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Inside Tender Flashcards

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1
Q

Symptoms of Shock

A
  1. Irregular Breathing
  2. Vacant Eyes
  3. Dilated Pupils
  4. Clammy Skin
  5. Weak Pulse
  6. Low Blood Pressure
  7. Confusion
  8. Sweating
  9. Thirst
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2
Q

Treatment of Shock

A
  1. Maintain Breathing
  2. Control Bleeding
  3. Administer Oxygen
  4. Elevate lower extremities
  5. Avoid rough handling
  6. Keep Warm
  7. Lie Down
  8. Give nothing by mouth
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3
Q

What is the Strength Scale?

A

0) Paralysis - no movement

1) Profound Weakness - flicker and traces

2) Severe Weakness - able to move, but not overcome gravity

3) Moderate Weakness - able to over come gravity, but not examiner

4) Mild Weakness - able to resist slight force of examiner

5) Normal - equal strength bilaterally

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4
Q

Explain the Recovery Position?

A

Fetal position on the left side

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5
Q

3 types of bleeding control?

A
  1. Direct Pressure
  2. Pressure Points (13 of them)
  3. Tourniquet
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6
Q

What is the IV flow rate?

A

75 to 100 cc/hr

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7
Q

What are the 5 steps of a Neuro?

A

M ental Status
C oordination
M otor
C ranial Nerves
S ensory
D eep Tendon Reflexes

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8
Q

Urinary Output requirements?

A

0.5 cc/kg/hr

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9
Q

Pain descriptions?

A

Dull
Sharp
Throbbing

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10
Q

What are the 2 medkits and their locations and purpose?

A

Primary MedKit
Location: Inside Chamber
Purpose: Diagnostic

Secondary MedKit
Location: Outside of Chamber on the side
Purpose: Therapeutic

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11
Q

What are the 5 vitals?

A
  1. Breathing
  2. Pulse Ox
  3. Blood Pressure
  4. Temp
  5. Heart Rate
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12
Q

What are the two types of hypothermia and their treatments?

A

Regular Hypothermia
Tx: Active Rewarming

Severe Hypothermia
Tx: Passive Rewarming

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13
Q

What is the difference between severe and regular CO Poisoning?

A

If its noticeable its severe

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14
Q

What do you do for a patient having a seizure during a treatment table?

A
  1. Off O2
  2. Notify Topside
  3. Protect patient from hurting himself
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15
Q

what kind of IV’s can you use?

What should you avoid?

A

USE:

Lactated ringers
Normal saline
Avoid:
-Dextrose if brain or spinal cord injury is present

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16
Q

What is a barotrauma?

A

damage to body tissues caused by a difference in pressure between

a gas space inside, or in contact with the body, and the surrounding gas or fluid.

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17
Q

What are the symptoms of type 1 DCS

A

P-Pain
M-Marbling
S- Swelling of the lymph nodes

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18
Q

When could an individual start to feel the symptoms pulmonary oxygen toxicity?

A

Whenever the oxygen partial pressure exceeds 0.5 ata.
A 12 hour exposure to a partial pressure of 1 ata will produce mild symptoms and measurable decreases in lung function.
The same effect will occur with a 4 hour exposure at a partial pressure of 2 ata.

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19
Q

How do you treat a Tension Pneumothorax?

A

Insert mid-clavical line between 2nd and 3rd intercostal space on affected side.
14 gage, 3.25 in long

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20
Q

Vital sign ranges for BP, Breaths per min, Pulse oximetry, Temp, heart rate

A

BP-120/80 normal
Breaths- 12-20
Pulse Ox- 96-100
Temp- 98.6
Heart rate- 60-80 bpm

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21
Q

What is systolic and diastolic blood pressure?

A

Systolic: pressure created in the arteries when the heart pumps blood into circulation

Diastolic: pressure remaining in the arteries when the heart is relaxed
Systolic pressure is always reported first and then the diastolic

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22
Q

Symptoms of mediastinal emphysema

A

Substernal chest pain
tightness or dull ache in chest
pain radiating to shoulder or upper back
pain swallowing
coughing

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23
Q

When giving artificial ventilation, what should the rate of ventilation be?

