Environ flash cards.txt

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Environ flash cards.txt
2011-01-23 14:38:44

Invironmental emergencies
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  1. What are Heat Cramps?
    Loss of sodium resulting in muscle cramps
  2. What is Heat Exhaustion?
    Fluid loss and vasodilation resulting in shock
  3. What is Heat Stroke?
    Failure of the bodies cooling mechanism resulting in increased core temperature
  4. What is Hyponatremia?
    • Loss of essential electrolytes (Potassium) do to excessive water intake coupled with increases sweating and urination
    • Very similar to heat exhaustion
    • Key Hx is "in" and "out" (Fluid in VS fluid out)
  5. How do you tell the difference between heat exhaustion and heat stroke?
  6. What are the SXS of heat Cramps and how do we treat it?
    • SXS: Hx, Muscle cramps
    • Treatment: Stop activity, replace electrolytes, message
  7. What are the SXS of Mild Heat Exhaustion and how do we treat it?
    • BP normal no orthostatic changes
    • HR < 100 (at rest ten minutes)
    • Nausea and vomiting transit (less then 3 times)
    • No Diarrhea
    • No syncope
    • No significant medication/medical history
    • Treatment: Oral Rehydration
  8. What are the SXS of Moderate heat exhaustion and how do we treat it?
    • SXS: BP decreases possible orthostatic changes, HR >120, Nausea and vomiting three or more times, diarrhea, syncope, Positive medications or medical Hx, able to tolerate oral fluids in two hrs
    • Treatment: Oral rehydration/IV
  9. What is the SXS and treatment of Severe heat exhaustion?
    • SXS: BP severe hypotension, HR > 140 or arrhythmias, nausea and vomiting persistent, positive orthostatic signs, Unable to tolerate oral fluids
    • Treatment: IV, Transport and treat for shock
  10. What are the SXS of heat stroke and how do we treat it?
    • Sever mental changes, reduced LOC, seizures, temperature hot (may or may not be sweating) Core temp >40C, VS pattern for volume shock, skin may be red or pale with shell/core
    • Treatment: Modify activity, modify environment, rehydrate oral/IV, electrolyte replacement, immediate cooling, evacuation
  11. What is the most field effective way to cool a patient?
    Disrobing the patient, wetting them with tepid water and fanning
  12. What are the SXS of Hyponatremia?
    • Intake of water > 1 liter per hr
    • Resting pulse <110
    • Temperature normal or low
    • BP normal or low
    • Ataxia
    • Urinary incontinence
    • Seizures
    • Polyuria
  13. How do we treat Hyponatremia?
    • CNS Alteration (No)
    • Restrict fluids replace electrolytes
    • Pee it out
    • CNS Alteration (Yes)
    • Evacuate
    • Tx SXS
    • High mortality
  14. What controls Thermo-regulation?
    • The Hypothalamus
    • The Hypothalamus takes measurements from the skin and blood and adjust the body's temperature through regulation both voluntary and involuntary
  15. How does the body regulate its Core temp (What does the Hypothalamus control to change the core temp)?
    • Vasodilation
    • Vasoconstriction
    • Sweating
    • Shivering
    • Increased/ decreased activity
    • Behavioral Responses
  16. By the body dilating/constricting its vessels how does this affect Temperature?
    • Dilation: Increases surface blood flow, increases heat loss (Normal 300-500 cc/min can increase to 3000cc/min)
    • Vasoconstriction: Decreases blood flow to the periphery, decrease heat loss (Decreases to 30cc/min)
  17. How does sweating/shivering affect temp?
    • Sweating: Cools body through evaporation
    • Shivering: Generates heat increase in chemical reaction of muscle activity (50% for a few hrs)
  18. How does a 10% dehydration affect the metabolic efficiency?
    10% dehydration = a 40% decrease in metabolic efficiency
  19. How long does it take to become acclimatized?
    3 weeks
  20. What is Bergmann's Rule?
    • Carl Bergmann 1847
    • Within the same species of warm blooded animals populations having less massive individuals are found more in warm climates
  21. What is Allen's Rule?
    • Joe Allen 1877
    • The length of arm, legs and other appendages also has an effect in the amount of heat loss to the surroundings
