Environmental Emergencies & Drowning Response
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Questions and Answers

What is a primary treatment for heat stroke?

  • Elevate the legs
  • Administer pain medication
  • Cold water immersion or ice packs (correct)
  • Warm fluids and blankets
  • What could tea-colored urine indicate in a patient with heat-related issues?

  • Urinary tract infection
  • Liver failure
  • Kidney stones
  • Rhabdomyolysis and dehydration (correct)
  • What is an appropriate method of active warming for a patient with hypothermia?

  • Cold compresses
  • Application of warm towels
  • Warm fluids and bear huggers (correct)
  • Immediate exercise
  • Why is it preferable to drown in cold water?

    <p>It preserves oxygen in the body longer (A)</p> Signup and view all the answers

    What should be removed from a patient who has been stung to prevent swelling?

    <p>Jewelry (D)</p> Signup and view all the answers

    Which situation requires immediate action before administering charcoal for poisoning?

    <p>The patient had a bowel obstruction (B)</p> Signup and view all the answers

    What should be done for a drowning victim upon rescue?

    <p>Administer oxygen and stabilize the airway (B)</p> Signup and view all the answers

    In cases of opioid overdose, which symptom is NOT typically observed?

    <p>Increased heart rate (D)</p> Signup and view all the answers

    What is a significant risk associated with cat bites?

    <p>Sharp teeth can cause deep puncture wounds and infection (C)</p> Signup and view all the answers

    What parental injury can lead to permanent damage if not addressed within 24 hours?

    <p>Spinal cord injury (A)</p> Signup and view all the answers

    When treating a puncture wound that is 6 to 12 hours old, what is critical?

    <p>Administration of antibiotics (C)</p> Signup and view all the answers

    What is the typical source of rabies in bite cases?

    <p>Wild animals with unknown vaccine status (C)</p> Signup and view all the answers

    What is a common cause of spinal cord injuries?

    <p>Automobile accidents (B)</p> Signup and view all the answers

    What reflex loss characterizes spinal shock?

    <p>Deep tendon reflex (A)</p> Signup and view all the answers

    Which medication is recommended for opioid overdose management?

    <p>NARCAN (A)</p> Signup and view all the answers

    What precaution should be taken when dealing with a narcotics overdose case?

    <p>Monitor airway, breathing, and circulation (C)</p> Signup and view all the answers

    What is the highest priority action during the primary survey when faced with uncontrolled circulation?

    <p>Stop the bleeding first (B)</p> Signup and view all the answers

    Which of the following denotes the most severe Emergency Severity Index (ESI) level?

    <p>Level 1 (C)</p> Signup and view all the answers

    What is a critical lab value indicating severe sepsis when the lactate level is greater than which value?

    <p>4 mmol/L (A)</p> Signup and view all the answers

    Which of the following conditions would most likely lead to renal failure in a patient with sepsis?

    <p>No blood flow to the kidneys (B)</p> Signup and view all the answers

    What is an essential action to prevent neutropenia patients from developing infections?

    <p>Practice frequent hand hygiene (A)</p> Signup and view all the answers

    What should be monitored closely in patients experiencing thrombocytopenia?

    <p>Signs of bleeding (B)</p> Signup and view all the answers

    Which of the following is a potential consequence of hypercalcemia in cancer patients?

    <p>Dehydration and renal failure (D)</p> Signup and view all the answers

    Which law requires stabilization of a trauma victim before transferring to another facility?

    <p>No dumping law (A)</p> Signup and view all the answers

    What symptom is commonly associated with neurogenic shock resulting from T6 and above injuries?

    <p>Decreased cardiac output (A)</p> Signup and view all the answers

    Which spinal cord injury level requires respiratory support to keep the diaphragm functional?

    <p>C3, C4, C5 (C)</p> Signup and view all the answers

    What is a critical sign of autonomic dysreflexia in patients with T6 injuries or above?

    <p>Severe headache (D)</p> Signup and view all the answers

    What emergency intervention is indicated for a tension pneumothorax?

    <p>Needle decompression (A)</p> Signup and view all the answers

    Which of the following describes flail chest?

    <p>Multiple broken ribs leading to paradoxical movement (D)</p> Signup and view all the answers

    Which of the following should NOT be done in case of an abdominal injury with an impaled object?

    <p>Remove the impaled object (D)</p> Signup and view all the answers

    What is a potential complication from long bone fractures?

    <p>Compartment syndrome (A)</p> Signup and view all the answers

    What is an effective strategy recommended for managing symptoms associated with traumatic brain injury (TBI)?

