Environmental

Question 1

Dog’s younger than what year are more responsible for highest incidence of bites?

Answer 1

1 year

Question 2

Abx indications timeline for dog bite?

Answer 2

Bite on face present for > 24 hours OR bite on extremity > 8 hours
without irrigation

Question 3

What abx is used for bites?

Answer 3

Augmentin

Question 4

What if PCN allergy, what abx is used for bites?

Answer 4

Clinda + cipro

Question 5

Cat bites have a higher infection rate in comparison

Answer 5

True

Question 6

Treatment for cat bites?

Answer 6

Same as dog bites

Question 7

70% of cat bite infections are due to?

Answer 7

Pasteurella

Question 8

Abx for bites in the water?

Answer 8

• Bactrim

* Doxy

Question 9

What are you treating for in fresh water bites?

Answer 9

Aeromonas hydrophila

Question 10

What are tou treating for in salt water bites?

Answer 10

Vibrio Species

Question 11

Tx for salt water bites?

Answer 11

Doxy + Ceftriaxone

Question 12

Hymenoptera is?

Answer 12

includes ants, bees, and wasps

Question 13

Tx for stingers?

Answer 13

(a) Remove the stinger
1) Scrape away the stinger in a horizontal fashion.
2) Try not to grasp the stinger sac.
3) However, if one is unable to remove the stinger in a horizontal fashion, it is most important to remove it as soon as possible by any available means.
(b) Wash the site with soap and water.
(c) Place a cold compress or ice on the site.
(d) Give oral analgesics as needed for pain relief.
(e) Topical steroid cream can be helpful for swelling, as are oral antihistamines.

Question 14

What antihistamines are given for stingers?

Answer 14

Loratadine (Claritin) -
Desloratadine (Clarinex) -
Fexofenadine (Allegra) –
Cetirizine (Zyrtec) -

Question 15

What if hives and or resp difficulty happens?

Answer 15

EPI, then every 5-10 minutes
Albuterol
Oral steroids

Question 16

Tick removal?

Answer 16

1) Use thin-tipped tweezers or forceps to grasp the tick as close to the skin surface as possible.
2) Pull the tick straight upward with steady even pressure

Question 17

What snake is neurotoxic?

Answer 17

Coral snake

Question 18

What does neurotixns cause?

Answer 18

Respiratory paralaysis

Question 19

Signs of neurotoxin?

Answer 19

ptosis, dysphagia, diplopia, and respiratory arrest via diaphragmatic paralysis

Question 20

What snakes are cytolytic?

Answer 20

Rattlesnakes and other pit vipers

Question 21

What does cytolytic venom do?

Answer 21

tissue destruction by digestion and hemorrhage due to hemolysis and destruction of the endothelial lining of the blood vessels

Question 22

Signs of cytolytic venom? *

Answer 22

Pain

• redness
• tingling
• Metallic taste
• nausea and vomit
• Hypotension

Question 23

So diff between neurotoxin and cytolytic?

Answer 23

Cytolitic is blood

Question 24

Tx for snake bite?

Answer 24

• No tourniquet
• Irrigate
• Loose dressing
• MEDEVAC
• Immobilize

Question 25

Black widow signs?

Answer 25

(neuro) Generalized muscular pains, muscle spasms, and rigidity

Question 26

Black widow tx?

Answer 26

Pain may be relieved with pain control and muscle relaxants

Question 27

Brown recluse signs?

Answer 27

(hemocytolytic) progressive local necrosis as well as hemolytic reactions (rare). Bite is usually painless Bites occasionally progress to extensive local necrosis and may require excision of the bite site and oral corticosteroids

Question 28

Tx for brown recluse bite?

Answer 28

1) Pain management for secondary local necrosis and close monitoring initially. 2) Consider antibiotic prophylaxis in field setting

Question 29

Initial management on scene?

Answer 29

``` Scene safety C - A - B * Circulation * airway * Breathing ```

Question 30

Scorpion signs?

Answer 30

(a) muscle cramps, (b) twitching and jerking, (c) occasionally hypertension, (d) convulsions, (e) pulmonary edema

Question 31

Initial management of spider bites?

Answer 31

Monitor and pain management

Question 32

Tx for north American scorpions?

Answer 32

Su[[ortive care

Question 33

Signs of Jellyfish sting?

Answer 33

(a) Pain, (b) erythema, (c) edema, (d) pruritus, (e) vesiculations, (f) Anaphylaxis

Question 34

Tx for jellyfish?

Answer 34

* Rinse with salt water * DO NOT USE FRESH WATER * Remove tentacles with a gloved hand the scrape off any remaining nematocyst by covering with sand/shaving cream/baking soda and scraped off with straight edge. Sticky tape may also remove nemocysts Antihistamines, topical corticosteroids, and pain medications

Question 35

Signs of coneshell?

Answer 35

(a) Mild to severe pain, (b) stinging or numbness, (c) local to total paralysis

Question 36

Tx for coneshell?

Answer 36

* pressure immobilization dressing * Monitor for resp status * MEDEVAC if needed

Question 37

Stingray and stinging fish sx?

Answer 37

(a) Barbed spines that are a penetrating injury and envenomation. (b) Spine commonly remains lodged in wound.

Question 38

Tx for stingray and stinging fish?

Answer 38

* Remove and irrigate * TOXIN is heat labile so place wound in water heated 40-45 Celsius (104-113 Fahrenheit) for 30min intervals * Does not respond well to pain relievers

Question 39

What are you also concerned with for stingrays or stinging fish?

Answer 39

Vibrio

Question 40

What is vibrio treated with?

Answer 40

Doxy

Question 41

Stonefish stings not responsive to hot water immersion- should receive antivenom, and patient closely monitored for anaphylaxis

Answer 41

Ok

Question 42

(f) Treatment for scorpionfish and catfish envenomation should be treated in a similar manner.

Answer 42

Ok

Question 43

most persistent biological and chemical contaminants tend to concentrate in sediment rather than in the water column

Answer 43

Cool

Question 44

b. Chemical Contaminants

Answer 44

Chemical contaminants include any chemicals which have leaked, spilled or dumped, or have been otherwise found in a body of water

Question 45

c. Biological Contaminants

Answer 45

(a) harmful algal blooms (e.g., red tide), (b) bacteria (e.g., fecal coliforms), (c) viruses and parasites which could potentially harm an unprotected diver. (2) Biological contaminants may be present in storm water runoff and pose hazards to divers and to surface support personnel, especially when diving in near shore, urban areas within 36 hours of a storm event.

Question 46

Tx for soft tissue infections following water exposure?

Answer 46

(a) Assessment to determine whether treatment requires hospitalization, (b) Empiric antibiotic administration, assessment of tetanus vaccination status, (c) Surgical consultation for potential debridement in patients with necrotizing infections.

Question 47

Abx tx for soft tissue infections following water exposure?

Answer 47

Look up abx in tg