  22. How does the body acclimatize to the cold?
    • Increase fat storage
    • Increase in Metabolic Rate
    • Decrease response to the cold challenge
  23. In what humidity is sweating ineffective?
    Sweating is not effective above 70% humidity
  24. What are the four means of physical heat loss/gain?
    • Convection
    • Radiation
    • Evaporation
    • Conduction
  25. What is convection?
    Convection os the transfer of heat by movements of air (or water) masses
  26. What is Evaporation?
    Evaporation is the process of a liquid changing state into a gas
  27. What is Radiation?
    Radiation is the outward flow of energy (Long wave) from a source to the surrounding environment
  28. What is Conduction?
    Conduction is the process where energy is transferred between objects through direct contacts
  29. What is the actual heat load on a person?
    The actual heat load on a person is roughly ten degrees higher than what a dry bulb thermometer reads
  30. What areas are at a higher risk of frostbite?
    • Head
    • Hands
    • Feet
    • genitalia
  31. What are the different levels of Frostbite?
    • Superficial - 1st degree - AKA: Frostnip
    • Partial Thickness - 2nd degree
    • Full Thickness - 3rd degree
  32. What are the SXS of Superficial Frostbite?
    • Soft, pale or red (Blushed) skin
    • Intact sensation
    • No actual freezing involved
  33. What are the SXS of Partial thickness frostbite?
    • Soft, pale skin
    • Dulled sensation in the area
    • Involves dermis only
    • Moves freely over subcutaneous tissue
  34. Hard, pale or blue skin
    • No sensation in the area
    • Frozen into subcutaneous tissue
    • Involved joints do not move
  35. How do we treat Superficial and Partial Thickness frostbite?
    • Immediate field re-warming
    • Reverse shell core effect
    • Protect from refreezing
  36. How do we treat Full Thickness Frostbite?
    • Ideal - controlled re-warming in the hospital
    • Pre-treat with ibuprofen 800mg P.0.
    • Consider narcotics for additional pan control
    • Immerse in 37 - 40.5 C water until warm
    • Field treatment: Evacuation will exceed 24hrs
    • Use of the extremity will not be necessary for survival and evacuation
    • Re-freezing must be prevented
  37. How is frostbite prevented?
    • Don't be lazy, act to correct cold response
    • Stay hydrated/well fed
    • Keep insulated dry and clean
    • Don't underestimate the heat loss
    • Dress for the conditions avoid vasoconstrictors and tight boots
    • Early recognition = easy cure
  38. What is Trench Foot?
    • Prolonged cold exposure, >0 C
    • Vasoconstriction and loss of local perfusion
    • Ischemia to infarction in skin tissue
    • Inflammation and secondary infection
  39. How is Trench Foot treated?
    • Dry and warm
    • Preserve perfusion, reverse shell/core
    • Clean, treat infection as necessary
    • NSAID's
  40. What is Raynaud's Phenomenon?
    • Abnormal vascular spasm in response to cold
    • White to blue discoloration
    • Generally sharply demarcated
  41. How do we treat Raynaud's Phenomenon?
    Keep warm
  42. How long does it take for the hypothermic patient to have a build-up metabolic waist?
  43. What are the different classifications of hypothermia?
    • Mild (98.6 - 93.2 F) (36-34 C)
    • Moderate (86 F) (30 C)
    • Severe (<86 F) (<30 C)
    • 86 F is where the LOC id effected, normally loss of consciousness (don't rapidly rewarm normally)
