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Flashcards in Environmental Trauma Deck (52)
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1

Hyperthermia is

warming of body temp greater than 38 degrees

2

The body's mechanisms for heat loss are:

radiation
conduction
convection
evaporation
vasodilation

3

Causes of hyperthermia

external heat source
exercise
infection
seizures

4

Risk factors of hyperthermia

long period of warm weather
high humidity
athletes
military
labourers
elderly
infants and children

5

Patho of hyperthermia

excessive heat denatures proteins and stabilises lipids leading to failure of vital energy producing processes and loss of cell membrane function.
redistribution of blood flow and loss of fluids and electrolytes

6

Heat stress or cramps

muscular cramps as a result of water and sodium loss

7

presentation of heat stress

alert
pale, sweaty
tachycardia
weakness
nausea
painful cramps
history of vigorous activity

8

treatment of heat stress

gently stretch muscles, dont massage
move to cooler place
oral fluids (500ml)

9

Heat exhaustion

water and electrolyte loss and peripheral blood pooling

10

presentation of heat exhaustion

anxious, restless, disorientated
headache
thirst/dehydration
nausea and vomiting
pale and sweaty
tachycardia
orthostatic hypotension
tachypnoea
dizziness

11

treatment of heat exhaustion

move to cool place
auto infuse
fluid replacement
passive cooling until temp less than 38

12

Heat stroke

body unable to regulate temp through hypothalamic thermostat

13

presentation of heat stroke

elevated temp greater than 40
hot, flushed, dry
neuro dysfunction - anxious, restless, disorientated, seizures, coma
vomiting and dirrhoea
rapid bounding pulse
tachypnoea/hyperventilation
hypotension

14

Hypothermia

core body temp less than 35 degrees
mild: 32-35
mod: 28-32
severe: less than 28

15

Risk factors for hypothermia

elderly
dementia
neonates
children
sedatives and TCA
trauma
alcohol
immersion

16

Patho of hypothermia

exposure to cold stimulus leads to peripheral vasoconstriction and increase catecholamine release
Overall increase in BMR
Shivering mechanisms designed to increased CBT
Increased HR, BP, RR
Initial increase in temp then continued decrease
Reduced HR, BP, RR and tidal volume
FLuid shift from intravascular space to intersitial space

17

Signs and symptoms of hypothermia

mild: ACS
increased HR and BP
shivering
lethargy
hungry
Mod: ACS/confusion
no shivering
uncoordinated movement
myocardial irritability and potential for arrhythmias
severe: usually unconscious
absent vital signs
hypercapnic
may be cyanosed

18

Paradoxical undressing

pts remove their clothing due to disruption of hypothalamus temp control ability
Due to loss of peripheral vasomotor tone and rush of warm blood back to extremities, creates sense of overheating

19

Terminal Burrowing

Hide and die, pts crawl into a small enclosed space

20

Osborne/J Wave

positive deflection occurring at the junction between QRS segment and T wave

21

Passive External rewarming techniques

pts own body heat
dry clothing
warm, dry, wind free environment

22

Active external rewarming techniques

apply warm devices such as warm forced air blankets
hot bath immersion
heat packs/water bottles

23

Active core rewarming techniques

warmed IV fluids
irrigation of body cavities with warmed fluids
warmed humidified inhaled air
extracorporeal rewarming

24

Frostbite

when an isolated part of the body is exposed to intense cold for prolonged period of time

25

presentation of frostbite

cold
grey
mottled
inflammed
waxlike
hardening

26

Frost nip

usually only ear, nose etc
unaware until skin appears white

27

Superficial frostbite

cold and numbness, followed by extreme pain during warming
Oedema after rewarming which them becomes blistered and hard scar

28

Depp frostbite

medical emergency
solid to touch, but oedema slow to develop
do NOT rewarm

29

Altitude

the body can adapt to hypoxic environment:
hyperventilate
increased production of RBC
increased capacity of lungs to diffuse
increase vascularity of tissues

30

Acute mountain syndrome

6-24 hours after arrival