MOC III EXAM 4 STUDY GUIDE PDF

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height: 829px; position: relative;"}}" data-props="{"dataAttribs":{"data-slice-no":0},"altHeight":"829","top":"0","style":"width: 640px; height: 829px; position: relative;","sliceNo":0}"} ::: {.ch-page-slice data-slice-no="0" data-top="0" data-alt-height="829" style="width: 640px; height: 829px; position: relative;"} ::: {data-slice-bg="true" style="position: absolute; width: 640px; height: 829px; overflow: hidden;"} ![](./MOC%20III%20EXAM%204%20STUDY%20GUIDE.docx_files/saved_resource){.tw-pointer-events-none} ::: ::: {#t1_1.t.s1_1 data-top="89" data-oc="true" style="top: 89px; left: 171px;"} MOC Exam 4 Study Guide ::: ::: {#t2_1.t.s2_1 data-top="128" data-oc="true" style="top: 128px; left: 198px;"} Environmental Emergencies ::: ::: {#t3_1.t.s3_1 data-top="148" data-oc="true" style="top: 148px; left: 76px;"}  ::: ::: {#t4_1.t.s4_1 data-top="148" data-oc="true" style="top: 148px; left: 94px;"} Heat Cramps ::: ::: {#t5_1.t.s3_1 data-top="162" data-oc="true" style="top: 162px; left: 94px;"}  ::: ::: {#t6_1.t.s5_1 data-top="162" data-oc="true" style="top: 162px; left: 113px;"} Severe cramps in large muscle groups fatigued by heavy work. ::: ::: {#t7_1.t.s3_1 data-top="177" data-oc="true" style="top: 177px; left: 113px;"}  ::: ::: {#t8_1.t.s5_1 data-top="177" data-oc="true" style="top: 177px; left: 132px;"} S/S: brief & intense pain, [[[nausea]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-11661-11661" data-cha-target-name="concept-11661" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;" data-gtm-vis-recent-on-screen128233_971="822" data-gtm-vis-first-on-screen128233_971="822" data-gtm-vis-total-visible-time128233_971="100" data-gtm-vis-has-fired128233_971="1"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"11661","data-concept-text":"nausea","data-ppo-id":"-11661","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"11661","ppoid":"-11661","text":"nausea"}"}, tachy, pallor, weakness, & diaphoresis ::: ::: {#t9_1.t.s3_1 data-top="191" data-oc="true" style="top: 191px; left: 94px;"}  ::: ::: {#ta_1.t.s5_1 data-top="191" data-oc="true" style="top: 191px; left: 113px;"} Commonly occurs in healthy, acclimated athletes with inadequate fluid intake ::: ::: {#tb_1.t.s3_1 data-top="206" data-oc="true" style="top: 206px; left: 113px;"}  ::: ::: {#tc_1.t.s5_1 data-top="206" data-oc="true" style="top: 206px; left: 132px;"} Resolve w/ rest and oral or parenteral replacement of [[[sodium]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-7101-7101" data-cha-target-name="concept-7101" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;" data-gtm-vis-recent-on-screen128233_971="825" data-gtm-vis-first-on-screen128233_971="825" data-gtm-vis-total-visible-time128233_971="100" data-gtm-vis-has-fired128233_971="1"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"7101","data-concept-text":"sodium","data-ppo-id":"-7101","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"7101","ppoid":"-7101","text":"sodium"}"} & water ::: ::: {#td_1.t.s3_1 data-top="220" data-oc="true" style="top: 220px; left: 113px;"}  ::: ::: {#te_1.t.s5_1 data-top="220" data-oc="true" style="top: 220px; left: 132px;"} Education: Avoid exercise for 12 hours, Increase their fluid intake, make sure they ::: ::: {#tf_1.t.s5_1 data-top="235" data-oc="true" style="top: 235px; left: 132px;"} emphasize their salt replacement during this period, and prevention ::: ::: {#tg_1.t.s3_1 data-top="263" data-oc="true" style="top: 263px; left: 76px;"}  ::: ::: {#th_1.t.s4_1 data-top="263" data-oc="true" style="top: 263px; left: 94px;"} Heat Exhaustion ::: ::: {#ti_1.t.s3_1 data-top="278" data-oc="true" style="top: 278px; left: 94px;"}  ::: ::: {#tj_1.t.s5_1 data-top="278" data-oc="true" style="top: 278px; left: 113px;"} Prolonged exposure to heat over hours or days ::: ::: {#tk_1.t.s3_1 