    • 86 F is also where the loss of deep tendon reflexes and dexterity are effected
  44. What are the symptoms of Mild hypothermia?
    • Increases metabolic rate
    • Maximum shivering
    • Thermogenesis
    • Impaired judgement
    • slurred speech
  45. What are the SXS of moderate hypothermia?
    • Respiratory depression
    • Myocardial irritability
    • Bradycardia
    • Arterial fibrillation
    • Osborn waves
  46. What are the SXS of sever hypothermia?
    • BMR 50% of normal
    • Loss of deep tendon reflexes
    • Fixed and dilated pupils
    • Spontaneous VF
  47. What is Mild Hypothermia Acute?
    • Rapid onset, minutes to hours
    • Cold water, most common example
    • Usually not dehydrated or calorie depleted
    • Spontaneous re-warming is usually possible
  48. What is Sub-acute Mild Hypothermia?
    • Slow onset, hours to days
    • Dehydrate and calorie depleted
    • Re-warming must include food and fluids
  49. What are the SXS of acute mild hypothermia and how do we treat it?
    • SXS: Mild to moderate mental status changes, Cold, shivering, shell/core effect
    • Treatment: Immediate field rewarming, exercise, trap heat generated by shivering
    • Insulated from convection, conduction and radiation
    • Dry skin and clothing to reduce evaporation
    • No metabolic waste accumulation, safe to rewarm
  50. What are the SXS and treatment for Sub-acute Mild hypothermia?
    • SXS: Mild to moderate mental status changes, cold, shivering, shell/core effect
    • Treatment: Immediate field re-warming, food and fluid before exercise in Sub-Acute cases, trap heat generated by shivering, Insulate from convection, conduction and radiation, dry skin and clothing to reduce evaporation
    • No metabolic waist built up, safe to re-warm
  51. What are the SXS of Severe Hypothermia?
    • V, P or U on AVPU
    • Cold, shell/core effect
    • No shivering
    • Cardiac irritability
    • Dehydration
    • Metabolic derangement
    • VS may be undetectable
  52. What is the best way to evaluate the body temperature?
    • The urine
    • The rectal
  53. How do we treat severe hypothermia?
    • Package to prevent heat loss
    • Urgent but gentle transport
    • Dry pt and or remove clothing
    • PPV with heat and humidified oxygen
    • IV warmed to 40 C
  54. What is the difference in the hypothermic code?
    • Only one dose of meeds below 30 C
    • Defibrillate once below 32 C
    • Never defibrillate below 25 C
    • Intubation is ok
  55. How long can a patient last in a hypothermic state?
    Pt cant last more then 24hrs core hypothermia
  56. If the hypothermic patient does not respond to to 1 shock what do we do?
    • If the hypothermic patient does not respond to 1 shock, further defibrillation attempts should be deferred, and the rescuer should focus on continuing CPR and rewarming the patient to a range of 30 C to 32 C before repeating the defibrillation attempts. If core temperature is <30 C, successful conversion to normal sinus rhythm may not be possible until rewarming is accomplished.
    • Remember to address the underlying problem
  57. In the hypothermic patient what can pacemaker stimulation and defibrillation?
    Pacemaker stimulation and defibrillation may cause the patient's heart to go into VF
  58. In the hypothermic patient what is the concern with Cardioactive medications?
    There is concern that in the severely hypothermic patient cardioactive medications can accumulate to toxic levels in the peripheral circulation if given repeatedly. For thee reasons IV drugs are often withheld of the patients core temp is <30 C. Of the core temp is > 30 C, IV medications may be administered but with increases intervals between doses.
  59. What are some CPR consideration in the hypothermic patient?
    • Consider no performing CPR if:
    • You can feel a pulse
    • The monitor shows an organized activity
    • There is any sign of life
    • Performing CPR will endanger the rescuers
    • Chest is frozen
    • Chest compressions may cause a functioning but very slow cardiac rhythm to decay into ventricular fibrillation
  60. For testing purposes when do high altitude problems usually arise?
  61. What is 1 atmosphere consist of?
    1 atmosphere is 14.7lbs at see level
  62. What is the atmospheric pressure at 8000 and 18000ft?
    • 8000 = 3/4 of 1 atmosphere
    • 18000 = 1/2 atmosphere
  63. What is the cause of HAPE and HACE?
    In high altitude the air is much thinner, though the concentration of oxygen is the same the pressure gradient is different do to the pressure in hog altitudes being lower. When this is the case the body picks up the RR to compensate for the decrease in O2 due to the change in pressure. As the body increases it RR just to get the same amount of oxygen the same amount of oxygen, it is still blowing off the same amount of CO2 so the pt becomes alkalotic. As the bodies pH is altered it changes to permeability of the capillaries and causes them to begin to leak causing hypoxia and edema. This is the cause for HAPE and HACE
  64. What is considered when a patient gets sick in higher altitude?
    Any illness at high altitude is considered caused by altitude illness until proven otherwise
  65. What is the short term compensation for high altitude sickness?
    • Hyperventilation and tachycardia
    • Kidneys help maintain pH
  66. What is the long term compensation for high altitude sickness?
    • Boy produces more red blood cells and hemoglobin
    • Capillary bed increase in density
  67. What are the tolerable side effects for compensating in high altitude illnesses?
    Hyperventilation progresses to respiratory alkalosis, respiratory alkalosis leads to irregular respiratory control. Irregular respiratory control leads to sleep hypoxia and delayed adjustment