A

10 to 12 breaths per minute or one every 5 seconds

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24
Q

What do you do for a near drowning?

A

ABCs

100% O2

Recovery position on left side because right lung with three lobes is relieved of pressure / in case of vomit

Keep warm

Monitor for need of CPR

Get to hospital

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25
Mediastinal Emphysema
occurs when gas is forced into the loose mediastinal tissues middle of the chest surrounding the heart trachea major blood vessels
26
At what ppO2 do individuals become hypoxic to the point of helplessness? Unconsciousness?
0.11 (helplessness) - 0.10 (Unconsciousness)
27
What are techniques of artificial ventilation?
Mouth to mouth Mouth to nose Mouth to stoma (windpipe) Mouth to mask
28
Hyperthermia Treatment
-reduce core temperature mild to moderate: remove clothing spray with a mist/ fan pack neck, pits, groin, with ice Severe: transport to medical give IV during transport
29
Symptoms of Pneumothorax
sudden sharp chest pain shortness of breath weak pulse increase heart rate labored breathing
30
What will not be read by an AED and requires ACLS?
1. Asystole (ay-sis-toll-lee) - when your heart's electrical system fails entirely, which causes your heart to stop pumping 2. Pulseless Electrical Activity (PEA) - heart stops because the electrical activity in your heart is too weak to make your heart beat
31
Chamber temperatures over 104 95-104 85-94 under 85
over 104- no treatments 95-104- 5,9 for 2 hours 85-94- 5, 6, 6a, 1a, 9 for 6 hours under 84- all treatments
32
Pulmonary O2 poisoning when PP exceeds what ATA?
0.5 ATA
33
How to install OPA/NPA?
1. Measure from tip of nose to tip of ear lobe 2. Lube NPA with water soliable lube 3. Insert NPA right nostril with bevel towards the septum *if you have to insert left nostril face the bevel towards the septum and half way through rotate 180 to resume alignment.
34
CNS O2 toxictiy when PP exceeds what ATA for wet and dry?
Wet- 1.3 ATA Dry- 2.4 ATA
35
Pulmonary Overinflation Syndromes (POIS)
Leaking of gas into the pulmo­nary interstitial tissue
36
When can you stop CPR?
1. Signs of life 2. Pronounced dead by a doctor 3. Qualified person relieves you/ higher care 4. AED shock
37
What are four means of keeping air way open?
1. OPA oropharyngeal airway #4 and #5 2. NPA nasal airways #32f and #34f 3. Cricothyrotomy kit 4. Alternative Emergency airway device *Dive manual 17-8/17-9 table
38
Symptoms of subcutaneous emphysema?
1. Fullness in throat 2. Change in voice 3. Rice Krispies (crepitus) 4. Difficulty swallowing
39
Partial pressure of oxygen below what causes the onset of hypoxia?
0.16
40
Tourniquet/ hemorrhage control
1. Direct pressure and pressure points first 2. Use tourniquet as a last resort 3. Put on high and tight mark T on head and the time you put it on 4. Do not take off or loosen 5.Seek higher medical care and notify that you put on a tourniquet
41
What are the shockable rhythms an AED will read?
Ventricular Fibrillation (type of irregular pulse) Pulsesless Ventricular Tachycardia (very rapid but ineffective contractions) *both are types of arrhythmia (irregular heartbeat)
42
Subcutaneous Emphysema
A when that gas subsequently migrates into the subcutaneous tissues of the neck
43
What is the first step in pulmonary over-inflation?
Interstitial Emphysema: -rupture of the alveolus with a collection of air in the lung tissues
44
CPR compression rate?
100 per min 30/2 as a rule of thumb
45
What are the three bones in the ear?
Malleus (hammer) Incus (anvil) Stapes (stirrup)
46
AGE
gas enters the arterial circulation, dispensing to all organs. CNS and heart are especially susceptible
47