    <p>Maintain a regular sleep routine (B)</p> Signup and view all the answers

    What serious condition can occur due to tumor lysis syndrome within 24 to 48 hours after chemotherapy treatment?

    <p>Metabolic acidosis (C)</p> Signup and view all the answers

    Which of the following is an important precaution to take before administering chemotherapy?

    <p>Check all blood levels (B)</p> Signup and view all the answers

    What symptom is associated with SIADH that indicates a potential critical condition?

    <p>Mental status changes (B)</p> Signup and view all the answers

    In case of spinal cord compression, which symptom is indicative of the condition?

    <p>Pain relief when sitting up (C)</p> Signup and view all the answers

    What action should be taken immediately if there are burns in the mouth and throat?

    <p>Intubate the patient without delay (D)</p> Signup and view all the answers

    Flashcards

    Heat Stroke vs. Heat Exhaustion

    Heat stroke is a severe condition where the body loses its ability to regulate temperature, resulting in a dangerously high core body temperature. Heat exhaustion is a less severe condition, and the body can still sweat.

    Treating Heat Stroke

    Lower core body temperature using cold water immersion or ice packs. Administer cold fluids, monitor temperature closely, and look for irregular heartbeats. Maintain airway and breathing.

    Hypothermia Symptoms

    Hypothermia is when body temperature drops below normal, causing blood to thicken, increasing risk of clots, heart attack, and pulmonary emboli.

    Hypothermia Treatment

    Remove cold clothes, use warm blankets, and employ active warming methods (warm fluids, bear huggers) or passive warming (blankets, warming rooms) to slowly raise body temperature.

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    Drowning in cold water

    Drowning in cold water slows down bodily functions, increasing the chance of survival.

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    Drowning injuries

    Drowning can cause pulmonary edema (fluid in the lungs) and ARDS (Acute Respiratory Distress Syndrome) due to decreased surfactant and damaged alveoli-capillary membranes.

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    Cat Bites vs. Dog Bites

    Cat bites often involve deep puncture wounds and increased risk of infection, while dog bites can affect larger areas due to the mouth's size.

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    Bite Wound Antibiotics

    Puncture wounds, especially those near joints or on extremities, often warrant prophylactic antibiotics (antibiotics to prevent infection).

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    ESI Level 1

    The most critical and unstable patient with a life-threatening condition requiring immediate attention. This patient needs immediate treatment and resources, usually requiring resuscitation.

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    Primary Survey

    A rapid assessment of a trauma patient's vital functions: Airway, Breathing, Circulation, Disability, Exposure. It helps quickly identify life-threatening conditions.

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    Secondary Survey

    A more thorough assessment of a trauma patient after addressing immediate life threats. It involves complete head-to-toe examination, vital signs, and investigations like lab tests, imaging, and monitoring.

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    Sepsis

    A serious condition where the body's immune system overreacts to an infection, causing widespread inflammation and organ dysfunction.

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    Severe Sepsis

    A worsening form of sepsis with signs of organ dysfunction and a high lactate level. This stage requires urgent medical intervention.

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    Neutropenia

    A condition with low white blood cell count, particularly neutrophils, making the body more susceptible to infections.

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    Thrombocytopenia

    A condition characterized by low platelet count, leading to increased bleeding risk. Cautious handling and prophylactic measures are critical.

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    Hypercalcemia

    High calcium levels in the blood, often seen in cancer patients, especially those with bone cancer. Treatment focuses on excretion and management.

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    Treating Stings

    To manage a sting, first assess the severity. Remove any stinger using a flat object or blade. Check if the person has been stung multiple times, and if they have any allergies. If allergic, administer epinephrine, an antihistamine, and steroids. Remove restrictive items like rings and watches to prevent swelling and potential complications.

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    Tumor Lysis Syndrome

    A serious complication of chemotherapy where dying cancer cells release their contents into the bloodstream, leading to high levels of potassium, phosphate, and uric acid, and low calcium. This can cause kidney damage and metabolic acidosis.

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    What are some signs of Tumor Lysis Syndrome?

    Symptoms of tumor lysis syndrome include hyperkalemia (high potassium), hyperphosphatemia (high phosphate), hypocalcemia (low calcium), and metabolic acidosis. It typically occurs 24-48 hours after chemotherapy.

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    Treating Poisoning

    In case of poisoning, prioritize ABCs (airway, breathing, circulation) before decontamination. Brush off powder before showering the victim to avoid unwanted reactions. Call poison control for specific instructions and follow their guidance. Consider administering activated charcoal if appropriate.