data-top="292" data-oc="true" style="top: 292px; left: 94px;"}  ::: ::: {#tl_1.t.s5_1 data-top="292" data-oc="true" style="top: 292px; left: 113px;"} Clinical syndrome characterized by: ::: ::: {#tm_1.t.s3_1 data-top="307" data-oc="true" style="top: 307px; left: 113px;"}  ::: ::: {#tn_1.t.s5_1 data-top="307" data-oc="true" style="top: 307px; left: 132px;"} [[[Fatigue]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-11476-11476" data-cha-target-name="concept-11476" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"11476","data-concept-text":"Fatigue","data-ppo-id":"-11476","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"11476","ppoid":"-11476","text":"Fatigue"}"}, N/V, extreme thirst, & feeling of anxiety. ::: ::: {#to_1.t.s3_1 data-top="321" data-oc="true" style="top: 321px; left: 113px;"}  ::: ::: {#tp_1.t.s4_1 data-top="321" data-oc="true" style="top: 321px; left: 132px;"} VSS (3) ::: ::: {#tq_1.t.s3_1 data-top="336" data-oc="true" style="top: 336px; left: 132px;"}  ::: ::: {#tr_1.t.s5_1 data-top="336" data-oc="true" style="top: 336px; left: 151px;"} 1\) hypotension ::: ::: {#ts_1.t.s3_1 data-top="350" data-oc="true" style="top: 350px; left: 132px;"}  ::: ::: {#tt_1.t.s5_1 data-top="350" data-oc="true" style="top: 350px; left: 151px;"} 2) [[[tachycardia]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-12196-12196" data-cha-target-name="concept-12196" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"12196","data-concept-text":"tachycardia","data-ppo-id":"-12196","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"12196","ppoid":"-12196","text":"tachycardia"}"} ::: ::: {#tu_1.t.s3_1 data-top="365" data-oc="true" style="top: 365px; left: 132px;"}  ::: ::: {#tv_1.t.s5_1 data-top="365" data-oc="true" style="top: 365px; left: 151px;"} 3\) elevated body temperature (mild to severe, range from ::: ::: {#tw_1.t.s5_1 data-top="365" data-oc="true" style="top: 365px; left: 441px;"} 99.6 to 105.8) ::: ::: {#tx_1.t.s3_1 data-top="379" data-oc="true" style="top: 379px; left: 113px;"}  ::: ::: {#ty_1.t.s5_1 data-top="379" data-oc="true" style="top: 379px; left: 132px;"} Additional s/s: Dilated pupils, mild confusion, ashen color, and profuse diaphoresis ::: ::: {#tz_1.t.s3_1 data-top="393" data-oc="true" style="top: 393px; left: 94px;"}  ::: ::: {#t10_1.t.s5_1 data-top="393" data-oc="true" style="top: 393px; left: 113px;"} Interventions: ::: ::: {#t11_1.t.s3_1 data-top="408" data-oc="true" style="top: 408px; left: 113px;"}  ::: ::: {#t12_1.t.s5_1 data-top="408" data-oc="true" style="top: 408px; left: 132px;"} Correlate fluid replacement to clinical and lab findings. ::: ::: {#t13_1.t.s3_1 data-top="422" data-oc="true" style="top: 422px; left: 113px;"}  ::: ::: {#t14_1.t.s5_1 data-top="422" data-oc="true" style="top: 422px; left: 132px;"} Place moist sheet over patient to decrease core temperature ::: ::: {#t15_1.t.s3_1 data-top="437" data-oc="true" style="top: 437px; left: 113px;"}  ::: ::: {#t16_1.t.s5_1 data-top="437" data-oc="true" style="top: 437px; left: 132px;"} Hospital admission considered for: Older adults, chronically ill & those who don't ::: ::: {#t17_1.t.s5_1 data-top="451" data-oc="true" style="top: 451px; left: 132px;"} improve in 3 to 4 hours ::: ::: {#t18_1.t.s3_1 data-top="480" data-oc="true" style="top: 480px; left: 76px;"}  ::: ::: {#t19_1.t.s4_1 data-top="480" data-oc="true" style="top: 480px; left: 98px;"} Heatstroke ::: ::: {#t1a_1.t.s3_1 data-top="495" data-oc="true" style="top: 495px; left: 94px;"}  ::: ::: {#t1b_1.t.s6_1 data-top="495" data-oc="true" style="top: 495px; left: 113px;"} medical emergency ::: ::: {#t1c_1.t.s7_1 data-top="495" data-oc="true" style="top: 495px; left: 210px;"} , ::: ::: {#t1d_1.t.s5_1 data-top="495" data-oc="true" style="top: 495px; left: 216px;"} results from failure of hypothalamic thermoregulatory processes ::: ::: {#t1e_1.t.s3_1 