Topic 9 - Environmental/Sepsis/Infection Flashcards
Electric shock - factors in extent of injury
- Amount of current that passes through tissue
- Duration of exposure
- The tissue traversed by the current
Management of electric shock
- C-spine managment
- Compartment syndrome management
- IV access
- Analgesia
- 12-lead ECG
- IV fluid
- Dysrythmia treatment
- Burns managment
Heat exhaustion
- 37-40 degrees
- Severe headache and dizziness
- Diaphoresis, nausea and vomiting
- Tachypnoea, tachycardia, hypotension
- Muscular pain, fatigue and cramps
Heat Stroke
- >40 degrees
- CNS dysfunction (bizarre behavious, seizures, ALOC)
- Extreme fatigue, headache and syncope
- Facial flushing, vomiting and diarrhoea
- Skin hot and dry
- Dysrythmias and hypotension
- ARDS
- Hypoglycemia and hyperkalemia
Prehospital active cooling method
- Strip-spray-fan-ice
Hyperthermia management
Ceftriaxone (Indications)
- Suspected meningococcal septicaemia (with a non-blanching petichial AND/OR purpuric rash)
Ceftriaxone (Contraindications)
- KSAR or hypersensitivity to cephalosporin drugs
- Known anaphylaxis or severe allergic reaction to penicillin based drugs
Ceftriaxone (Precations)
- Nil
Ceftriaxone (Side effects)
- Nausea AND/OR vomiting
- Pain at the IM administration site
Depth of burns
Consider airway burns
- Facial/oral burns
- Singed nasal hair
- Carbonaceous sputum
- Tachypnoea, stidor or hoarsness
Burns requiring managment in a dedicated burns unit
- Partial thickness burns >20% or >10% in <10 and >50 years
- Full thickness burns >5%
- Burns involving the face, eyes, ears, hands, feat, genitalia, perineum or overlying a major joint
- All inhlational burns
- All significant electrical burns
- Significant co-morbidities
IV fluid contraindictions in burns
- Should not be administered to patients with significant facial, neck or upper chest burns with high potential for airway or ventilation compromise before airway is formally secured at hospital
Rule of 9’s
Burns managment
Hypothermia causes
Increased heat loss:
- vasodilation
- environmental
- trauma
- loss of skin integrity
- neuropathy
Decreased heat production
- age
- endocrine disorders
- nutritional deficits
- immobility
CNS dysfunction
- trauma
- CVA
- hypoxemia
- malignancy
- encephalopathy
Mild hypothermia
- 32-35 degrees
- vasocontriction, tachycardia, tachypnoea and normotension
- Ataxia, apathy/lethargy
Moderate hypothermia
- 28-32 degrees
- Condusion, delirium, ALOC
- Hypotension, bradycardia, muscle rigidity
Severe hypothermia
- <28 degrees
- Stupor, coma, diminished or absent signs of life, dilated pupils
- Reduced absent reflexes and apnoea
- Dysrythmiaas including SB, slow AF (may present with J waves), VF and assystole
Hypothermia complications
- Blunted catecholamine release
- Hypo/perglycemia
- Hypo/perkalaemia
- Coagulopathy/DIC/thromboembolic disorders
- Rhabdomyolysis
Hypothermia managment
Sepsis (definition)
Infection complicated by systemic inflammation and can result in organ dysfunction, shock and death
Diagnosis of sepsis
Requires the presence of a presumed or known site of infection with evidence of Systematic Inflammatory Response Syndroms (SIRS) characterised clinically in adults by the presence of 2 or more of:
- Tempurature >38.3 or<36
- Heart rate >90/min
- RR >20
- BGL >6.6 (unless diabetic)
- Acutely altered mental state
Diagnosis of severe sepsis
Defined by the presence of sepsis and evidence of organ hypoperfusion or dysfunction and is characterised clinically in adults by one or more of:
- BSP <90 or MAP <65 mmHg
- O2 saturations <90%
- Not passed urine in 8 hours
- Prolonged bleeding from minor injury or gums
Fluid overload detaction in sepsis
- Hard to detect where sepsis-induce ARDS present
