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For an alkali poisoning what is the first thing to do
Dilute with water or milk
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pH level goal when flushing out the eyes
7.0
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Where should the poision control number be located
- outside sickbay
- outside the antidote locker
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You should train all non medical personal in emergency procedures dealing with Poisoning cases
True
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Give some reasons to do a gastric lavage
- Ingestion of CNS depressant
- Collection of gastric contents
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If a patient inhales an acid what is the TX for it?
- Fresh air
- O2
- Treat for pulmonary edema
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What is the treatment of an ingested alkali/acid poisoning
- Dilute with H2O or milk, 200ml
- numb with viscous lidocaine
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What is produced by bacterial action on sewage
Hydrogen sulfide gas
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It is characterized by a rotten egg odor and has similar affects as cyanide poisoning
Hydrogen sulfide gas
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A pt that is vasodilated from tx of poisoning, to prevent hypotension what would you give
epinephrine
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What is the primary tx action for poisoning
- Airway
- Breathing
- Circulation
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A poisoin that produces an irritation or inflamation
Irritant
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What are the contraindications for emisis
- drowsiness
- unconsciounses
- convulsions
- corresive ingestion
- petroleum distinalate injestion
- convulsion causing esophageal blowout
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what is the correlation of in and out for gastric levage
What goes in should equal what comes out
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What is something that soothes irritated tissue from
injestion of poisons and name an example?
- Demulcents
- b. Egg whites beaten in 500 ml of water or milk
- c. Thin mixture of flour or starch with water
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If an alkali gets into the eyes what is the Tx
Flush eyes till pH 7.0
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Tx for Isopropyl alcohol, when should you not inducE vomiting
If respiratory depression is present
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What is not an affective tx for isopropyl alcohol
Activated charcoal
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TX for hydrocarbons
Dilution
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A Tx for methanol ingestion which will prevent metabolism
Ethanol
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Fish poisoning caused by red tide and usually happens at certain times of the year primarily tropical fish
Ciguatera
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Rattle snakes, copperheads, and water moccosins are what type of snakes
Crotalidae (pit vipers)
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What is a main S/S of Hydrophidae (sea snake) venom
Rapid ascending paralysis
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TX for marine life envenimation when the antidote is not available
Hot water neutralizes venom
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LAtrodectus
Widow spiders
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Loxosceles
- Recluse spiders
- cytotoxic venom
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TX for loxosceles bites
Cut out necrotic tissue
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S/S for tynganaria bite
Blister will rupture within 36 hours
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What is the TX for a jelly fish sting
Meat tenderizer, papaine
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What is the amount of calories that should be ingested in a cold enviroment
12000
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tx for bends/ Cassion disease (decompression sickness)
immediate recompression
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MAjor concern for salt water aspiration
Affects on salt water sulfactant
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Defining temp for heat stroke
106
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While diving pt notes sinus pain while submerged and blood or serosinus fluid in mask
Sinus squeeze
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What antidote do you give for opiate poisening
Narcan (naloxone) 2mg IV Q3min
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What is the TX for barbituate poisoning?
- ConScious-Activated charcoal lavage
- Unconscious- vitals, neuro checks, R+ET suctioning, I-O
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What is the antidote for somebody having anticholinergictoxicity (such as atropine/tricyclics)?
- Physostigmine salicylates 0.5-2 mg IV initially
- over 5 minutes; repeat Q30-60mins PRN
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What are some mild signs and symptoms of organophosphate
toxicity?
- a. Substernal discomfort
- b. Anxiety
- c. Tremor
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What is the antidote treatment for organophosphate toxicity?
- a. Atropine 2 mg IM Q5-10mins
- b. Pralidoxime (2-PAM) 1 gm over 5-10 minutes
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What do you give for treatment of amphetamines?
Diazepam 5 mg IV
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What type of poison directly destroys tissue
Corrosive
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This is a poisonous substance secreted by an animal or
insect.
Venom
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This describes the quality or degree of being poisonous.
Toxicity
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This is any substance which when ingested, inhaled, applied (topically), injected, or developed within the body in small amounts, may cause structural damage or functional disturbance.
Poison
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What is the quickest method to remove contents from the GI tract, but is no longer routinely used?
Emesis
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To initialize emesis, what do you give a patient?
- 15-30 cc’s of Syrup of Ipecac
- b. 1-2 glasses of room temperature water
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What is the antidote for acetaminophen?
Acetylcysteine
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What is the antidote for hydrofluoric acid?
Calcium gluconate
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What is the antidote for hydrogen sulfide?