data-top="509" data-oc="true" style="top: 509px; left: 113px;"}  ::: ::: {#t1f_1.t.s5_1 data-top="509" data-oc="true" style="top: 509px; left: 132px;"} Increased sweating, vasodilation, and increased respiratory deplete fluids and ::: ::: {#t1g_1.t.s5_1 data-top="524" data-oc="true" style="top: 524px; left: 132px;"} electrolytes, specifically ::: ::: {#t1h_1.t.s5_1 data-top="524" data-oc="true" style="top: 524px; left: 257px;"} [[[sodium]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-7101-7101" data-cha-target-name="concept-7101" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" data-gtm-vis-has-fired128233_971="1" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"7101","data-concept-text":"sodium","data-ppo-id":"-7101","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"7101","ppoid":"-7101","text":"sodium"}"} -- normal 135 to 145 ::: ::: {#t1i_1.t.s3_1 data-top="538" data-oc="true" style="top: 538px; left: 113px;"}  ::: ::: {#t1j_1.t.s5_1 data-top="538" data-oc="true" style="top: 538px; left: 132px;"} Sweat glands stop functioning ::: ::: {#t1k_1.t.s3_1 data-top="552" data-oc="true" style="top: 552px; left: 94px;"}  ::: ::: {#t1l_1.t.s5_1 data-top="552" data-oc="true" style="top: 552px; left: 113px;"} S/S ::: ::: {#t1m_1.t.s7_1 data-top="552" data-oc="true" style="top: 552px; left: 131px;"} : ::: ::: {#t1n_1.t.s3_1 data-top="567" data-oc="true" style="top: 567px; left: 113px;"}  ::: ::: {#t1o_1.t.s5_1 data-top="567" data-oc="true" style="top: 567px; left: 132px;"} Core temperature rises within 10 to 15 minutes; higher than ::: ::: {#t1p_1.t.s5_1 data-top="567" data-oc="true" style="top: 567px; left: 435px;"} 105.8° F (41° C) ::: ::: {#t1q_1.t.s3_1 data-top="581" data-oc="true" style="top: 581px; left: 113px;"}  ::: ::: {#t1r_1.t.s5_1 data-top="581" data-oc="true" style="top: 581px; left: 132px;"} Altered mental status; ::: ::: {#t1s_1.t.s3_1 data-top="596" data-oc="true" style="top: 596px; left: 113px;"}  ::: ::: {#t1t_1.t.s5_1 data-top="596" data-oc="true" style="top: 596px; left: 132px;"} confusion leading to [[[coma]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-12968-12968" data-cha-target-name="concept-12968" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" data-gtm-vis-has-fired128233_971="1" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"12968","data-concept-text":"coma","data-ppo-id":"-12968","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"12968","ppoid":"-12968","text":"coma"}"}. ::: ::: {#t1u_1.t.s3_1 data-top="610" data-oc="true" style="top: 610px; left: 113px;"}  ::: ::: {#t1v_1.t.s5_1 data-top="610" data-oc="true" style="top: 610px; left: 132px;"} Hypotension, ::: ::: {#t1w_1.t.s3_1 data-top="625" data-oc="true" style="top: 625px; left: 113px;"}  ::: ::: {#t1x_1.t.s5_1 data-top="625" data-oc="true" style="top: 625px; left: 132px;"} [[[tachycardia]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-12196-12196" data-cha-target-name="concept-12196" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"12196","data-concept-text":"tachycardia","data-ppo-id":"-12196","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"12196","ppoid":"-12196","text":"tachycardia"}"}, ::: ::: {#t1y_1.t.s3_1 data-top="639" data-oc="true" style="top: 639px; left: 113px;"}  ::: ::: {#t1z_1.t.s5_1 data-top="639" data-oc="true" style="top: 639px; left: 132px;"} tachypnea, ::: ::: {#t20_1.t.s3_1 data-top="654" data-oc="true" style="top: 654px; left: 113px;"}  ::: ::: {#t21_1.t.s5_1 data-top="654" data-oc="true" style="top: 654px; left: 132px;"} weakness, ::: ::: {#t22_1.t.s3_1 data-top="668" data-oc="true" style="top: 668px; left: 113px;"}  ::: ::: {#t23_1.t.s5_1 data-top="668" data-oc="true" style="top: 668px; left: 132px;"} hot, dry skin; absence of perspiration, ::: ::: {#t24_1.t.s3_1 data-top="683" data-oc="true" style="top: 683px; left: 113px;"}  ::: ::: {#t25_1.t.s5_1 data-top="683" data-oc="true" style="top: 