Environmental Emergencies Quiz
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Questions and Answers

What is a key characteristic that differentiates heat stroke from heat exhaustion?

  • Heat strokes are not related to dehydration.
  • Heat exhaustion is always more severe than heat stroke.
  • Heat stroke patients are unable to sweat. (correct)
  • People with heat stroke can still sweat.

Which intervention is essential for treating heat stroke?

  • Providing them with sedatives to calm down.
  • Administering hot fluids to promote sweating.
  • Packing them with ice packs. (correct)
  • Allowing them to rest without monitoring.

What should be monitored in a patient with hypothermia?

  • Blood pressure only.
  • Mental state, but not vital signs.
  • Heart rate and urine output. (correct)
  • Only body temperature without any further assessment.

What is the desired body temperature before declaring time of death in a hypothermic patient?

<p>86 to 90 degrees Fahrenheit. (C)</p> Signup and view all the answers

What physiological impacts does drowning in cold water have compared to warm water?

<p>Cold water slows metabolic processes, increasing chances of recovery. (C)</p> Signup and view all the answers

What is a common concern specific to cat bites?

<p>Their sharp, pointy teeth can lead to deep puncture wounds. (B)</p> Signup and view all the answers

Why is it important to know the vaccination status of an animal that bites a human?

<p>To assess the risk of rabies infection. (A)</p> Signup and view all the answers

Which of the following is NOT considered an active warming method for treating hypothermia?

<p>Warm blankets. (B)</p> Signup and view all the answers

What is the immediate action to take after a person is stung by a bee?

<p>Remove the stinger with something flat or a blade. (A)</p> Signup and view all the answers

What is a potential consequence of a T6 and above spinal injury?

<p>Orthostatic hypotension (B)</p> Signup and view all the answers

Which characteristic is associated with anomic dysreflexia in patients with T6 injuries or above?

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

What should be assessed regarding a patient who has been poisoned after decontamination?

<p>Breathing and cardiac status. (B)</p> Signup and view all the answers

In the case of opioid overdose, which of the following symptoms is NOT typically associated?

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

What should be done when encountering an impaled object in an abdominal injury?

<p>Leave the object in place (C)</p> Signup and view all the answers

Which is a critical sign of tension pneumothorax?

<p>Tracheal deviation (C)</p> Signup and view all the answers

What defines a primary spinal cord injury?

<p>Obvious injuries such as head lacerations. (A)</p> Signup and view all the answers

What can result from edema to the spinal cord?

<p>Compression and restriction of blood flow. (C)</p> Signup and view all the answers

What is a major risk associated with long bone fractures?

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

What does FAST stand for in the context of abdominal trauma assessment?

<p>Focused abdominal sonography for trauma (A)</p> Signup and view all the answers

What does spinal shock entail after a spinal cord injury?

<p>Loss of deep tendon reflex and sensations below the injury site. (A)</p> Signup and view all the answers

Which condition can lead to rhabdomyolysis following compartment syndrome?

<p>Fractures and crush injuries (C)</p> Signup and view all the answers

Why is it crucial to not give activated charcoal to patients with abdominal issues?

<p>They may not be able to process it properly. (C)</p> Signup and view all the answers

What should be done first when treating a patient for poisoning?

<p>Call poison control. (B)</p> Signup and view all the answers

What is a recommended strategy for managing symptoms of traumatic brain injury (TBI)?

<p>Establish a supportive routine (D)</p> Signup and view all the answers

What condition can result from chemotherapy leading to an imbalance of electrolytes, specifically hyperkalemia and hyperphosphatemia?

<p>Tumor lysis syndrome (C)</p> Signup and view all the answers

Which of the following is a key action to take prior to administering chemotherapy to protect kidney function?

<p>Ensure proper hydration (B)</p> Signup and view all the answers

What symptoms indicate a potential issue with SIADH that must be addressed carefully?

<p>Excessive water gain and decreased reflexes (B)</p> Signup and view all the answers

In the context of spinal cord compression, when does the pain often worsen?

<p>When lying supine (C)</p> Signup and view all the answers

What is the recommended action for patients with burns affecting the mouth and throat due to potential swelling?

<p>Intubate them immediately (B)</p> Signup and view all the answers

Which level in the ESI indicates the most severe condition?

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

During a primary survey, which assessment should be prioritized first?

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

What is the appropriate action to take if a patient shows uncontrolled circulation?

<p>Stabilize the bleed before addressing other issues (C)</p> Signup and view all the answers

What condition is indicated by a lactate level greater than 4?

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

In cases of neutropenia, which of the following is critical to monitor?

<p>WBC count (B)</p> Signup and view all the answers

What is a common complication of severe sepsis that affects the respiratory system?

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

What is the primary reason for administering bisphosphonates to patients with hypercalcemia related to bone cancer?