Would a simple eye twitch be considered a neurological disorder?
No, because simple eye twitch is common with large amounts or people sensitive to caffeine, fatigue, and stress.
48
What is the medical procedure of suction?
clearing obstructions of breathing such as vomit or blood through a suction device.
49
Symptoms of AGE/ type 2 DCS
u- unconsciousness w-weakness p-paralysis n-numbness e-ears ringing roaring b- blurred vision d- dizziness f- fatigue p- pins and needles
50
What is the flow rate for a Bag Valve Mask (BVM)?
15 liters per min - bag is about 1 liter
51
Symptoms of CNS 02 toxicity
V- visual symptoms E- ears ringing and roaring N- nausea / vomiting T- TWITCHING I- Irritability D- Dizziness C- Convulsion
52
Symptoms of Pulmonary 02 Toxicity
C- Cough/ Severe B- Breathing pain while inhaling S- Substernal chest pain/ burning
53
Needle Thoracentisis
14 gauge by 3.25 inch cathiter Insert mid clavicle line between 2nd and 3rd intercostal space of affected side. Always insert over the rib
54
Pneumothorax
Air trapped in the pleural space between the lung and the chest wall
55
What is the POIS tree?
56
Anatomy of the ear? Draw
57
How much and what should a patient drink during a treatment table?
1-2 liters of water, juice, or non-carbonated over the course of a treatment
58
What are the tender oxygen breathing requirements?
All stops at 30FSW and breathing on ascent from 30FSW TT5 Without extensions :00 (* :20) With extensions :00 (* :20) TT6 Without extensions :30 (* :90) With extensions :60 (* :120) TT6A Without extensions :60 (* :120) With extensions :90 (* :150) *if tender has previous hyperbaric exposure within 18hrs
59
What are the 6 tests for coordination?
1. Walk 2. Heel-to Toe 3. Romberg 4. Finger-to-Nose 5. Heel Shin Slide 6. Rapid Movement
60
What are the 4 Deep Tendon Reflexes?
1. Bicep 2. Tricep 3. Knee 4. Ankle (Achilles)
61
What are the questions to remember for mental status?
Red Ball Green Tree Couch Spell "world" backwards Count backwards from 100 by 7 (93,86,79,72)
62
What is the I cranial nerve and function?
OLFACTORY - smell
63
What is the II cranial nerve?
OPTIC - vision
64
What is the III cranial nerve?
OCULOMOTOR - controls eye movements along with TROCHLEAR (IV) and ABDUCENS (VI)
65
What is the IV cranial nerve?
TROCHLEAR - Eye movements along with the OCULOMOTOR (III) and ABDUCENS (VI)
66
What is the V cranial nerve?
TRIGEMINAL - sensation of the forehead, face and clenching of jaw
67
What is the VI cranial nerve?
ABDUCENS - eye movements along with OCULOMOTOR (III) and TROCHLEAR (IV)
68
What is the VII cranial nerve?
FACIAL - controls face muscles
69
What is the VIII cranial nerve?
ACOUSTIC - hearing and balance
70
What is the IX cranial nerve?
GLOSSOPHARYNGEAL - sensation from upper mouth and throat area
71
What is the X cranial nerve?
VAGUS - control of roof of mouth and vocal cords
72
What is the XI cranial nerve?
SPINAL ACCESSORY - turning head side to side and shoulder shrug with resistance
73
What is the XII cranial nerve?
HYPOGLOSSAL - controls the tongue
74
What are the 6 factors known to affect the Risk of CNS O2 Toxicity?
1. Individual Susceptibility (increases or decreases risk) 2. CO2 Retention (hypercapnia increases rick by increasing brain blood flow affecting brain O2 levels) 3. Exercise (increases risk) 4. Immersion in Water (unknown why, but increases risk) 5. Depth (increases risk) 6. Intermediate Exposure (decreases risk)
75
Do you press a pulseless diver?
A pulseless diver should not be compressed unless there is no possibility of evacuation. Unless ABCs are restored, the diver will likely die.
76
Is the AED allowed to be used in the chamber?
No
77
4 types of thermometers for the chamber?
