Temperature Emergencies Flashcards
Cold urticaria
hypersensitivity to cold air or water
may lead to FATAL anaphylaxis
cold urticaria diagnosis
confirmed with cold water test during follow up
cold urticaria tx
Antihistamine
then go to anaphylaxis management if severe rxn
Chiliblains
mild but unconfortable inflammatory lesions of the skin precipitated by acute exposure to cold
12 hrs of exposure
pernio
aka chilblains
pruritus or burning paresthesia
hands, ears, lower legs, feet MC
re warming and chilblains
may cause formation of tender blue nodules that persist for days
tx of pernio
affected skin rewarmed, bandaged, elevated
some evidence of pharm tx in European studies
immersion injury patho
direct injury to soft tissue following prolonged cooling in wet conditions
vasoconstriction, red cell and thrombocyte pudding, tissue edema, nerve and small vessel injury
clinical features of trench foot
numbness and tingling of affected tissue
pale, mottled, anestehtic, pulseless, immobile
hyperemic phase
immersion injury
hours after re=warming, severe burning pain and reappearance of proximal sensation
late phase immersion injury
excessive sweating and cold sensitivity
persist for months to years
tx of immersion in jury
supportive +/- pain control
clean, warm, dry bandage, elevate affected area
frostbite
frozen tissue secondary to heat loss
causes ice crystal formation in superficial or deep tissue
MC in peripheral locations
clinical summary frostbite
numbness + sensory loss in digit
thawed tissue but mottled blue, violet, yellow or waxy color
hyperemia
Favorable prognostic signs frostbite
return of normal sensation/color/warmth
edema w.in 3 hrs of thawing
early formation of bulla to tips of digit
poor prognostic indicators frostbite
lack of edema
small dark hemorrhagic bulla that DO NOT go to tips of digit
necrotic tissue
superficial frostbite (1st degree)
frost nip
numbness, white tissue, erythema
superficial frostbite (2nd degree)
clear vesicle or blebs with erythema
deep frostbite (3rd degree)
hemorrhagic blisters
not extend to tip of appendage
deep frostbite (4th degree)
necrotic tissue involving muscles, tendon bone