<p>To inhibit calcium release from bones (C)</p> Signup and view all the answers

What effects can occur from acute kidney failure in cancer patients treated with antibiotics?

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

Flashcards

Heat Stroke Treatment

Lower core temperature (cold water immersion, ice packs, cold fluids), monitor temperature and for dysrhythmias, 100% oxygen, watch urine output for dehydration.

Heat Stroke vs. Heat Exhaustion

Heat stroke is significantly worse and involves the inability to sweat, while heat exhaustion does allow for sweating.

Hypothermia Treatment

Remove cold clothing, use warm blankets and active warming (warm fluids, bear huggers) or passive warming if active warming isn't successful.

Cold Water Drowning Issues

Slows down body function, possibility for revival, check for pulmonary edema, ARDS, decreased surfactant, and alveolar capillary membrane issues

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Animal Bites - Treatment

Cat bites: deep wounds, potential infection, prophylactic antibiotics. Dog bites: larger areas affected, also potential for infection. Puncture wounds, older wounds, wounds near joints, or on hands/feet require antibiotics.

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Drowning Injury

Possible airway and breathing issues, needs c-collar in case of neck injury; oxygen and ABC monitoring is critical.

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Hypothermia Monitoring

Monitor ABCs (Airway, Respiration, Circulation); cardiac monitor necessary and watch urine output due to dehydration and acidosis.

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Rabies Prevention

Wild animal bites always warrant prophylactic rabies vaccination.

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Sting treatment

Remove the stinger, assess for allergies, administer epinephrine, antihistamines, and/or steroids, and remove restrictive items like rings.

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Poisoning management

Decontaminate the patient, give a shower using cautious ABCs management (airway, breathing, circulation), call poison control, consider activated charcoal (based on medical advice), depending on the type of poisoning.

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Opioid overdose

Characterized by pinpoint pupils, loss of consciousness, and respiratory depression; administer naloxone (Narcan), monitor ABCs, and observe for seizures.

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Spinal Cord Injury (SCI)

Injuries are classified as primary (visible) and secondary (hidden edema, ischemia). Males are more commonly affected by automobile accidents.

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Secondary SCI damage

Edema (swelling), ischemia (reduced blood flow), inflammation, and other hidden impacts. These can lead to permanent effects.

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Spinal shock

Sudden loss of reflexes (deep tendon, sphincter), sensation, and motor function after the SCI. The severity of the damage might not be fully apparent until the swelling subsides.

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Phrenic Nerve Function

The Phrenic nerve controls the diaphragm, which is important for breathing. Damage to this nerve can impact respiratory function.

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Male SCI prevalence

Males are more often involved in automobile accidents leading to Spinal cord injuries..

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Neurogenic Shock

A life-threatening condition caused by damage to the spinal cord at or above T6. It disrupts the sympathetic nervous system, leading to decreased cardiac output, blood pressure, and body temperature regulation.

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Respiratory Issues with High Spinal Cord Injuries

Injuries to the spinal cord at C3, C4, or C5 can damage the nerves controlling the diaphragm, leading to breathing difficulties and the need for mechanical ventilation.

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Autonomic Dysreflexia

A dangerous condition occurring in individuals with spinal cord injuries at or above T6. It involves uncontrolled high blood pressure, severe headache, and sweating, often triggered by bladder or bowel distention.

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Tension Pneumothorax

A life-threatening condition where air accumulates in the chest cavity, compressing the lung and heart. Symptoms include tracheal deviation, JVD, dyspnea, and decreased cardiac output.

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Flail Chest

A severe chest injury involving multiple rib fractures, leading to a paradoxical inward movement of the chest wall during inhalation.

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FAST

A bedside ultrasound exam used to diagnose abdominal injuries. It can quickly assess internal bleeding and organ damage.

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Compartment Syndrome

A serious condition occurring after a major bone fracture or crush injury, where pressure builds within a muscle compartment, restricting blood flow and causing tissue damage.

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Traumatic Brain Injury (TBI)

A brain injury caused by a sudden, forceful impact. Symptoms can range from mild, short-term effects to severe and lifelong disabilities.

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ESI Triage Levels

A system used in emergency departments to prioritize patients based on their acuity level. Level 1 is the most critical, requiring immediate attention, while Level 5 is the least urgent.

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Primary Survey

A rapid assessment of a trauma patient's life-threatening conditions, focusing on airway, breathing, circulation, disability, and exposure. It's a quick check to identify and address immediate threats.

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Secondary Survey

A more thorough assessment of a trauma patient after the primary survey, covering a detailed history, physical exam, and vital signs. This helps identify other injuries and plan further treatment.

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Sepsis

A serious infection that spreads throughout the body, causing a systemic inflammatory response. Untreated sepsis can lead to organ failure and death.

