Environmental Flashcards
(209 cards)
1
Q
Most common bite
A
dogs younger than one year
2
Q
Common pathogen found in dog bites
A
pasteurella multocida
3
Q
Dog bite antibiotic
A
- Augmentin 875/125mg
- Clindamycin
- Cipro 750mg
4
Q
Highest infection rate for domestic animal bites
A
cats
5
Q
Wild animal bite antibiotic
A
Bactrim 160mg
6
Q
Larger animal injuries
A
penetrating trauma
deep arterial damage
nerve damage
organ damage
7
Q
Hymenopteras
A
ants, bees, and wasps
8
Q
Most common hymenoptera reaction
A
local reaction
9
Q
Victims of multiple stings sx
A
NVD
dyspnea
hypotension
tachy
syncope
10
Q
Sting tx
A
remove stinger in a horizontal fashion
wash site
cold compress
11
Q
Sting meds
A
antihistamines
12
Q
Non-infectious ascending paralysis within 5 days of a tick bite
A
tick paralysis
13
Q
Tick bite tx
A
removal
wash site
Doxy
14
Q
Do nots of tick removal
A
petroleum jelly
nail polish
rubbing alcohol
hot match
gasoline
15
Q
What snake toxin causes respiratory paralysis?
A
neurotoxins from coral snake
16
Q
What releases cytolytic venom?
A
rattlesnakes and pit vipers
17
Q
Cytolytic venom destroys
A
tissue and endothelial lining of blood vessels
18
Q
Pit viper head
A
triangular shape
nostril with pit
19
Q
Coral snake head
A
round head
nostril without pit
*split anal plate
20
Q
Nonvenemous snake head
A
oval shape
oval pupil
21
Q
Cytolytic bite sx
A
pain
swelling
tingling
metallic taste
22
Q
Neurotoxic bite sx
A
ptosis
dysphagia
diplopia
respiratory arrest
23
Q
Snake bite tx
A
imobilize
remove jewelry
clean bite
loose dressing
MEDEVAC
24
Q
Black Widow bite sx
A
muscle pain
spams
rigidity
25
Spider Bite tx
pain control and muscle relaxers
26
Scorpion bite sx
convulsions
muscle spasm
pulmonary edema
27
Jellyfish meds
antihistamines
corticosteroids
pain meds
28
Jellyfish tx
rinse with sea water
vinegar
sand
shaving cream
baking SODA
29
Jellyfish sting sx
pain
erythema
pruritis
edema
30
Sting Ray tx
heated water for 30min at 40-45C or 104-113F
poison control for antivenom
31
Sting ray penetrating wound via
barbed spine
32
Sting Ray med
Doxy 100mg 7 days
33
Coneshell tx
Doxy and Medevac
34
Near Drowning
survival after suffocation or LOC in a liquid
35
Near Drowning risks
inadequate supervision
inability or over estimation of swimming
alcohol
hypothermia
36
Lubricating agent in lung tissue
surfactant
37
Physiology of dying from drowning
hypoxemia
38
Near Drowning physical findings
neurologic deficits
arrhythmias
acidosis
renal failure
39
Near Drowning Tx 3 phases
Prehospital
Emergency department
Inpatient
40
Near Drowning acute inteventions
rescue
remove wet clothing
CPR
C-spine
do not Heimlich
41
Near Drowning airway management
neurologic deterioration
inability to maintain SPO2 of 90
PaCO2 above 50
42
Near Drowning factors of poor prognosis
submersion >5 min
BLS after >10 min
Ressucitation >25 min
Glasgow <5
blood ph <7.1
43
Contaminants concentrate where in polluted water?
sediment
44
Polluted water protection
dry suit and full facemask
45
Biological water conatminants
algal bloom
bacteria
virus
parasites
46
After a storm Urban areas are at higher risk for contaminants for how long?