A lcohol B i-metallic L iquid Crystal E electric
78
What are the types of IV fluid?
1. Isotonic (same or very similar solution of solute) Ex: normal saline or lactated ringers 2. Hypotonic (lower concentration of solute) Ex: distilled water 3. Hypertonic (higher concentration of solute) Ex: high sodium drinks
79
What does ACLS stand for?
Advanced Cardiac Life Support
80
What is the flow rate for surface o2?
15 liters / min
81
When is the only time the patient should be kept awake during treatment?
During O2 periods at depths greater than 30 FSW
82
When can food be eaten in the chamber?
Anytime
83
What do you ask for history before a neuro?
S igns/Symptoms A llergies M edication P revious Symptoms L ast time victim ate/drank E vents preceding problem
84
What is the blood flow through the heart?
Body>right atrium>right ventricle>lungs>left atrium>left ventricle>body
85
Whatis the blood flow through the body?
heart>aorta>arteries>arterioles>capillaries>venoules>veins>superior/inferior vena cava>heart
86
What is the acronym for hypoxia?
WILLDEALL
87
What are the respiration phases?
1. ventilation of lungs 2. exchange of gases between blood and air 3. transport of gases by blood 4. exchange of gases between blood and tissue fluid 5. exchange of gases between tissue fluids and cells 6. use and production of gases by cells *air in lungs>gas to blood>gas to tissue fluid>tissue to cell>cell to body
88
What is the acronym for hypercapnia?
ICHILD
89
What is the acronym for CO poisoning?
Tiny Headhunters Practice Ninja Chicken Voodoo
90
What are the symptoms of near drowning?
Unconcious Pulmonary Edema Increased RR
91
Most common barotrauma?
Middle Ear Squeeze
92
Primary symptoms of IEB?
Hearing loss and PERSISTENT vertigo
93
What is the acronym for AGE/ Severe DCS?
Underwater People Need Extremely Big Drinks To Party
94
What is the treatment of a pneumothorax?
BOTH: 100% O2 Neuro to rule out AGE Simple: trapped air will naturally reabsorb Tension: Chest tube or large bore catheter
95
Treatment for Mediastinal/Subcutaneous Emphysema?
100% O2 Neuro to rule out AGE and pneumothorax Shallow water Decompression by UMO only
96
What is the treatmet for O2 absorption syndrome (Draeger Ear)?
Valsalva
97
What is ABC?
Air Breathing Circulation
98
When is a neurological exam required?
When diving related issues are suspect
99
What are you checking on a IV bag?
1. No discoloraton 2. Nothing floating 3. Time administered 4. Bag #
100
What is needle thoracentesis?
Needle D
101
What is required to start an IV?
1. Needle 2. IV Solution 3. Tourniquet 4. Transfer tube 5. Guaze 6. Cleaning swap
102
When is an IV required?
if the patient isn't peeing .5cc/kg/hr or can not pee or ingest (unconscious)
103
When MUST you breath air in the chamber?
Deeper than 45 FSW, 1 person must breath air
104
What is the off O2 effect?
1-2 min after O2 you can still susceptible to a O2 hit
105
What is the first and primary duty of an IT?
DO NO HARM
106
What info must be put on the IV after being administered?
Date/Time, Person Administering, Bag#
107
What is the treatment of CO poisoning?
100% O2 transport to chamber or a medical facility SEVERE (change in mental state, neurological symptoms, severe headache) use TT6
108
How to treat Cardiac Arrest in the chamber?
1. CPR 2. Bring the diver to the surface 3. ACLS 4. Press someone for qualified with patient
109
What is a Myringotomy?
a procedure to create a hole in the ear drum to allow fluid that is trapped in the middle ear to drain out UMO's job
110
O2 and CO2 limits in chamber?
O2 19-25% CO2 1.5 SEV
111
3 tests that cant be done in the chamber?
1. Rhomberg 2. Walk Normal 3. Heel-Toe-Walk

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