  68. What is the MIO of HACE?
    Swelling with increased ICP
  69. What are the SXS of mild, moderate and severe HACE?
    • Mild AMS - Mild headache, reduced appetite and nausea
    • Moderate HACE - Severe head ache, nausea and vomiting
    • Severe HACE - AVPU changes, persistent vomiting and ataxia
  70. What is our treatment for mild, moderate and severe HACE?
    • Mild AMS - Pain meeds, O2, hydration and food and Acetazolamide and rest a day
    • Moderate HACE - Moderate HACE - Above plus immediate descent of 500 meters - Consider Dexamethazone
    • Severe HACE - Gamow bag treatment, immediate descent of 500 meters, Dexamethazone and PROP
  71. What are two medications that can be used in HACE that we don't have to know the dosages?
    • Acetazolamide (Diamox)
    • Dexamethazone (Decadron)
  72. What is the MOI of HAPE?
    Capillary dilation and leakage of fluid into the alveoli of the lungs
  73. What are the SxS of mild, moderate and severe HAPE?
    • Mild AMS - Dry cough, mild SOB on exertion
    • Moderate HAPE - Persistent cough, rales on auscultation, SOB at rest, low grade fever
    • Severe HAPE - AVPU changes, respiratory failure, white or blood tinged sputum and marked rales
  74. How do we treat Mild, moderate and severe HAPE?
    • Mild - O2, rest day and hydration and food, medications
    • Moderate - Above plus immediate descent of 500 meters, consider Nifedipine
    • Severe - Above plus Gamow bag treatment, immediate descent of 500 meters, Nifedipine and PROP
  75. What medication do we have to know for the treatment of HAPE, but no doses?
    • Acetazolamide (Diamox)
    • Nifedipine (Procardia, Alalat)
    • Oxygen
  76. What are some Altitude-related problems?
    • Contact lens
    • Cough
    • Dehydration
    • Sunburn
    • Slow blindness
  77. How do contacts cause altitude related problems?
    • Regular lenses can obstruct oxygenation of the cornea resulting in ulceration
    • Use high-permeability lenses (High DK valve)
    • Remove lenses when sleeping
  78. How is Dehydration an Altitude-related problem?
    High probability due to dry air and reduced appetite
  79. How is Snow blindness an altitude-related problem?
    • Can be caused by dry air as well as HAPE
    • Use dark UV protective lenses and shields
  80. How does Altitude cause slow healing?
    • Reduced oxygenation results in prolonged healing time
    • No healing above 6000 meters
  81. What is HACE?
    HACE = is swelling/hypoxia of the brain => to ICP the treatment for HACE is no different for ICP with the exception of the need to descend
  82. What is HAPE?
    HAPE = is progressive pulmonary edema/ The treatment for HAPE is no different than any other cause of pulmonary edema with the exception of the need to descend
  83. What are the risk factors for Altitude illnesses?
    • Past history of altitude illness
    • Respiratory depression
    • For AMS, age <50
    • Rapid ascent
    • Lives below 1000 meters
    • Exertion and cols air for HAPE
    • For HAPE, pre-existing respiratory illness
    • Sudden drop in atmospheric pressure
  84. What is a Gamow bag?
    • A Gamow bag is simply a pressurized sack that will allow you to simulate descending when travel is not possible
    • Can't treat the patient when their in the Gamow bag
  85. What are all the medications we need to know in HAPE and HACE?
    • O2
    • Valium
    • IV fluids
    • Morphine Diuretics
    • OTC for headache
    • Acetazolamide (Diamox - Special approval)
    • Dexamethazone (Decadron - Special approval)
  86. What kind of energy is Lightening?
    Lightening is DC: High voltage and amperage, short duration. Lightening occurs to equalize the + and - charges created by large air masses moving across the ground
