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Cold Weather Medicine > TEST REVIEW > Flashcards

TEST REVIEW Flashcards

1
Q

Things to use to evaluate Avalanche danger.

A

SLOPE ANGLE: Steep slopes (35-50degree slope)
SLOPE ASPECT: Leeward deposits of snow are higher risk than windward sides of mountains.
TERRAIN ROUGHNESS/ANCHORING: tress, rocks, ledges, boulders.
SLOPE SHAPE: Convex is more concerning than concave that can hold its snow.
VEGETATION: signs of open slope, broomed/flagged trees, or disaster species.
ELEVATION: Different elevations can have very different risks.
PATH HISTORY: Slides tend to be in similar locations.

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2
Q

What is the sign that distinguishes HACE from AMS

A

Ataxia

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3
Q

What should you do if you get caught in an avalanche?

A
  1. Call out to others
  2. discard pack, skis, poles
  3. Assess the best line of escape
  4. Delay the departure (let avalanche go by if possible)
  5. Try to work to the side.
  6. Swim out and roll to stay on the surface.
  7. As snow slows, thrust an arm upwards towards surface, cover face to create an air pocket.
  8. Relax to conserve oxygen.
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4
Q

Hypothermia levels and temperatures.

A

90-95 degrees = mild
82-90 degrees = moderate
<82 degrees = severe.

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5
Q

Why don’t we re-warm frostbite in the field?

A

If you freeze-thaw-refreeze it increases the depth, degree, and area involved.

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6
Q

How does hypothermia actually kill you?

A

Cardiovascular collapse.

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7
Q

What is cocooning?

A

Turning inward on yourself and being more concerned with self comfort. Diminishes situational awareness and no tactical mindset. Just want to be warm and get more sleep.

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8
Q

What are the four heat injuries?

A

Heat Cramps
Heat Exhaustion
Heat Stroke
Hyponatremia

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9
Q

What is the difference between a sprain and a strain?

A

A sprain is a stretching/partial tear of a ligament or tendon.
A strain is a stretching/partial tear of a muscle or the muscle-tendon junction.

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10
Q

What are the signs and symptoms of appendicitis?

A

Periumbilical pain that moves to the right lower quadrant, rebound tenderness at McBurney’s point, pain with straight leg raise, Anorexia.

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11
Q

What are the signs and symptoms of intraabdominal bleeding?

A 
Bruising
Rebound tenderness
Hypotension
Cramping
Lethargy
Confusion
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12
Q

What are the 5 areas of the body that you can internally exsanguinate?

A 
Abdomen
Chest/Thorax
Thighs
Pelvis
Renal/Retroperitoneal
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13
Q

Types of shock

A

Neurologic - sympathetic chain destruction, hypotension, bradycardia
Hypovolemic - Bleeding, massive dehydration
Septic/Distributive - infectious, anaphylactic
Obstructive - clots (PE), tension PTX.
Cardiogenic - pump failure

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14
Q

What are the signs/symptoms/treatment of CO poisoning?

A

Headache, nausea, ruddy color, shortness of breath/tachypnea, confusion, lethargy. Patient should be removed from the CO source, get supplemental O2 and transport to the hospital for consideration of Hyperbaric O2.

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15
Q

What percent of patients have a dry snake bite?

A

1/5 (20%)

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16
Q

Brown vs. Black bear

How do you fight back to each?

A

Fight back to Black bears.

Brown/Grizzly Bears fetal position, do not fight back. Stand your ground if they charge, but do not look in their eyes.

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17
Q

What are the types of snow grains and how do they develop?

A

Rounded grains develop when laters are uniform in temperature.
Faceted grains develop when there are significant changes within/between layers in the snowpack.

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18
Q

Timeline for AMS, time, sx, treatments?

A

High Altitude Headache: The first unpleasant symptom of altitude. Usually develops within 24 hours of ascent above 2500, resolves within 8 hours of descent.
AMS: Includes Headache and insomnia, anorexia, nausea, dizziness, fatigue. Symptoms rarely begin over 36 hours after altitude exposure, but can begin almost immediately. They usually resolve within 24 hours if ascent is arrested. Treat with Acetazolamide.
HACE: is usually above 3000m, may or may not have AMS symptoms, and includes altered mentation and ataxia. This can happen as quick as 12 hours, but often takes 1-3 days. TREAT with Descent and steroids.
HAPE: Usually happens at 3500+, but can be lower. Symptoms include cough, dyspnea, weakness. Treat with Nifedipine, descent, O2.

19
Q

What is the biggest risk factor for AMS?

A

Rate of ascent and elevation reached.

Other things include exertion, recent exposure, and genetic susceptibility.

20
Q

What are the degrees of frostbite?

A 
Frostnip: surface of the skin only, no pain. waxy feeling.
1st Degree, pain
2nd degree, numbness/clear vesicles
3rd degree, blood-filled vesicles
4th degree, dead/necrotic tissue.
21
Q

What is the pathophysiology of trench foot

A

Non-freezing cold injury. Prolonged vasoconstriction causes peripheral malperfusion and neuromuscular damage.

22
Q

Explain Afterdrop?