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    SIADH

    Syndrome of Inappropriate Antidiuretic Hormone Secretion. This condition occurs when the body releases too much antidiuretic hormone (ADH), causing the kidneys to retain water and dilute the blood.

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    Opioid Overdose Symptoms

    Opioid overdose is characterized by pinpoint pupils, loss of consciousness (LOC), respiratory depression, seizure activity, and hypoxia.

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    Superior Vena Cava Syndrome

    A life-threatening condition where a tumor or blood clot blocks the superior vena cava, the major vein that carries blood from the head and arms back to the heart.

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    Opioid Overdose Treatment

    Treat opioid overdose with NARCAN, which is an opioid antagonist, and carefully monitor ABCs.

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    Spinal Cord Injuries: Primary vs. Secondary

    Spinal cord injuries involve both primary and secondary damage. Primary injuries are the visible ones, like head lacerations. Secondary injuries are more concerning because they are internal and may lead to long-term complications.

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    What's the most important thing to remember about spinal cord compression?

    Spinal cord compression is a neurologic emergency that occurs when a tumor presses on the spinal cord. It causes pain, numbness, and weakness in the affected area. The pain is worse when lying down and improves when sitting up.

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    Spinal Cord Injuries: Secondary Damage

    Secondary injuries involve edema, ischemia, and inflammation. Edema compresses the spinal cord and cuts off blood flow. The phrenic nerve can be affected, compromising breathing.

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    Spinal Cord Injuries: Spinal Shock

    Spinal shock is characterized by loss of deep tendon reflexes, sphincter reflexes, sensation, and paralysis below the level of the injury. It occurs immediately after the injury but the true extent of damage won't be known until swelling subsides.

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    Spinal Cord Injuries: Delayed Diagnosis

    The severity of spinal cord injuries cannot be fully assessed until the swelling subsides, which can take days or weeks.

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    Neurogenic Shock

    A life-threatening condition caused by spinal cord injury at T6 or above, leading to dysfunction of the sympathetic nervous system. Symptoms include decreased cardiac output, venous pooling, low blood pressure, temperature dysregulation, and skin changes.

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    Respiratory Issues with Spinal Cord Injury

    Injuries at C3-C5 can affect the diaphragm, crucial for breathing. Injuries at T6 and above may lead to bradycardia and vulnerability to vagal nerve stimulation.

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    Autonomic Dysreflexia (AD)

    A potentially life-threatening condition occurring in patients with spinal cord injuries at or above T6. It involves severe hypertension, headache, nausea, and excessive vasoconstriction.

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    Tension Pneumothorax

    A serious condition where air accumulates in the space between the lung and the chest wall, putting pressure on the heart and lungs. It is a medical emergency requiring immediate decompression.

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    Flail Chest

    A chest injury involving multiple broken ribs, allowing the chest wall to move paradoxically. This affects breathing and can be life-threatening.

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    Long Bone Fractures

    Long bone fractures can cause significant blood loss and risk of infection. Crush injuries can lead to compartment syndrome and rhabdomyolysis, potentially causing kidney damage.

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    Traumatic Brain Injury (TBI)

    A brain injury caused by trauma, often with long-term neurological consequences.

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    PTSD and TBI

    Traumatic brain injury may increase the risk of developing post-traumatic stress disorder (PTSD), a condition affecting mental and emotional wellbeing following a traumatic event.

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    Study Notes

    Environmental Emergencies

    • Heat Stroke vs. Heat Exhaustion: Heat stroke is worse; the body cannot sweat.
    • Heat Stroke Treatment: Lower core body temperature, preferably with cold water immersion. Provide ice packs and monitor for dysrhythmias. Administer fluids. Monitor O2.
    • Hypothermia: Thickens the blood, increasing risk of clots, heart attacks (PE). Treat with removal of cold clothes, warm blankets, active and passive warming techniques. Warm fluids. Monitor body temp and urine output (look for tea-colored urine reflecting dehydration).

    Cold Water/Warm Water Drowning

    • Treatment Strategy: Cold water slows down processes, so cold water drowning allows for recovery possibilities.
    • Injuries: Think pulmonary edema (ARDS, decreased surfactant, and alveoli cap membrane).
    • Treatment: Monitor airway, breathing, circulation (ABCs). Administer oxygen and control for injuries. Warm the victim if in cold water. Use proper equipment like a collar.

    Bites

    • Cat Bites: Risk of infection; prophylactic antibiotics are typically given. Puncture wounds need antibiotics.
    • Dog Bites: Greater risk of infection, particularly in larger bite areas due to mouths. Antibiotics may be needed for puncture wounds over joints, hands, or feet within 6-12 hours of injury.