  87. What is the difference between AC and DC energy?
    • DC - High Amperage, AC - Low Amperage
    • DC - High Voltage, AC- Low Voltage
    • DC - Short Duration, AC - Longer duration
    • DC - No muscle tetany, AC - Muscle tatany
    • DC - Internal burns uncommon, AC - Internal burns common
    • DC - Rhabdomyolysis is rare, AC - Rhabdomyolysis more common
    • DC - Entrance/exit wounds rare, AC - Entrance/exit wounds are common
  88. What are the different ways Lightening can strike?
    • Cloud to ground
    • Ground to cloud
    • Within the cloud
    • Cloud to space
    • Cloud to cloud
  89. How do we calculate the distance of a lightening strike?
    • Every five seconds form flash to bang equals one mile distance
    • Count 30 seconds means the strike is within 6mi, when the strike is within 6mi get to cover
    • Times of less than 15 seconds from F to B should initiate your lightening drill
  90. When caught in a lightening storm how can you protect yourself and others?
    • Spread people out. People should be no more than 15 -20 feet
    • Seek the lowest ground or hollow, away from trees, put on waterproofs and sit on mat with knees drawers up to body
  91. How far can Lightening travel through the ground?
    • Lightening can travel through the ground, fence, water pipes etc
    • The current can travel 100m
  92. At what distance is the energy from the lightening strike diminished enough to survive?
    Typically the power is diminished enough at 15-20ft to survive the strike
  93. Where/when was the longest known strike away from the storm?
    May 2004 in Osborne country Kansas a cloud to ground bolt of lightening stretch 28 miles from the storm
  94. How is cardiac arrest caused by lightening triaged?
    Cardiac arrest caused by lightening is triaged as immediate in a triage situation. CPR is not stopped in lightening strike patients
  95. What are the two different forms of lightening burns did Cy discuss in class?
    • Punctate lightening burn
    • Ferning lightening burn
  96. What are the lightening and Cutaneous Markings of lightening strikes?
    • Small deep entry/exit (Maybe absent)
    • Contact metal burns
    • Superficial (Flash over)
    • Lichtenberg figure
    • Clothing and shoes exploded off, torn, singed shredded
  97. What can lightening do to Auditory and ocular?
    • Tympanic rupture
    • Deafness, tinnitus, vertigo
    • Transient blindness - Photophobia, conjunctivitis, corneal damage
    • Retinal abnormalities - macular hole, optic neuritis, cataracts
  98. What is Tetany?
    A condition marked by intermittent muscular spasms, caused by malfunction of the parathyroid glands and a consequent deficiency of calcium
  99. In diving how many feet down = 1 atmosphere?
    Every 33ft a diver descends equals another 14.7 psi
  100. At 66ft how many atmospheres are there?
    3 = 1 from sea level + 1 at sea level + 1 at 33ft + 1 at 66 ft
  101. What is Boyles Law?
    • Boyles law - P = I/V
    • For every additional atmosphere the driver picks up an additional 14.7 psi of pressure is added to their body.
    • Closed air filled pagans are crushed
    • Water filled organs experience an increase in pressure but no change in size
    • Open air filled organs are reduced in volume in exactly the reverse relationship to the amount of pressure - Twice the pressure = 1/2 the volume
  102. What is Henry's law?
    • Gas exchange over the Alveoli membrane is pressure dependent. As the Pressure increases the amount of gas driven into solution (in the blood) increases
    • The amount of dissolved gas is pressure dependent
    • Increase in pressure = Increase Gas in Solution
  103. What is the normal solution to getting rid of dissolve gas in the blood?
    Breathing - Excess gas just takes more time
  104. What does AGE stand for?
    AGE (Arterial Gas Embolus)
