MilMed-Cold Injury Flashcards Preview

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Flashcards in MilMed-Cold Injury Deck (24)
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1
Q

What ways do we lose heat?

A

Radiation, evaporation, conduction and convection

2
Q

What ways do we make heat?

A

Activity, shivering, vasoconstriction and insulation

3
Q

What puts you at risk for hypothermia?

A

Immersion, exhaustion, inadequate nutrition, alcohol and poor judgement

4
Q

A patient comes to see you with shivering, numb hands, confusion and frustration. Their temperature is 34C. What category of hypothermia is he?

A

Mild

5
Q

A patient comes to see you with violent shivering and is irrational. Temperature is 28-34C (83-93F). What category of hypothermia is he?

A

Moderate

6
Q

A patient comes to see you with slowed heart rate, is unconscious and a temperature below 28C (83). What category of hypothermia is he?

A

Severe

7
Q

How much brain function do you lose for every 1C drop in temperature below 35C?

A

10.00%

8
Q

What are the most common cardiac symptoms when someone has a temperature below 32C?

A

Atrial and ventricular arrhythmias

9
Q

Why do respirations fall in people with hypothermia?

A

CO2 production falls and they don’t need as much oxygen.

10
Q

Why do people recovering from hypothermia often become hypovolemic?

A

Movement of fluid centrally from peripheral vasoconstriction causes diuresis. When they recover they need fluids to keep their blood pressure up as they vasodilate.

11
Q

Why don’t you test coagulation factors in someone who is hypothermic?

A

The machine heats them up, so it’s worthless.

12
Q

What is your 1st choice for hypothermia above 30C?

A

Passive rewarming if they are stable vitals and have stable cardiac rhythm

13
Q

What is the most dangerous thing you can do for someone with hypothermia?

A

Climb in a sleeping bag. This can cause after drop (hypovolemia) as they vasodilate)

14
Q

What are some of the good hospital solutions for mild to moderate hypothermia?

A

Active INTERNAL rewarming via humidified air (40-45C), heated IV, extracorporeal bypass etc

15
Q

How long should you wait before going into BLS on a patient with hypothermia?

A

1 minute

16
Q

Why are you at higher risk for frostbite at higher altitude?

A

You have less oxygen getting to the tissue so it will become ischemic faster.

17
Q

What are the different degrees of frostbite?

A

1= hyperemia and edema 2 = large clear bullae 3= hemorrhagic bullae 4 = necrosis with gangrene

18
Q

How does frostbite actually occur?

A

ECF freezes, water is drawn out of the cells,intracellular hyper-osmolarity, intracellular ice crystals form and cell membranes don’t rupture. The indirect effects come from ischemia, thrombus formation and ischemai

19
Q

When would you consider amputation of a frostbit finger?

A

60-90 days to allow healing to occur.

20
Q

What drugs have been shown to decrease amputation?

A

TPA and Heparin. They increase blood flow and decrease thrombus formation.

21
Q

What are the different phases of this condition?

A

This is trench foot. There is a hours to days pre-hyperemic phase (cold, swollen, numb, weak pulses), a 2-6 week hyperemic phase (warm, red, swollen with bounding pulses), and post-hyperemic phase (most, smelly, gangrenous necrosis)

22
Q

What is the biggest risk for trench foot?

A

Having your feet wet all the time

23
Q

What is the medical term for Hailey and Maggie’s noses getting red and rosy when they go out in the cold?

A

Chilblains (pernio). It is caused by hypervasoconstriction from cold.

24
Q

What drug makes frostbite, chilblains and trench foot worse?

A

Tobacco. It is a vasoconstrictor.