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Emergency Medicine > Wilderness medicine > Flashcards

Wilderness medicine Flashcards

1
Q

What to do when an authority arrives?

A

LISTEN TO THEM

let them do the protocols

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2
Q

Situational awareness

A

need to know your limitations

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3
Q

Care is delayed by

A

situation
distance
environment

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4
Q

wasp, hornet, and honeybee anaphylaxis

A

3 different types of venoms

but they cross react

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5
Q

someone gets a bee sting and then loses consciousness, what do you do? Why was there a delay?

A

15-30 min before you get an anaphylactic event

get epinephrine

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6
Q

anaphyatic reaction, what to administer

A

epinephrine

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7
Q

what happens during anaphyalxis

A

hypotension, bradycardia, decreased respiration

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8
Q

what side is the needle of an epipen?

A

orange side

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9
Q

What is the adult vs child dose?

A

0.15mg for 33-66 pounds

0.3mg for 66+ to 999 pounds

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10
Q

where does the epipen go

A

anterolateral thigh THROW the clothes

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11
Q

If you are allergic to bees, what can you do?

A

Check allergies for specific species of bees

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12
Q

How much more affinity is CO then O2 to hemoglobin?

A

210 times

CANNOT be seen with pulse ox

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13
Q

treatment of CO poisoning

A

hyperbaric oxygen chamber

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14
Q

When do you treat pH of lactic acidosis

A

< 7.15 pH

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15
Q

Heat illness, what you see

A

Heat edema
Heat syncope
Heat cramps
Heat exhaustion
Heat stroke

as you go down, the list, it becomes worse

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16
Q

Heat edema

A

legs swell because there is no core body temperature change

just rest, cooling of skin, and rehydration

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17
Q

Heat syncope

A

BP drops but temperature is ok

hypernatremic even if normal sodium

need fluids IV or oral, can send home after stabilizing

18
Q

Heat cramps

A

muscles are not getting enough O2, caused by hyponatremia

19
Q

If you take less than ____ your body can STILL absorb it

A

6%, meaning that Gatorade allows you to absorb the most carbs without it just sitting in your stomach

sometimes you can cut to 3%

20
Q

Heat exhaustion

A

need to use rectal thermometers for core temperature

104F

BP cannot stay up
hypernatremic (too much water loss) OR hyponatremic (water gain)

21
Q

why is water alone in extreme exhaustion not ok?

A

Can lead to hyponatremia

need electrolytes

22
Q

Heat stroke

A

Body cannot pump blood

liver kidneys, vascular endothelium, and nerves

CV collapse d/t not enough fluid

23
Q

Sepsis

A

Body becomes dysregulated d/t infection
Gram negaitve MC
Body injures itself
Goes into shock
circulatory collapse
Need pressors
SIRS (can quickly begin AB in one hour)

s/s
100.4
tachycardic
RR decreases
WBC can be increased or decreased
Hypotension

24
Q

thyroid storm

A

T4 and T3
Temp elevated
shaking
N/V/D anxious
mortality is 75% if untreate

25
Q

Serotonin syndrome

A

Taking too many sertonin drugs (SSRIs, SNRIs, saint john’s wort, tramadolol)

looks like a heat illness or thyroid storm

temp increases (even up to 106)
agitation
sweating
tremors
dilated pupils
diarrhea
seizures and muscle breakdown

26
Q

tumor lysis syndrome

A

often in tumor patients
ALL
lymphomas

cells in body get destroyed by cancer, or chemo kills the cells and then the waste products cause issues

hyperurcemia, hyperk, hypoPhos, hypocacemia

treated with: hydration, allopurinaol, rasburicase

27
Q

How to tell if someone is clinically heat stroke

A

HA, dizziness, confusion

brusing, petechia, skin is hot flush and dry

28
Q

In heat stroke, what needs to happen

A

EMS
CBC, PT/PTT
CMP
Creatinine kinase
EKG
CXR

rapid cool

29
Q

fastest way to cool down

A

evaporation with fan + ice cold towels

needs to go to 102F

cool brain with caps

30
Q

What IV fluid do you use for heat stroke?

A

IV fluids with NS or LR

aggressive

31
Q

What is trench foot

A

seen in homeless
washing dishes
sleeping under a bridge
can’t walk
warm feet with baths
pain never resolved

NOT freezing

32
Q

Frost bite

A

You amputate in july what is frostbite in january

33
Q

1st, 2nd, and 3rd degree frostbite

A

1st = red
2nd = purple +
4th = necrotic

let third one go as long as it can before cutting it off

34
Q

pain with frostbite

A

happens with rewarming

35
Q

treatment of rewarming for frostbite

A

rewarm continuously

36
Q

what is mild, moderate, severe, and dire hypothermia

A

consious + shivering (only one can you self recover)
decreased cognition and

37
Q

hypothermia treatment outpatient

A

insulate the ground
strip down (you and them) and cuddle in a sleeping bag
ABCs
warm liquids

38
Q

what is the rescue method?

A

lay them down
keep them laying down

39
Q

ER workup for hypothermia

A

CBC
CMP
TSH
Cortisol
PT/PTT
Lactic acid

rewarm, IV fluids, horizontal, airway is needed

40
Q

when can you do one defibrillation

A

core temp less than 30 degrees C (86 F)

only ONE d fib

41
Q
A

Emergency Medicine (14 decks)

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