  105. What is a Mask Squeeze?
    Mask Squeeze - Results from not equalizing pressure in diving mask on descent
  106. What are the SXS of a Mask Squeeze?
    Ruptured capillaries of the eyes, nose and soft tissue
  107. What are the SxS of Nitrogen Narcosis?
  108. How do we treat Nitrogen Narcosis?
    • Ascend
    • Limit depth of dive
    • Use mixed gases
  109. What is AGE?
    • Rapid ascent from depth, rapid onset
    • Hyper-expansion and rupture of the lungs
    • Air embolus from pulmonary tree
  110. What are the SxS of AGE?
    • Subcutaneous emphysema
    • Neurologic deficit
    • Bloody sputum
    • Shock
    • Pneumot√≥rax
    • Mediasteinum
    • CVA
  111. What are other names for Decompression sickness?
    • Caissons disease
    • Bends
  112. What is Decompression sickness?
    • Prolonged exposure, delayed onset
    • Insufficient time to decompress
    • Bubbles in blood from slow dissolution of gas
    • Micro vascular damage
  113. What are the SxS of Decompression sickness?
    • Skin itching
    • Paresthesia, joint pain
    • CNS symptoms, focal signs, AVPU changes
    • Respiratory distress and shock in severe cases
  114. What is the treatment for AGE and Decompression sickness?
    • Treat each SxS, ie. pneumo, CVA
    • Left sided recumbent
    • Hyperbaric chamber
    • DAN 1-919-684-8111
    • If flying stay below 1000' (300m)
    • Don't disturb diving equipment
  115. How deep must one go to recompres a diver?
    To recompose a diver you must go much deeper than their last dive
  116. How many atmospheres does a hyperbaric chamber go to?
    Usually only 3 atmospheres
  117. Compare AGE vs. BENDS.
    • AGE:
    • Onset fast
    • SQ Emphysema
    • Neuro Deficit (AVPU)
    • Cardiovascular collapse
    • Respiratory distress
    • Bends:
    • Onset somewhat delayed
    • Skin rash and itching
    • Neuro complaints
    • Cardiovascular collapse
    • Respiratory distress
    • Biggest clues:
    • Onset
    • Length of dive
    • Depth of dive
  118. Marine injuries can be grouped into what three main types?
    • Stinging problems
    • Spine problems
    • Bite problems
  119. What is a Nematocyst?
    A specialized cell in the tentacles of a jellyfish or other coelenterate, containing a barbed or venomous coiled thread that can be projected in self-defense or to capture prey
  120. What three Nematocysts do we need to know?
    • Corals
    • Jellyfish
    • Anemones
  121. What kind of problem do Nematocysts cause?
  122. What Tx to do and not do in a Nematocyst sting?
    • Tx Do:
    • Salt water rinse
    • Vinegar
    • Scrape off remains
    • Topical corticosteroids
    • Tx Don't:
    • Fresh water rinse
    • Rub
  123. What are the different marine spine injuries?
    • Sting rays
    • Catfish
    • Stone fish
    • Sea Urchins
  124. Tx for marine spine injuries?
    • H2O soak (105 F, 40 C) 90 min or until pain subsides
    • Remoce barb/stinger
    • Pain medication
  125. Compare Spine VS stinging injuries.
    • Spine:
    • Typically tissue toxin, sometimes combined with neurotoxin
    • Immediate evacuation for progressive neurologic symptoms
    • Stinging injuries:
    • Typically neurotoxin with some skin inflammation
    • Immediate evacuation for progressive neurologic symptoms
  126. What are the types of marine bites that Cy discussed in class?
    • Any of the large predator fish
    • Sharks
    • Barracuda
    • Eels
  127. What are the three types of marine bites?
    • Hit and run
    • Bump and bite
    • Sneak attack
  128. How do we treat marine bites?
    • Remove pt. from water
    • Hemorrhage control
    • Temperature control
    • Tx for shock
    • Wound high risk for infection
  129. What is a sneak attack from a marine bite?
    The shark had identifies its prey and has decided to feed
  130. What is a hit and run by a marine bite?
    This is typically a castoff mistaken identity. The shark assumes it is feeding on its normal prey and discovers the mistake on the first bite - Typically does not return
  131. What is a Bump and bite marine injury?
    The shark is uncertain what it is dealing with. In some cases it will bump into the pry and scrap off a small amount of fresh to try and identify the prey - typically returns to bite
  132. What are the three near drowning types?
    • Fresh water
    • Salt water
    • Cold water
  133. What is a Laryngospasm?
    • Occurs when the larynx closes involuntarily do to irritation. This occurs in most drowning. As a result most drowning results in dry lungs initially
    • 15% of Laryngospasm don't relax when the patient surfaces. Consider what your airway pitons are.
  134. What is the priorities in the drowning patient?
    • Get the patient out of the water
    • It is possible to provide PPV while in shallow water
    • If there is the possibility of a C-spine injury immobilize the patient
  135. What are the steps for back boarding a patient in the water?
    • Gasp the patient head, neck and shoulder
    • Moving backward roll them onto their back
    • Submerge the backboard underneath the patient
    • Consider partial immobilization and rapid extrication if the water is cold
  136. What happens if a patient drowns in salt water?
    • Salt water drownings result in pulmonary edema over time
    • Water flows to the area of lower concentration to higher concentration
    • If the water in the lungs is higher concentration of salt then the blood it will take the fluid from the blood to the lungs
