Ailments Flashcards
(16 cards)
Motion Sickness (Not True Illness)
Cause: Sensory mismatch (vision, vestibular, proprioception)
Types: Air, car, sea sickness; physiologic vertigo
S/Sx: Nausea, vomiting, sweating, pallor, yawning, anxiety, dizziness, fatigue, confusion
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Prevention
• Meclizine 25mg PO 30–60 min before travel & BID
• OR Scopolamine patch 1.5mg behind ear (up to 4h before)
• Sit center of transport, gaze at horizon
• Light meals, improve airflow
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Management
• Follow Nausea/Vomiting Protocol
• If severe: Midazolam 1–2mg IV q6–12h
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Disposition
• Evac not needed unless risk to mission/self/others
• Reevaluate if S/Sx persist >24h post-travel
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Special
• Rule out: altitude illness, GI infection, stroke, toxins
• Meds may cause drowsiness—consider mission impact
Bronchitis
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Bronchitis (Usually Viral)
Definition:
Inflammation of trachea/bronchi from URI or irritants (viruses = most common).
S/Sx:
Cough (starts dry, then productive), URI sx, fatigue, +/- fever >100.4, +/- dyspnea, injected pharynx, wheezing, sputum (color not diagnostic).
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Management
1. PO fluids
2. Acetaminophen 1000mg q6h PRN & Ibuprofen 800mg q8h
3. Antitussive, decongestant, expectorant as needed
4. If wheezing: Albuterol MDI 2 puffs q4–6h
5. Hydration, lozenges, smoking cessation
6. O₂ if SpO₂ <92%; consider Pneumonia Protocol if worsening
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Disposition
No evac unless severe dyspnea/hypoxia. Use observation/routine evac as needed.
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Special
• Rule out: HAPE (at altitude), PE, pneumothorax
• Self-limiting; antibiotics not usually needed
• Cough may persist for weeks
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Cellulitis / Abscess
(Bacterial Skin Infection)
Cellulitis / Abscess (Bacterial Skin Infection)
Definition:
Superficial bacterial infection after skin break. May progress to deep tissue involvement.
S/Sx:
Red, warm, swollen, painful area ± fever, lymphadenopathy.
Watch for: rapid spread, necrotizing fasciitis signs, or abscess (fluctuant, tender, well-defined mass).
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Management
1. Clean/dress wound; mark borders
2. Abx for mild:
• Doxycycline 100mg BID
• OR TMP-SMX DS 1 tab QID
• OR Cephalexin 500mg QID × 7d
• OR Clindamycin 450mg TID × 7d
3. If worsening after 48h: Add ertapenem 1g IV/IM QD
4. Look for abscess; treat pain; limit activity
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If Abscess Present (and setting allows):
• I&D after local anesthesia
• No sutures—pack loosely
• Irrigate with sterile/clean water
• Daily wound checks
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Disposition
Evac if: critical area, worsening, IV abx needed, or necrotizing concern.
Priority evac for neck/face/genital/hand/joint involvement.
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Special
Only attempt I&D if:
a) Mission-critical; b) I&D at higher level not possible;
c) Clearly demarcated/superficial; d) Local anesthesia & antiseptic available.
Chest Pain (Cardiac Rule-Out)
Chest Pain (Cardiac Rule-Out)
Definition:
Suspected MI or other cardiac cause of chest pain.
S/Sx (Cardiac):
Substernal pain ± radiation (arm, neck, jaw)
Described as pressure/squeezing
Worse with exertion, relieved by rest
+/- Dyspnea, diaphoresis, nausea, lightheadedness, syncope
Abnormal vitals: tachycardia, bradycardia, hypo/hypertension
Bilateral rales/crackles = possible heart failure
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Management
1. Aspirin 324mg PO (chewed)
2. O₂ & monitor SpO₂ if available
3. Nitroglycerin 0.4mg SL q5min x3 if not hypotensive or on ED meds
4. IV fluids (250–500mL) for hypotension
5. Pain management per protocol
6. Avoid exertion; position of comfort
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Disposition
Urgent evac—do not delay even if non-cardiac cause suspected
Use ACLS platform if available
Seek med control if unsure of diagnosis
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Special / Non-Cardiac Considerations
1. GERD: Lying flat, foul taste, relieved by antacids
2. Esophageal rupture: Vomiting + chest pain; evacuate urgently
3. Pleuritic pain: PE or pneumothorax; unilateral breath sounds → needle decompression if needed
4. MSK pain: Worse with movement or palpation; trial of NSAIDs
5. Respiratory infection: Consider Bronchitis/Pneumonia Protocol
Compartment Syndrome
Definition:
Ischemic muscle/nerve damage from increased pressure in closed compartment; can follow trauma or fracture.
