Environmental Emergencies Quiz

Removing dead or damaged tissue from a wound.

Transferring tissue from one part of the body to another or from another person to promote wound healing.

Material Safety Data Sheet; a document providing information on the hazards of a chemical or material.

Presence of radioactive material in an area or on an object.

The process of removing or neutralizing a harmful substance from a surface or object.

Steps taken to prevent the spread of infectious agents.

Pain that appears suddenly and lasts for a short time.

Personal Protective Equipment; protective gear used to avoid infection or exposure to harmful substances.

Estimating the extent of a burn using the Rule of Nines.

A formula for calculating the volume of fluid needed for burn victims in the first 24 hours.

Checking for airway blockage or narrowing due to edema or soot.

Monitor pulse and blood pressure (BP), and urine output (UOP) to detect shock or fluid loss.

Providing fluids (often Lactated Ringer's solution) using the Parkland formula in a burn injury.

Surgical procedure to cut through tight burn scar tissue to reduce edema and improve blood flow.

Surgical incision deep into the fascia to reduce swelling caused by burn or trauma that might restrict blood flow

Evaluating the depth of burns (first, second or third degree) to properly assess severity.

D-dimer measurement is the best single lab test for diagnosing Disseminated Intravascular Coagulation (DIC).

Treat the underlying cause of DIC (e.g., sepsis, malignancy, trauma) and provide supportive care.

Sepsis is treated with antibiotics.

A major concern in a burn victim, affecting the airway above the glottis causes airway swelling and blisters.

More concerning for Carbon Monoxide poisoning, and looks for soot in nares, and monitors airways.

A superficial burn. Do not pop blisters. Monitor at home.

Partial thickness burn, pink shiny moist layer. Released home with silvodin/cream

Full thickness burn, white waxy or black charred skin. Requires grafting.

Severe muscle cramps, usually in the legs, caused by excessive sweating and electrolyte loss during strenuous activity in hot weather.

A more serious heat illness characterized by fatigue, nausea, vomiting, dizziness, and a rapid heartbeat, often accompanied by a mild increase in body temperature.

A life-threatening condition where the body's temperature regulation system fails, leading to extremely high body temperature, confusion, seizures, and even coma.

The body's temperature control system fails, leading to a dangerously high temperature. Sweat glands stop functioning, and the body cannot release heat effectively. This can cause serious damage to organs, especially the brain.

Key to treating heat-related illnesses, providing fluids (oral or IV) and electrolytes (especially sodium) to restore balance and support the body's normal functions.

A life-threatening condition where the body's temperature regulation system fails, leading to extremely high body temperature, confusion, seizures, and even coma.

Rapidly decreasing core temperature to save brain and organs.

Remove clothing, cover with wet sheets, place in front of a fan, immerse in cool water, apply ice packs to groins and axilla, peritoneal lavaging.

Heatstroke can damage muscle tissue, releasing myoglobin into the bloodstream, which can damage the kidneys.

Heat cramps are muscle spasms caused by electrolyte loss, exhaustion is a milder form of heat illness with fatigue and dizziness, heatstroke is the most serious with very high temperature and altered mental status.

True tissue freezing that results in the formation of ice crystals in the tissues and cells.

To prevent further tissue damage and promote healing.

Tissue death (necrosis) can occur, leading to amputation in severe cases.

Tissue damage caused by extreme cold exposure, often affecting extremities like fingers, toes, and the nose.

Mildest form of frostbite, characterized by pale or blue, crunchy skin, tingling, numbness, and burning sensation. Blisters may form.

Severe form of frostbite involving muscle, bone, and tendon. Skin appears white, hard, and numb.

Rewarming the affected area by immersing it in temperature-controlled water (98.6-104°F). Debridement of blisters, sterile dressings, and pain management.

A dangerously low body temperature, often below 95°F (35°C).

High levels of calcium in the blood, often caused by increased bone resorption.

High calcium levels can occur in people with certain cancers, especially those affecting bones.

Confusion, lethargy, muscle weakness, nausea, vomiting, constipation, polyuria, polydipsia, and kidney stones.

Hypercalcemia often presents with sinus bradycardia, prolonged PR interval, and shortened QT interval on an EKG.

Hypercalcemia interventions include telemetry monitoring, 12-lead EKG, lab monitoring, and addressing the underlying cause.

Severe hypercalcemia can lead to seizures, ileus (intestinal blockage), pathologic fractures, and even cardiac arrest.

Preventing hypercalcemia involves identifying high-risk individuals (e.g., those with bone cancer, renal failure, or taking thiazide diuretics) and addressing risk factors.

Hydration is crucial in managing hypercalcemia. Aim for 3000-4000 ml daily if tolerated, and consider IV isotonic solutions (normal saline) if needed.

Bisphosphonates are the gold standard treatment for hypercalcemia. Calcitonin can be used in emergencies. Loop diuretics are helpful after hydration.

Hemodialysis is used in severe hypercalcemia cases, particularly with renal impairment.

Patients with low albumin levels are at increased risk for hypercalcemia.

A serious condition that occurs when rapidly dividing cancer cells are killed, releasing their contents into the bloodstream. This causes electrolyte imbalances like hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia.

The four hallmark electrolyte abnormalities are hyperkalemia (high potassium), hyperphosphatemia (high phosphate), hyperuricemia (high uric acid), and hypocalcemia (low calcium).