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Lactate Level

A measure of how much lactic acid is in the blood. In sepsis, elevated lactate levels indicate tissue hypoxia (lack of oxygen). Levels above 4 are concerning.

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Neutropenia

A condition where the body has a low white blood cell count, making it more susceptible to infections.

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Thrombocytopenia

A condition characterized by a low platelet count, leading to increased risk of bleeding.

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Hypercalcemia

A condition where the calcium level in the blood is too high, commonly seen in cancer patients. High calcium can cause various problems, including kidney failure.

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Tumor Lysis Syndrome

A serious complication of chemotherapy that occurs when cancer cells are rapidly destroyed, releasing their contents into the bloodstream, leading to high potassium, phosphate, and low calcium levels.

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Tumor Lysis Syndrome: Risk Factors

Patients with a large tumor burden, high tumor growth rate, and high sensitivity to chemotherapy are at an increased risk of developing tumor lysis syndrome.

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Tumor Lysis Syndrome: Prevention

Prior to chemotherapy, patients should be well-hydrated to help flush out the cell debris and prevent electrolyte imbalances.

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Superior Vena Cava Syndrome

A condition caused by obstruction of the superior vena cava, the large vein that returns blood from the head, neck, and arms to the heart, leading to swelling and pressure in the upper body.

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Spinal Cord Compression

A neurological emergency caused by a tumor pressing on the spinal cord, leading to pain, weakness, and numbness.

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Study Notes

Environmental Emergencies

  • Heat Stroke vs. Heat Exhaustion: Heat stroke is worse; the body cannot sweat, while heat exhaustion allows for some sweating.

  • Heat Stroke Treatment: Lower core body temperature with cold water immersion (if possible), ice packs, and cold fluids. Monitor temperature, dysrhythmias, and breathing.

  • Hypothermia Treatment: Remove cold clothing, use warm blankets and warm fluids, Active and passive warming. Warm the room to a temperature between 86-90 degrees Fahrenheit. Monitor ABCs, cardiac function, and urine output.

Treating Heat Stroke

  • Lower Core Temperature: Use cold water immersion if possible and ice packs.
  • Monitor Vital Signs: Monitor temperature, heart rhythm (dysrhythmias), and breathing (ABCs).
  • Fluid Administration: Ensure cold fluids are administered.
  • Shivering Prevention: Shivering can make the body work harder; thus, minimize it.
  • Urine Output Monitoring: Monitor for dark (tea-colored) urine, which indicates dehydration.

Hypothermia

  • Cause of Thick Blood: Hypothermia can lead to blood clotting, heart attacks, and pulmonary emboli (PE).
  • Cold Clothing Removal: Take cold clothes off immediately
  • Active Warming: Utilize warm blankets, fluids, and bear huggers to warm the body
  • Passive Warming: Passive warming involves strategies like manipulating the room temperature. Aim for 86-90 degrees Fahrenheit for patient warming.
  • Monitor for Death: Check patient temperature to confirm whether death was from cold or heat; warm patient before declaring death.

Cold Water Drowning

  • Cooling Effect: Cold water slows down the body's processes, increasing the chances of resuscitation.
  • Drowning Injuries: Injuries like pulmonary edema and acute respiratory distress syndrome (ARDS) can occur.
  • Treatment Focus: Immediate airway management and warming the body. Use a cervical collar and monitor ABCs.
  • Water Type Considerations: The type of water where the incident occurs is relevant to treatment.

Bites

  • Cat Bites: Cat bites can cause deep puncture wounds, increasing the risk of infection. Prophylactic antibiotics are often prescribed.
  • Dog Bites: Dog bites tend to be more problematic due to larger, more extensive wound areas, and infection risk is higher.
  • Dental Issues (Puncture wounds): Wounds located on hands, feet, or over joints should receive antibiotic therapy 6 to 12 hours after the bite.
  • Rabies Exposure: The animal's vaccine history is crucial information to determine whether or not rabies prophalaxis (vaccination) is appropriate.

Stings

  • Removal Technique: Remove the stinger with a flat object or a blade.
  • Allergy Assessment: Determine if the person has any allergies.
  • Medication Administration: EPI, antihistamines, and steroids may be required.
  • Jewelry Removal: Remove any tight jewelry that can restrict blood flow due to swelling.

Poisoning

  • Decontamination: Brush away powder before showering.
  • Poison Control: Call for expert counsel.
  • Treatment Strategies: Use charcoal to bind to toxins.

Opioid Overdose

  • Vital Signs: Monitor pupils (which may be pinpoint), breathing, and responsiveness.
  • Treatment: Administer naloxone (Narcan) as required and monitor ABCs.
  • Monitor closely: Observe and document for any and all changes.