A

This is the continued decline in a hypothermic patients core temperature after removal from the cold caused by equilibration of the warmer core and the cooler periphery.

23
Q

Why you need to stay warm and dry?

A

Energy saved when warm and dry.

24
Q

How long do you check for a pulse in hypothermia?

A

Check for a pulse for at least 1 minute especially in severe hypothermia as inappropriate CPR can cause cardiac arrest.

25
Q

What are the stages of submersion?

A

Phase 1: Cold shock and Dive Response
Phase 2: Cold incapacitation
Phase 3: Hypothermia
Phase 4: Circumrescue Collapse

26
Q

How does one die in submersion?

A

First minute: cardiac arrhythmia
2-10 minutes: Exhaustion
10-60mins: unconsciousness
>60mins: Hypothermia (heart stops beating because it becomes too cold).

27
Q

Describe APASSNGG

A

This is the evacuation algorithm.
Apply essential first aid
Protect the patient from the elements
Avoid unnecessary handling of the patient
Select the easiest route
Set up relay points and warming stations
Normal litter teams must be augmented in arduous terrain.
Give litter teams specific goals
Gear of the patient should be kept with them at all times.

28
Q

What are the keys to good leadership?

A

Pre-environmental training
Prepare for increased casualties
Understand your capabilities and limitations
Control the situation

29
Q

What are the main leadership errors?

A 
Cocooning
Group Hibernation
Loss of personal communication and contact
Time and Space Planning
Failure to adequately sustain the unit.
30
Q

How fast can mountain leaders, assault climbers, scout skiers, companies/battalions move in the cold weather wilderness?

A

MTN leaders: 3km/hr
Assault climbers/scout skiers: 2km/hr
Company/battalion: 1km/hr
** For all, add 1 hour for each 300m of ascent or 600m of descent. Note MTN leaders may only need 1 hour for every 800m descent.

31
Q

Weather

A

?

32
Q

Caloric Guidelines for High Altitude/cold?

A

Average requirements increase approx. 25%. Caloric guidelines suggest 3500kcal for women, 4000kcal for men as a baseline estimate. Breakdown is 50% carbohydrates, 15% protein, 35% fat with 25-35g fiber daily.

33
Q

Femur fracture mgmt.

A 
Evaluate NV status.
Return to anatomic position so that you can splint. 
** Check for pelvic fracture.
Traction vs. regular sprint.
Immobilize.
Casevac.
34
Q

Complications of a spinal immobilization?

A

ICP, Interfere with treatment of neck injuries, pulmonary compromise, aspiration, pressure sore

35
Q

S/S of neurologic injury?

A

?

36
Q

Classes of shock (VS, symptoms)

A

I: Pulse <100, normal BP, RR 14-20, slightly anxious but otherwise normal.
II (compensated): Pulse >100, BP normal, pulse pressure decreased, RR 20-30, mildly anxious.
III (Decompensated): Pulse >120, BP low, pulse pressure low, UOP 5-15ml/hr, confused/altered.
IV (Irreversible): Pulse >140, decreased BP; dec pulse pressure, RR >40, UOP negligible, altered/lethargic/unconscious.

37
Q

What is the big concern with tarantulas?

A

Tarantulas have urticating hairs that can be flung at the face and need to be removed from the eyes (keratoconjunctivitis) (remove with tape) followed by rinsing. Bites are self-limited.

38
Q

6 Ps of Compartment Syndrome.

A 
Pain
Pallor
Parestheisia
Paralysis
Poikilothermia
Pulslessness
39
Q

State the signs of snow instability.

A

Recent avalanche activity on similar slopes
Booming/whumping
Visible cracks
Sloughing debris
Sunballing
Recent excessive snowfall
Significant wind loading
Rapid rise of temperature after a long cold period.
Prolonged periods of above freezing temps
Snow temps remaining at or below 25F slowing the strengthening/settling process.

40
Q

What are the benefits and issues with filtration, UV, Boiling as methods of water treatment.

A

Filtration: Need a 0.02 micron filter for viruses. Slower than other methods unless you have a high-efficiency filter.
UV: Does not remove chemicals, tastes, particles, but kills or inactivates all bugs.
Boiling: disinfects water but does not purify/remove metals or other chemicals.
Chemical: Poor taste, has to wait 30-60 mins depending on temperature before drinking, higher doses are required for some species.

41
Q

What is the presentation of a Black Widow spider?

A

Concern is neurotransmitter release causing paralysis of respiratory muscles, though most people have muscle spasms and weakness. Some have nausea and vomiting with abdominal pain. Many complain of painful legs/feet.

42
Q

What is the concern with brown recluse spider.

A

Spiders are mostly in the southern/southcentral US. Envenomation causes hemorrhage, necrosis, delayed wound healing, and renal failure.

43
Q

What is the most concerning snake species in the US and what effect does the venom have?

A

Pit vipers (cottonmouths, rattlesnakes, copper heads). The venom is a neurotoxin and hematoxin. It has the effect of causing muscle inactivation, including paralysis of the diaphragm in rare cases, though normal symptoms are swelling, tenderness, erythema, and often systemic symptoms of hypotension, vomiting, and angioedema. Death comes from cardiorespiratory collapse.

Cold Weather Medicine (21 decks)

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