Patients receiving chemotherapy and radiation, those with lymphoma, cancers with high growth factor, and those with large tumors are at higher risk.

Tumor Lysis Syndrome usually develops 24-48 hours after chemotherapy and lasts for 5-7 days.

Hyperuricemia is treated with hypouricemic agents like allopurinol (intermediate risk), febuxostat (higher cost, less drug interactions), and rasburicase (high risk).

Aggressive IV hydration is crucial to prevent kidney damage, but monitoring for fluid overload and cardiac function is essential.

Metabolic acidosis can occur due to the accumulation of acidic byproducts released from tumor cells. It is treated with sodium bicarbonate to correct the acid-base imbalance.

The electrolyte imbalances can lead to cardiac arrhythmias, seizures, and renal failure.

A private room is crucial to minimize the risk of spreading radioactive contamination. It prevents the patient's bodily fluids from contaminating other areas and people.

1. Evacuate the area to prevent further exposure. 2. Remove outer clothing to isolate the contamination. 3. Place contaminated clothing in a plastic bag to prevent spreading. 4. Wash or shower all exposed body parts to remove any residual contamination.

Using appropriate precautions, including thorough cleaning, disinfection, and sterilization, is essential to prevent the spread of infections and hazardous materials.

Procedural pain. It's pain associated with a medical procedure, in this case, the process of changing dressings which can be painful and requires pain relief.

Cancerous tumors, either originating in the CNS or spreading from other locations to the bone, like prostate, lung, breast, GI, renal, and melanoma. Lymphomas can also invade the epidural space.

Localized back or neck pain, particularly worse when lying flat, vertebral tenderness, loss of bladder and/or bowel function, and sensation and/or motor impairment.

Magnetic Resonance Imaging (MRI) is the most accurate way to diagnose spinal cord compression because it provides detailed images of the spinal cord and surrounding structures.

Favorable factors include female gender, slow onset of symptoms, radiosensitive tumors, and compression in the lower spine compared to the upper spine.

A serious condition characterized by both a fever (single oral temperature of 38.3°C or higher over one hour) and a low absolute neutrophil count (ANC) below 1500 (or 1000 in some cases). Severe neutropenia is defined as ANC < 500.

Low neutrophil counts put patients at a high risk of developing infections, sepsis (widespread infection), and even death.

Monitoring for fever (as defined above), closely tracking the ANC counts, and practicing meticulous hand washing! Hospitalized patients may require isolation precautions.

These patients should be placed on Neutropenic Precautions to minimize their risk of infection.

Tumor Lysis Syndrome (TLS) is a serious condition that occurs when rapidly dividing cancer cells are killed, releasing their intracellular contents into the bloodstream, leading to electrolyte imbalances.

The four hallmark electrolyte abnormalities in TLS are:

1. Hyperkalemia (high potassium)
2. Hyperphosphatemia (high phosphate)
3. Hyperuricemia (high uric acid)
4. Hypocalcemia (low calcium)

Patients receiving chemotherapy and radiation, those with lymphoma, cancers with high growth factor, and those with large tumors are at higher risk for TLS.

TLS usually develops 24-48 hours after chemotherapy and lasts for 5-7 days.

Hyperuricemia in TLS is treated with hypouricemic agents like allopurinol (intermediate risk), febuxostat (higher cost, less drug interactions), and rasburicase (high risk).

Aggressive IV hydration is crucial in TLS to prevent kidney damage, but monitoring for fluid overload and cardiac function is vital.

Metabolic acidosis can occur in TLS due to the accumulation of acidic byproducts released from tumor cells. It requires treatment with sodium bicarbonate to correct the acid-base imbalance.

The electrolyte imbalances in TLS can lead to cardiac arrhythmias, seizures, and renal failure.

Special measures taken to protect patients with low white blood cell counts (neutropenia) from infections. It involves limiting exposure to germs, using masks, gloves, and gowns, limiting visitors, and avoiding exposure to live plants.

A life-threatening condition where the body's blood clotting system malfunctions, leading to both excessive clotting and bleeding simultaneously.

Treating the underlying cause of DIC is essential. DIC is a symptom of another problem, so addressing that root cause is crucial.

Tiny, red, pinpoint-sized spots on the skin caused by bleeding under the surface.

A blood test that measures a protein fragment (D-dimer) released when a blood clot dissolves. High levels suggest the body is forming and breaking down clots.

DIC can be chronic, where the body compensates for the clotting/bleeding imbalance, making symptoms less noticeable.

Excessive clotting can lead to blockages in blood vessels, causing tissue death (ischemia) and organ damage, especially affecting the lungs, kidneys, and intestines.

Treating the underlying cause and providing supportive care to manage bleeding and clotting issues.

The international color for oxygen containers is white.

Nitrous oxide containers are typically light blue.

Bioterrorism involves the use of biological agents as weapons, such as anthrax, smallpox, botulism, and plague.

Anthrax is not contagious from person to person, but transmission happens through contact with infected animals or their products.

Smallpox diagnosis can be challenging due to the lack of experience among clinicians and its similarity to other diseases.

The incubation period for smallpox is typically 7 to 17 days.

Febrile neutropenia is a serious condition characterized by fever and low neutrophil count, putting the patient at high risk for infection.

Burns that extend beyond the skin layers, potentially causing loss of body parts due to compromised blood flow.