S/Sx:
• Pain out of proportion, deep ache, burning
• Paresthesia, weakness
• Tense, shiny skin, passive stretch pain
• Late: pressure feeling, numbness, weak/absent distal pulses
Management:
1. Remove constriction
2. Open/irrigate/dress wounds
3. Pain control
4. IV access
5. Ertapenem 1g IV qd OR Ceftriaxone 2g qd OR Moxifloxacin 400mg PO qd
6. Fasciotomy ONLY with training and med direction
Disposition:
Urgent evac to surgical facility
Conjunctivitis
Conjunctivitis
Definition:
Inflammation of eye conjunctiva (allergic, viral, or bacterial)
S/Sx:
• Allergic: Bilateral, itchy, watery/mucoid
• Viral: Watery, unilateral → bilateral, URI, node tenderness
• Bacterial: Purulent, uni/bilateral, eye injection
Management:
1. Remove contact lens
2. Visual acuity before/after tx
3. Tetracaine 0.5%, 2 drops for exam only (do NOT dispense)
4. Irrigate if foreign body; stain if needed
5. • Allergic: Artificial tears → naphazoline PRN
• Viral: Supportive care
• Bacterial: Erythromycin 0.5% oint q4h × 3–5d OR fluoroquinolone drops q6h
Disposition:
Routine evac only if unresolved
Constipation / Fecal Impact
Constipation / Fecal Impact
Back (Answer Side):
Definition: Infrequent, hard, dry stools.
S/Sx: Cramping, straining, hard stools, abdominal pain. Red flag: pain + vomiting + no gas/stool = possible obstruction.
Management:
1. ↑Fiber (30g/day) + 80–120 oz water
2. Polyethylene glycol 17g PO QD
3. If no relief: Bisacodyl 10mg PO or Docusate 100mg PO BID
4. Manual disimpaction if trained
5. No narcotics; treat pain supportively
Disposition: Routine evac only if no response
Special: Rule out: obstruction, appendicitis, infections, volvulus, diverticulum rupture
Contact Dermatitis
Contact Dermatitis
Definition: Skin reaction to irritants/allergens
S/Sx: Itching, erythema, edema, vesicles, crusting.
Management:
1. Remove cause, cleanse skin
2. Cool compresses, triamcinolone 0.1% or 1% hydrocortisone
3. Diphenhydramine 25–50mg PO/SL q6h
4. Severe cases:
• Prednisone 60mg PO x 5d
• OR Dexamethasone 10mg IM qd x 5d
• OR Medrol 125mg IM x 5d
Disposition: Priority evac for eye/mucosa/≥50% BSA
Special: Consider insects, cellulitis, fungal infection, or toxin exposure
Corneal Abrasions / Corneal Ulcers
Trauma to cornea with 3 risks: eye pain, corneal ulcer (infection), and globe rupture.
S/Sx:
Eye pain, tearing, blurred vision, photophobia, foreign body sensation; fluorescein staining; white/gray spot = possible ulcer.
