Environmental Emergencies

Question 1

J-waves/Osborn waves are seen in:

Answer 1

hypothermia

Question 2

characteristic EKG finding of hypothermia

Answer 2

J-waves/Osborn waves

Question 3

In treating hypothermia, at what temperature should you initiate resuscitation meds and defibrillation attempts?

Answer 3

T > 30C

Question 4

What are treatments for high altitude pulmonary edema? (4)

Answer 4

descent acetazolamide dexamethasone nifedipine

Question 5

pressor to use in heat stroke

Answer 5

dobutamine - supports BP and HR while keeping vessels dilated for heat dissipation

Question 6

when should you consider active rewarming measures

Answer 6

cardiovascular instability, T < 32ºC, or inadequate response to passive re-warming methods

Question 7

order of tissues with resistance to electricity

Answer 7

Bone > fat > tendon > skin > muscle > nerve.

Question 8

how do you grade frostbite injuries?

Answer 8

1st degree- numbness and erythema with no tissue loss
2nd - superficial blistering, with clear to milky fluid, surrounded by edema and erythema
3rd - deeper blisters with blood containing fluid (leave blisters alone)
4th - affects muscle and bone.

Question 9

mild vs moderate vs severe hypothermia

(definitions and treatment)

Answer 9

mild 32-35: active external warming
moderate 28-32: +active core (bladder, gastric lavage)
severe < 28: ECMO, pleural lavage

Question 10

treatment of shivering

Answer 10

BDZs