40 C or higher (proteins denature at 41C)

  • Can occur from environment, intracranial hemorrhage, overdose
27
Q

What are Classic Heat Strokes?

A

Impacts young and elderly due to prolonged heat exposure. Compounded by comobordities and medications

28
Q

What are Exertional Heat Strokes?

A

Athletes/military who operate in hot/humid environments; can’t disperse heat fast enough to maintain normal temperatures

29
Q

What happens with frostbite?

A

Tissue freezes from ice crystals forming in tissue; often unprotected body parts

  • Fluid shifts to extravascular space, blood vessels damaged
  • When warmed, blood flow restricted due to microvascular emboli
  • Causes hypoxia and tissue death
30
Q

Types of Frostbite?

A

Frostnip- mild blanching, mild pain
Superficial- waxy, white skin. Becomes painful during rewarming. Eschar tissue forms, peels away leaving red shiny skin
Deep - black ass skin (no racial), shit’s dead son

31
Q

At what temperature does the body stop shivering (thermogenesis)?

A

< 32 C

32
Q

On an ECG, what can you see in hypothermic patients?

A

J Wave (Osborn wave)

Mike and Nate's (7 decks)

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