Amyl nitrite ampule, 300 mg IV, slow infusion
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What do you give for somebody suffering a seizure after
ETOH poisoning?
Diazepam
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What snakes are elapidae?
- a. Corals
- b. Mambas
- c. Cobras
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What is considered a helodermae?
Gila monster
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This type of spider is found in 25 states and worldwide,
inhabit dark quiet areas, have medium dark to yellow color with a violin shape on their back and has cytotoxic venom.
Recluse
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What types of fish are classified as Coelenterates
- a. Corals
- b. Sea anemones
- c. Jellyfish
- d. Portuguese Man O’War
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How does the puncture wound look for the blue ringed
octopus?
2 small puncture wounds
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What temperature does the water have to be for treating octopus wounds?
113-122 degrees F
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What is another name for an Echinoderm?
Sea urchins
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How does the wound look for an Echinoderm “bite”?
Black and blue” (characteristic)
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What are the different venomous spiny fish?
- a. Stone fish
- b. Zebra fish
- c. Lion fish
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What medications do you avoid to prevent cold injuries
because they promote peripheral vascularity?
- Morphine
- b. Thorazine
- c. Barbiturates
- d. CNS depressants
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What type of hypothermia has a temperature of 94-97 degrees?
Mild
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What type of hypothermia has a temperature of 86-94
degrees?
. Moderate
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How does a patient present with mild hypothermia?
- Conscious, but mild to moderate clouding
- b. Shivering is present, but diminished
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How does a patient present with moderate hypothermia?
- Severe clouding, may be unconscious
- b. Shivering replaced by muscle rigidity
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For external re-warming, what must the temperature of the bath water be
104-107.6
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How warm should the oxygen be for heated humidified
oxygen?
110-115
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This is a result of intermittent exposure to temperatures above freezing accompanied by high humidity (32-35 degrees F)
Chillblains
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53.This is a complication of Chillblains after 12 hours to
3 days of exposure that affects finger, toes, and ears without freezing?
Pernio
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What are the two phases of cold water immersion syndrome
(trench foot)?
- Hyperemic – hot with intense burning
- Vasospastic – pale or cyanotic with diminished
- pulses
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When the skin is red and yields to pressure, what would
you diagnose them with?
First degree frostbite
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A patient presents with white and cold skin, that yields to pressure. What is their diagnosis?
Second degree frostbite
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57.How does a patient present with third degree frostbite?
- Deep reddish-purple skin with or without blistering
- b. Vesicles are deep and contain blood
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The skin is hard and white in this
Fourth degree frostbite
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How can you prevent a heat injury?
- Physical conditioning
- b. Fluid and salt intake c.
- Acclimatization (8-10 days)
- d. Proper clothing
- e. Avoid alcohol and CNS depressants
- f. Avoid fatigue and infections
- g. Drink water
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This condition is due to inadequate or collapse of peripheral circulation secondary to salt depletion and dehydration where you only take in 1-2 liters per hour and usually occurs in those with underlying disease.
Heat exhaustion
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This is a true medical emergency characterized by uncontrolled elevation of core body temp due to the failure of the hypothalamus.
Heat stroke
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With this, the body temp is 106 or higher and the skin
is hot, dry and flushed.
Heat stroke
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What is the sequence of events for drowning?
- Hypoxemia
- b. Laryngospasm
- c. Fluid aspiration ineffective circulation
- d. Brain injury
- e. Brain death (5-10 minutes)
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This is an occupational hazard of divers where dissolved
gases (nitrogen) saturate tissues from an increase in water pressure, escape as gas bubbles during ascent.
Decompression sickness
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What gas saturates the tissues in decompression
sickness?
Nitrogen
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By how much does the water pressure increase by when you dive?
One atmosphere every 33 feet
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This is due to gas entering the arterial system and
becomes a blockage or emboli; CNS and heart are the most susceptible.
Arterial gas embolism (AGE)
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71.What are the signs and symptoms of AGE?
- Sudden onset
- Dizziness
- Paralysis or weakness
- Blurred vision
- Parasthesias
- Convulsions
- Dyspnea
- Chest pain
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How do you treat somebody suffering from an AGE?
- Immediate recompression
- ABC’s
- O2
- MEDEVAC
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This is a collapsed lung.
Pnumothorax
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What are the signs and symptoms of a pneumothorax?
- Sudden onset of chest pain radiating to the
- shoulder or back
- Dyspnea
- Tachypnea
- Diminished or absent breath sounds
- Paradoxical respirations
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What are the signs and symptoms of a pulmonary embolism?
- Abrupt onset
- Dyspnea
- Cough
- Hemoptysis (most common complaint)
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