Management:
1. Remove contact lenses
2. Assess vision before/after
3. Tetracaine 0.5% (1-time use only)
4. Irrigate foreign body if present
5. Moxifloxacin drops OR erythromycin/fluoroquinolone q4h x 5d
6. Reduce light; pain control PRN
7. Monitor for worsening (ulcer signs); Do NOT patch
8. Reassess q24h
9. Evac Priority if ulcer suspected or Urgent if LASIK flap risk
Special:
• Contact lens = high ulcer risk
• LASIK trauma = possible flap dislocation
• Consider HSV/fungal if not improving
Cough
Cough typically viral; can indicate HAPE or pneumonia
S/Sx:
± sputum, dyspnea, sore throat, nasal symptoms, tachypnea
Management:
1. URI S/Sx = treat as URI
2. No fever = use Bronchitis Protocol
3. Fever + dyspnea = Pneumonia Protocol
4. High altitude = Altitude Medical Emergency Protocol
Disposition:
Based on cause and severity; follow protocol guidance
Differentials:
GERD, asthma, post-nasal drip (PND)
Deep Venous Thrombosis (DVT)
Clot in large veins (usually leg); risk of PE if dislodged
S/Sx:
Leg trauma, air travel, birth control, family hx
Unilateral calf pain/swelling, warmth, pain ↑ with dorsiflexion
Possible palpable “cord”
Management:
1. Monitor SpO₂ (drop suggests PE)
2. Aspirin 325mg PO q4–6h
3. Immobilize limb
4. Respiratory symptoms? → Treat per Chest Pain Protocol
Disposition:
Priority evac if no distress
Urgent evac if chest pain/resp symptoms
Special:
Can mimic ruptured Baker’s cyst
Dehydration
Definition:
Inadequate fluid intake, worsened by exertion or illness
S/Sx:
Lightheaded, dry mouth, decreased urine (tea-colored), fatigue, headache, poor performance
Management:
1. Address underlying cause
2. Oral fluids if tolerated
3. Electrolyte drink mix (1:4 dilution)
4. Avoid caffeine
5. If unable to drink:
• Try 1L IV bolus → reattempt PO
• If still intolerant: repeat 1L IV
Disposition:
Monitor closely. Priority evac if unresolved.
Special:
Troops often chronically dehydrated; heat, diarrhea, altitude all worsen dehydration
Dengue Fever
Mosquito-borne virus (Aedes spp.), common in tropics
S/Sx:
High fever + ≥2: retro-orbital pain, HA, myalgias, rash, petechiae
Hemorrhagic signs: Purpura, mucosal/GI bleeding
Management:
Supportive only—fluids and fever control
Tylenol 1,000mg q6hr (NO NSAIDs)
Disposition:
Urgent evac if suspected DF, DHF, or DSS
Special:
• No vaccine or antivirals
• Prevent mosquito bites
• Prior exposure ↑ risk for DHF/DSS
Dental Pain
Pain from decay, fracture, abscess, pericoronitis (e.g., wisdom tooth)
S/Sx:
Sharp or continuous pain, heat/cold sensitivity, visible fracture, swelling, abscess
Management:
1. Clove oil gauze for pain; follow Pain Protocol
2. If infected:
• Amoxicillin/clavulanate 875mg PO BID × 7d
• OR Ceftriaxone IV/IM + Azithromycin
3. Warm saline rinses; hygiene support
4. Local/regional anesthesia if trained
Disposition:
Evac only if IV antibiotics or no improvement → Routine
Determination of death
Field declaration in trauma/mass casualty when no pulse/respiration AND resuscitation would hinder care of others
S/Sx:
No respirations + one of:
• Decapitation
• Massive destruction
• Incineration
• Rigor mortis / decomposition
Management:
1. No CPR for obvious death
2. Stop CPR after:
• 15 min unknown cause
• 30 min hypothermia/lightning/drowning
3. Continue ACLS if doubt—get med control
4. Trauma: consider thoracostomy and airway for ROSC attempt
Disposition:
Evac remains when feasible.
Urgent evac if ROSC.
Special:
Lightning, cold, intermittent pulse → may still recover with CPR
Electrocution
Injury or death from electric current (AC or DC); may co-occur with blast or trauma
Management:
• Use Tactical Trauma Assessment Protocol
• DC → more likely to cause arrest
• AC → vfib common
• Watch for rhabdo, compartment syndrome, respiratory arrest
• Head trauma must be ruled out
Disposition:
Evac anyone with systemic symptoms → Higher level of care