  137. What happens if a patient drowns in fresh water?
    • RBC will accept the water until it laces/blows-up/ruptures
    • Water goes into the area of higher concentration, in this case the blood
    • Fresh water drowning typically result in dry lungs. However, as water migrates into the circulation volume it can dilute the blood and destroy RBC
  138. What can drowning in 70F or colder and where the patient is completely submerged result in?
    Cold water drowning can result in the MDR (Mammalian Diving reflex). The cold water reduce oxygen consumption by slowing down the metabolic rate
  139. What is the Mammalian diving reflex?
    • The Mammalian diving reflex is where a patient drowns in cold water lower then 70F and the patient is completely submerged
    • The MDR reduced the O2 consumption by slowing down the metabolic rate
  140. What can affect the MDR?
    • Length of submersion
    • Age of patient
    • Temperature of the water
  141. What is the cold water drowning rule?
    Consider the patient viable if they have been submerged in water 70F or colder for less then 60 min. Do not stop BLS or ALS treatment until you have reached the hospital or are in voice contact with medical control
  142. What precautions should a rescuer take in treating a patient with Lice?
    Easily transmuted from patient to rescuer so where gloves and change and wash uniform at work
  143. How do we treat lice?
    • Treatments like permethrin should be applied to dry hair
    • Can also be smothered with Vaseline, Mayonnaise or Dippity-Do
    • Malathione (Ovide) is fastes-killing
  144. What are the tick-borne Diseases we have to know?
    • Lyme disease
    • Colorado tick fever
    • Rocky Mt spotted fever
    • Ehirlichiosis
    • Q-fever
    • Tularemia
    • Tick-borne encephalitis
    • West Nile virus
    • Plague
  145. How is a tick removed?
    Grab the head of the tic when removing them. Because the head is cemented into the host it mat become detached when trying to remove the tick. If it happens it may be necessary to dig the head out with a scalpel blade. Tick cement themselves to their host. This requires less energy than hanging on to the hosts hair follicles during the blood meal. This is why they are so hard to pull off. The tick dissolves the cement by disgorging part of it blood meal at the end of the feed cycle - this is the point that the infection occurs.
  146. What are the SxS of Lyme Disease?
    • Rash (Bull's-eye Rash) - Typically occurs 3-30 days after bite. Rash occurs in 70-80% of infected people
    • Fever
    • Head ache
    • Fatigue
    • Joint pain
    • Circulatory system
    • Nervous system
  147. What are the types of Anthrax we need to know?
    • Cutaneous
    • Gastrointestinal
    • Inhalation
  148. What are the SxS of Cutaneous Anthrax?
    • Small sore >
    • Blister
    • Skin ulcer (Black center)
    • Not painful
  149. What are the SxS of Gastrointestinal Anthrax?
    Nausea, loss of appetite, bloody diarrhea fever and stomach pain
  150. What are the types of Inhalation Anthrax?
    • Flu like symptoms, severe head ache
    • Mild fever, tiredness, muscle ache
    • SOB and cough
  151. How does anthrax spread?
    • Bacterium
    • Soil
    • Infected animals
    • Infected animal products
    • Inhaling spores
    • Eating uncooked meat which is infected
  152. What are the SxS of Tularemia?
    • Skin ulcerations
    • Swollen and painful Enlarged lymph nodes
    • Sore throat
    • Head ache
    • Muscle weakness/joint pain
  153. How is Tularemia spread?
    • Bacterium
    • Tick
    • Deer flies
    • Food
    • Water
    • Inhalation
    • NOT: person to person
  154. What are the SxS of Plague?
    • Swollen, enlarged lymph node (called Bubo)
    • Warm to touch
    • Fever
    • Headache
    • General feeling of illness
  155. What is Septicemia?
    • Blood poisoning, esp. that caused by bacteria or their toxins
    • This happens when the Plague hits the blood stream
  156. What are the two types of Plague?
    • Bubonic:
    • Spread by a tick or flea bite
    • Pneumonic:
    • Inhaled
  157. Which source of plague is worse and how is it spread?
    • Pneumonic is the more serious form of plague
    • Bite flea
    • Inhalation of spores
    • Break in skin
    • Contact with infected body fluid
  158. What is Malaria?
    • An intermittent and remittent fever caused by a protozoan parasite that invades the red blood cells. The parasite is transmitted by mosquitoes in many tropical and subtropical regions.
    • Blood disease
    • Passed by anopheles mosquito
    • Infected with plasmodium falciparum
    • Digest red blood cells
    • Changes adhesion properties of cell