Spinal Cord Injuries

  • Common Cause: Automobile accidents are a common cause
  • Primary Injuries: Head lacerations are usually the initial or primary injuries.
  • Secondary Injuries: These are more concern for permanent damage: Edema, ischemia, and inflammation of the spinal cord are potential issues.
  • Spinal Shock: Immediate loss of reflex below the injury is notable with potential long-term damage if not addressed quickly.
  • Neurogenic Shock: Signs include warm, flushed extremities, systolic blood pressure below 90, and potential issues regulating temperature.
  • T6 and Higher Injuries: These result in temperature regulation problems, cardiac output issues and respiratory distress.

Trauma

  • Tension Pneumothorax: Tension pneumothorax has the potential to be life-threatening; it can shift the trachea and affect circulation and breathing. Immediate decompression with a needle or chest tube is crucial.
  • Flail Chest: Multiple rib fractures can result in flail chest; it causes paradoxical chest wall movement.

Abdominial Injuries

  • Caution: Do not pull out impaled objects.

Fractures

  • Blood Loss: Long bone fractures can cause significant blood loss.
  • Infection Potential: Open fractures increase the chance of infection.
  • Compartment Syndrome Risk: Crush injuries can lead to compartment syndrome, an acute limb-threatening complication.
  • AKI: Rhabdomyolysis can cause acute kidney injury (AKI).
  • Urine Appearance: Red or tea-colored urine is often a sign of rhabdomyolysis.

TBI- Traumatic Brain Injury

  • Long-term Effects: TBI can cause chronic issues.
  • Routine Needs: Maintain a routine that supports daily health and well-being.
  • Support Networks: Utilize support groups for stress management and symptom monitoring.
  • Avoid Irritants: Try to avoid substances that might worsen or trigger symptoms (alcohol, drugs, etc.)

Trauma Nursing

  • ESI Levels: Trauma care prioritizes the patient based on the ESI level.
  • Patient Considerations: Patient care needs may vary based on the ESI level.

TBI- Traumatic Brain Injury

  • Lifelong Care: Some TBI injuries may require care for the rest of the patient's life.

Sepsis

  • Severity Stages: Includes SIRS, sepsis, severe sepsis, and septic shock; this is noted by lactate levels, if above 4, immediate action is needed.
  • Critical Issues: Assess for and address severe metabolic acidosis, inadequate urinary output, and complications like acute kidney injury.
  • GI Involvement: Observe for gut symptoms like slowed bowel sounds, which are often caused by stress and/or lack of sufficient hydration; use caution and monitor closely.
  • Kidney Failure: Kidney injury or failure needs careful attention, usually requiring medication or assistance.

Oncology Emergencies

  • Neutropenia: Low white blood cell count increases susceptibility to infections.
  • Infections: Monitor for infections and take appropriate action to prevent or treat them.
  • Antibiotic Therapy: Follow antibiotic protocols meticulously to ensure correct application and monitoring.
  • Thrombocytopenia: Reduced platelet count requires close monitoring; avoid procedures that may increase bleeding risk.
  • Hypercalcemia: High calcium levels may result in many symptoms; carefully evaluate, treat as needed, and monitor for complications.

Tumor Lysis Syndrome

  • Chemo Effects: Chemotherapy treatment can cause the death of numerous cells; closely monitor for subsequent side effects.
  • Metabolic Acidosis: Monitor for metabolic acidosis.
  • Kidney and Fluid Balance: Ensure adequate fluids and monitor kidney function.
  • Electrolyte Imbalances: Be sure to check for electrolyte imbalances.

SIADH

  • Water Excess: Excessive water intake is common.
  • Assessment: Assess for mental status, reflex changes, and elevated sodium levels—critical to detect and address swiftly.

Superior Vena Cava Syndrome

  • Symptoms: Symptoms of the obstruction include higher blood pressure in the upper body.
  • Causes: Various factors or complications can cause the obstruction.

Spinal Cord Compression

  • Pain Changes: Worsening pain, especially in the supine position, often marks the onset of spinal cord compression.

Burns

  • Parkland formula: A formula to determine fluid requirements in burn patients.
  • Intubation: Intubate patients who are having a burn injury to the mouth or airway, quickly.
  • swelling issues in esophageal area: Early intubation is crucial to prevent further issues.

Lab work & monitoring

  • Vital monitoring: vital signs including temperature and rhythm.
  • Lab Work: lab tests such as blood work and urine.
  • Other Tests: NG tubes or OG tubes may be used for patients with facial trauma.
  • Medication Management: Provide pain management and other necessary medications.

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Description

Test your knowledge on environmental emergencies, focusing on heat-related conditions like heat stroke and heat exhaustion. This quiz covers treatment protocols, including lowering core temperature and monitoring vital signs. Assess your understanding of hypothermia treatment as well.

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