    Stings

    • Removal: Remove with a blade or flat object.
    • Reaction: Note if allergic; provide antihistamine, steroids, and possibly epinephrine. Keep restrictive items off (rings, watches, etc.) to prevent swelling.

    Poisoning

    • Decontamination: Brush off suspected poison before a bath. Treat if interacting with water.
    • Ingesting Poison: Contact poison control immediately. Follow their instructions for decontamination procedures in cases of ingesting poisons. Charcoal binds to toxins for removal. Use caution to not give charcoal in cases of possible bowel obstructions. Assess for other symptoms.

    Opioid Overdose

    • Symptoms: Pinpoint pupils, Loss of Consciousness (LOC), respiratory depression, seizures, hypoxemia.
    • Treatment: Administer NARCAN and monitor ABCs.

    Spinal Cord Injuries

    • Types: More common in males, especially in automobile accidents or from more commonly occurring, more obvious traumas/injuries. Head lacerations are common, but more concerning are internal injuries.
    • Secondary Injuries: Are less obvious but more concerning. Edema, ischemia, inflammation, and secondary injury to the spinal cord can result from edema.

    Neurogenic Shock

    • Symptoms: Symptoms include trouble regulating temperature, flushed warm skin near the injury, but can become cold and clammy. Blood pressure below 90 systolic, and various other issues associated with severe spinal cord injury, such as cardiac output issues and venous pooling.
    • Treatment: Proper temperature regulation, and treatment of respiratory and cardiac events are crucial.

    Trauma

    • Tension Pneumothorax: Shift in mediastinum (trachea); can affect respiratory function and cardiac output.
    • Needle decompression: Important for rapid correction of issues when the mediastinum is affected.
    • Flail chest: Multiple ribs broken in a way which may cause paradoxial movement causing breathing issues.

    Abdominal Injuries

    • Treatment: Do not remove impaled objects, as it could intensify the bleeding or damage to the surrounding organs).

    TBI

    • Traumatic Brain Injury (TBI): Can have long-term effects.
    • Post-Traumatic Stress Disorder (PTSD): A common secondary condition that may occur.

    Burns

    • Parkland Formula: Used as a guideline for fluid treatment in cases of burns.
    • Intubation: Do intubate the patient if mouth and airway are affected as quickly as possible. Swelling in the esophagus is particularly problematic in burn patients.

    Sepsis

    • Stages: SIRS, sepsis, severe sepsis, septic shock are increasing degrees of severity.
    • Clinical Presentation: Focus on lactate levels. Levels greater than 4 indicate severe cases. Watch for tachycardia, and other symptoms related to increasing degrees of severity.

    Oncology Emergencies

    • Neutropenia: Low white blood count; risk of infection; monitor infections closely.
    • Infections: Important to monitor for infection in case of impaired immunity.
    • Antibiotic Therapy: Carefully watch temperatures, and antibiotic administration and effectiveness.

    SIADH

    • Symptoms: Water retention; mental status changes; low sodium (hyponatremia); and decreased reflexes.

    Superior Vena Cava Syndrome

    • Symptoms: Obstruction of blood flow, higher blood pressure in upper extremities than lower ones; breathing issues.

    Spinal Cord Compression

    • Symptoms: Worsening pain (worse in a supine position; relieved by sitting or standing), and neurologic impairment.
    • Assessment: Important to rule this condition out as a possibility, since it can quickly lead to potentially devastating results if left unattended.

    Tumor Lysis Syndrome

    • Causes: Chemo causing cell death, and consequent release of electrolytes into body fluids.
    • Risk: Kidney damage as electrolytes overload kidney filter system. Electrolyte imbalances; monitor fluids, electrolytes, kidneys and cardiac output closely.

    Other

    • Cardiac Monitor: Used extensively throughout the assessment and treatment of a wide variety of issues. Monitor for abnormal heart rhythms (dysrhythmias).
    • Labs: Monitoring various labs (creatinine, lactate, etc.) is key in evaluating patient status and determining the best course of action. This includes tests relating to blood, urine, and other vital fluids, to understand if there are significant problems that need correction or intervention immediately.

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    Exam 4 Review PDF

    Description

    This quiz focuses on the critical differences between heat stroke and heat exhaustion, along with their treatment protocols. It also covers the treatment strategies for drowning victims in cold and warm water, including the management of injuries and monitoring techniques. Test your knowledge on these essential emergency care concepts.

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