36 hours
47
5 most common water* bacteria producing soft tissue infection
aeromonas
Edwardsiella tarda
Erysipelothrix
vibrio
mycobacterium marnium
48
Polluted Water empiric antibiotics (non-seawater)
Keflex 250mg
or
Clindamycin / Metronidazole
49
Vibrio antibiotic
Doxy
50
4 mechanisms of inhaled agents
physical particles
siple asphyxiants
chemical irritants
checmil asphyxiants
51
Upper airway injury symptoms
difficulty breathing
edema
52
Lower respiratory injury symptoms
SOB
productive cough
53
Toxic gas tx
remove from source
100% O2
BVM
ET tube if indicated
54
Simple asphyxiants examples
CO2
Nitrogen
Methane
Natural Gas
55
Simple asphyxiants affect on body
only hypoxemia
56
Simple asphyxiant tx
remove from source
100% O2
CPR
57
Chemical irritant that are highly reactive with water
hydrophilic chemical
58
Hydrophilic reaction
react with moist membrane and cause immediate burning and pain
59
Non-hydrophilic agent reaction
pass deep into lungs causing acute lung injury
60
Chemical irritant tx
Supportive care and irrigation of eyes with water or saline
albuterol
O2
Intubation
61
Most common chemicals asphyxiant
Carbon monoxide
62
H2S smell
rotten egg
63
3 drugs in cyanide antidote kit
1. inhaled amyl nitrite
2. IV sodium nitrite
3. IV sodium thiosulfate
64
Most common overdose method
ingestion
65
Tox exam
mental status
pupil size
skin temp
sweat or lack of
muscle tone
GI motility
66
Toxidrome
collection of signs and sx after an exposure to a substance; aka toxic fingerprint
67
If tox PT has AMS or coma administer
Naloxone .2 to rule out overdose
68
Alcohol withdrawal PT medication
Thiamine
69
GI tox decontamination
OG/NG tube lavage
Activated charcoal 1mg/kg
70
Anticholinergic toxidrome
dry as a none
red as a beet
hot as a hare
blind as bat
mad as a hatter
stuffed as a pipe
71
Anticholinergic most common use for overdose
antihistamines via ingestion, inhalation, or ocular
72
Anticholinergic inhibits what system
PNS
73
Most common EKG finding for anticholinergic
sinus tachycardia
74
Anticholinergic overdose tx
symptomatic
MEDEVAC
75
Dystonic reaction
akathisias
dyskinesia
hypokinesia
Parkinson syndrome
76
SSRI overdose tx
supportive care
d/c SSRI (with taper)
IV access MEDEVAC
77
Serotinin syndrome
fatal adverse drug reaction to SSRI causes neurological /muscular dysfunction
78
SSRI overdose sx
hypothermia
diaphoresis
tachy
bp changes
dilated pupils
confusion
agitation
nystagmus
MUST RULE OUT PYSCH CONDITIONS
79
SSRI overdose hallmark
myoclonus (twitching and jerking)
80
Main inhibitory neurotransmitter in the CNS
GABA
81
Benzo overdose sx
dizziness
slurred speech
ataxia
82
Sedatives and hypnotics effect what system
CNS
83
Sedative and hypnotic overdose tx
ABCs
flumazenil
84
Most frequently ingested intoxicant in the US
Ethanol
85
Opiods affect what systems
PNS/CNS and GI
86
Opiod work as agonist on 3 primary receptors
Mu
Kappa
Delta
87
Mu receptors
analgesia, sedation, respiratory depression
88
Opiod overdose tx
ABC
Naloxone
Activated Charcoal if ingested
89
Cocaine OD sx
mydriasis
tachycardia
hypertension
diaphoresis
hyperthermia
90
Cocaine OD tx
Sedation
EKG
Benzos
91
Contraindicated meds for cocaine use
beta blocker
92
Salicylates/ASA effect
medullary respiratory center
93
Salicylates/ASA emergency care
ABC
Activated Charcoal 1mg/kg
IV fluids
Glucose check
Sodium Bicarb
MEDEVAC
94
Most common cause of overdose/liver failure
Acetaminophen
95
Max acetaminophen in 24h
4g
96
Acetaminophen toxic metabolite
NAPQI
97
APAP stage 1
24 hours N/V malaise, anorexia
98
APAP stage 2
day 2-3, N/V, toxiicty, RUQ Px, jaundice
99
APAP stage 3
day 3-4 hepatic failure, lactic acidosis, coagulopathy, renal failure, encephalopathy
100
APAP stage 4
those who survive will begin to reover
101
APAP OD tx
NAC
102
NAC dose Oral/NG
140 mg/kg loading dose
wait four hours
70mg/kg Q4 x17
103
NAC IV dose
150mg/kg loading
wait four hours
50mg/kg over 4H
100mg/kg over 16H
104
Cholinergic/Insecticide binding type
(ORGANOPHOSPHATES)
irreversible binding to cholinesterase
105
Cholinergic sx SLUDGE
salivation
lacrimation
urinary
incontinence
defecation
GI px
Emesis
106
Cholinergic tx
Atropine 1mg Q5 min
2-PAM
Benzos
107
Cholinergic agent aka
Nerve
108
Heat Edema
mild swelling of feet, ankles, hands within first few days of heat expsure
109
Heat Edema Tx
leg elevation; selve resolving
110
Prickly Heat
pruritic , maculopapular rash in clothed areas
111
Prickly Heat tx
chlorhexidine
light, clean clothing
112
Heat cramps
painful involuntary spasm of skeletal muscle
113
4 electrolytes for muscle movement
calcium
magnesium
potassium
sodium
114
Heat cramp tx
fluid/salt
rest
IV NS
115
Heat Tetany
hyperventilation resulting in alkalosis, paresthesia and carpopedal spasm
116
Heat Tetany hallmarks
no pain; paresthesia of extremities and perioral region
117
Heat Tetany tx
remove from heat and dec respiration rate
118
Heat Syncope sx
postural hypotension
119
Most common non-acclimitized heat injury
Heat Syncope
120
Heat Syncope tx RRR
remove from heat
rehydration
rest
121
Heat Exhaustion criteria
difficulty continuing exercise
101F-104F
None or Mild CNS dysfunction
122
Heat exhaustion sx
tachycardia
hypotension
weakness
dehydration and electrolyte loss
ataxia
pallor
headache
NVD
muscle cramps
123
Heat exhaustion tx
ORS
supine with feet elevated
remove excess clothing
cool patient to 101
rehydrate
124
Heat Exhaustion disposition
LLD 7 days
two weeks activity in a cool environment
if unable to return after 4 weeks: refer
125
Heat Stroke Sx
104F
confusion
seizures
coma
CNS dysfunction
anhidrosis**
126
Heat stroke tx
ABC
O2
IV NS
serial temps
active cooling
127
Core temp associated with AMS
105F
128
Chilblains sx
edema
pruritic
paresthesia
erythema
cyanosis
nodules
129
Pale skin, mottled, anesthetic, pulseless, and immobile that does not change after rewarming
Chilblains
130
Chilblians tx
rewarm, bandage, elevate, corticosteroids
131
Chilblain prevention
warm
good boot fit
change socks
132
First degree frost bite
superficial, pallor and anesthesia of the skin
133
Second degree frost bite
large blisters with clear fluid with surrounding edema and erythema; eschar that sloughs off
134
Third degree frost bite
deeper, smaller blisters with hemorrhagic appearance; black eschar "Feels like block of wood"
135
Fourth degree frost bite
complete tissue necrosis
136
Frostbite tx
warm
remove wet clothing
pad or splint area
avoid walking
137
Hypothermia
core temp below 95
138
Hypothermia stages
mild 90-95F
moderate 82-90F
sever below 82F
139
Cold stressed
symptoms without hypothermia
140
Conduction
transfer of heat to an adjacent object
141
Convection
transfer of heat to currents of air or water
142
Mild Hypothermia sx
tachypnea
tachycardia
hyperventilation to ataxia
joint pain
shivering
143
Moderate Hypothermia sx
CNS depression
drop in heart rate
hypoventilation
loss of shivering
dysrhythmias (A-fib)
144
Severe Hypothermia sx
Pulmonary edema
oliguria
hypotension
bradycardia
ventricular arrhythmias
145
Most important cold injury lab
fingerstick glucose
146
Rewarm hypothermia patients requiring resuscitation to what temperature
90-95F
147
Mild hypothermia tx
passive warming
148
Moderate and mild refractory hypothermia tx
active external warmings
149
Severe hypothermia tx
active external and internal warming
150
HACE occurs above what elevation
2500 meters (8250ft)
151
HACE results from
cerebral vasogenic edema and hypoxia
152
HACE sx
headaches
confusion
truncal ataxia
urinary changes
focal deficits
NV
153
HACE tx
immediate decent at least 610 meters (2k feet)
O2
154
HAPE elevation
3000 meters (9840ft)
155
Leading cause of altitude illness death
HAPE
156
Early HAPE sx
cough
breathlessness at rest and active
157
Late HAPE sx
wheezing
orthopnea
hemoptysis
158
HAPE findings
fever
tachypnea
cyanosis
rales and rhonchi
presents like pneumonia
159
HAPE tx
immediate decent 610meters (2k FT)
O2
160
Shock
cirulatory insufficiency that creates imbalance of oxygen supply to to tissue
161
4 shock categories
hypovlemic
cardiogenic
distributive
obstructive
162
Hypovlemic shock
decreased volume from blood loss or fluid loss
163
Cardiac output formula
stroke volume x HR
164
Hypovlemic shock caused by
VD**
trauma
hemorrhage
GI bleed
DKA
165
Hypovlemic sx
tachycardia
hypotension
oliguria
dec JVP
narrow or weak pulse
166
Hypovolemic shock tx
Fluid replacement
167
Hypovelemic shock medications
Norepinephrine
Epinephrine
168
Cardiogenic shock
pump failure secondary to AMI, arrhythmia, valvular incompetence or stenosis
169
Cardiogenic shock sx
elevated JVP
pulmonary edema
limb edema
MI/arrhythmias
170
Cardiogenic shock tx
fluid replacement in smaller incriments
171
Cardiogenic shock meds
Norepinephrine
Epinephrine
172
Distributive shock
severe peripheral vasodilation; most commonly caused by sepsis
173
Distributive shock examples
sepsi, anaphylaxis, nuergenic
174
Nuerogenic shock
spinal cord injury resulting in los of sympathetic stimulation
175
Sepsis sx
fever, tachycardia, hypoperfusion despite fluid
176
Sepsis tx
ABC
O2
IV
Ertapenem
177
Obstructive shock associated with
poor right ventricle output
178
Obsturctive shock causes
massive PE
tension pnuemo
pericardial tamponade
abdominal compartment syndrome
179
Large animal bite common injuries
blunt and penetrating trauma, including deep arterial damage, nerve damage and internal organ damage
180
Cat bite medication
Augmentin
181
Salt Water bite bacteria
vibrio
182
Crocodile bite bacteria
Aeromonas hydrophila,
183
ASA overdose lab
Serum Levels every 4 hours
184
Diseases transmitted by ticks
(a) Lyme Disease
(b) Rocky Mountain spotted fever (RMSF)
(c) Relapsing fever
(d) Colorado tick fever
(e) Ehrlichiosis
(f) Babesiosis
(g) Tularemia
(h) Southern Tick-Associated Rash Illness (STARI)
185
Brown Recluse bite sx
Causes progressive local necrosis as well as hemolytic
reactions (rare). Bite is usually painless.
186
2 chemicals highly reactive with water
ammonia
hydrochloric acid
187
Most common physical particle
soot
188
Cat bite bacteria
Pasteurella
189
Freshwater antibiotic
Doxy or Bactrim
190
Active cool Heat Stroke to what temperature
102
191
Least concerning body of water for bacteria
River
192
Type of shock with JVD
Obstructive
193
Naloxone Dose
.4 - 2mg
194
Unresponsive with hypotension and no cyanosis; what is most likely diagnosis
Cyanide
195
Animal bite med if allergic to penicillin
clindamycin and fluoroquinolone
196
APAP overdose first step
activated charcoal
197
Do not do what to a stingray injury
surgical debrisment
198
South American injury with convulsions caused by
scorpion
199
Multiple sting BP hallmark
Hypotension
200
Age for poor drowning prognosis
>14 OVER OVER OVER OVER IS POOR POOR POOR
201
Attacked by a moose inury type
blunt trauma
202
Patient with J wave is at what risk during transport
arrhythmia
203
Near drowning patient that cannot maintain PO2 intervention
intubation
204
What important chacteristic appears before 32C
loss of shivering
205
Great pain after stepping on something in water disposition
MEDEVAC
206
Dry mucus membranes, dilated pupils, decreased VA, temp 105, what med was used of over dose
diphenhydramine
207
Fever, chills, SOB what kind of shock
distributive
208
What temp of water is at risk for hypothermia
any temp
209
Abdominal cramps and salivation require what antidote
2PAM and Atropine