683px; left: 132px;"} Circulatory collapse ::: ::: {#t26_1.t.s3_1 data-top="697" data-oc="true" style="top: 697px; left: 94px;"}  ::: ::: {#t27_1.t.s5_1 data-top="697" data-oc="true" style="top: 697px; left: 113px;"} Brain is extremely sensitive to thermal injuries; can lead to cerebral edema and ::: ::: {#t28_1.t.s5_1 data-top="711" data-oc="true" style="top: 711px; left: 113px;"} [[[hemorrhage]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-7121-7121" data-cha-target-name="concept-7121" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"7121","data-concept-text":"hemorrhage","data-ppo-id":"-7121","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"7121","ppoid":"-7121","text":"hemorrhage"}"}. ::: ::: {#t29_1.t.s3_1 data-top="726" data-oc="true" style="top: 726px; left: 94px;"}  ::: ::: {#t2a_1.t.s5_1 data-top="726" data-oc="true" style="top: 726px; left: 113px;"} Death is related to amount of the patient's body temperature remains high ::: ::: ::: ::: ::: ::: {style="width: 640px; height: 829px;"} ::: ::: ::: ::: ::: ::: ::: {.e2INc1YuVeWZdIdivy+8wg==.tw-m-auto.!tw-p-8.!tw-rounded-none.tw-border-b-2.tw-border-b-gray-20.last:tw-border-b-0 style="min-height: 829px; width: 100%;"} ::: {.tw-m-auto style="width: 640px;"} ::: {data-testid="SSI_VIEWPORT_ROTATION_TEST_ID-0"} ::: {data-html-viewer-page="2"} ::: {data-frozen="true"} ::: {#html-prev-2 data-width="640" data-height="829" data-oc="true" style="display: none !important;"} ::: {.html-preview-text data-height="829" data-width="640" data-oc="true"} ::: {#pg2 data-oc="true" style="z-index: -1; background-image: url("/api/v1/documents/215530894/content/unlocked/background/2/");"} ::: ::: {data-block="true" data-originaltag="{"tagName":"div","attribs":{"data-slice-no":"0","class":"ch-page-slice","data-alt-height":"829","data-top":"0","style":"width: 640px; height: 829px; position: relative;"}}" data-props="{"dataAttribs":{"data-slice-no":0},"altHeight":"829","top":"0","style":"width: 640px; height: 829px; position: relative;","sliceNo":0}"} ::: {.ch-page-slice data-slice-no="0" data-top="0" data-alt-height="829" style="width: 640px; height: 829px; position: relative;"} ::: {data-slice-bg="true" style="position: absolute; width: 640px; height: 829px; overflow: hidden;"} ::: ::: {#t1_2.t.s1_2 data-top="75" data-oc="true" style="top: 75px; left: 94px;"}  ::: ::: {#t2_2.t.s2_2 data-top="75" data-oc="true" style="top: 75px; left: 113px;"} Prognosis is related to: Age, baseline health status, & length of exposure ::: ::: {#t3_2.t.s1_2 data-top="103" data-oc="true" style="top: 103px; left: 113px;"}  ::: ::: {#t4_2.t.s3_2 data-top="103" data-oc="true" style="top: 103px; left: 132px;"} Heatstroke Interprofessional Care (ABC) ::: ::: {#t5_2.t.s1_2 data-top="118" data-oc="true" style="top: 118px; left: 132px;"}  ::: ::: {#t6_2.t.s2_2 data-top="118" data-oc="true" style="top: 118px; left: 151px;"} Rapidly decrease core temperature to save [[[brain]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-5887-5887" data-cha-target-name="concept-5887" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"5887","data-concept-text":"brain","data-ppo-id":"-5887","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"5887","ppoid":"-5887","text":"brain"}"} and organs ::: ::: {#t7_2.t.s1_2 data-top="132" data-oc="true" style="top: 132px; left: 151px;"}  ::: ::: {#t8_2.t.s2_2 data-top="132" data-oc="true" style="top: 132px; left: 170px;"} Remove clothing ::: ::: {#t9_2.t.s1_2 data-top="147" data-oc="true" style="top: 147px; left: 151px;"}  ::: ::: {#ta_2.t.s2_2 data-top="147" data-oc="true" style="top: 147px; left: 170px;"} Cover with wet sheets ::: ::: {#tb_2.t.s1_2 data-top="161" data-oc="true" style="top: 161px; left: 151px;"}  ::: ::: {#tc_2.t.s2_2 data-top="161" data-oc="true" style="top: 161px; left: 170px;"} Place patient in front of large fan ::: ::: {#td_2.t.s1_2 data-top="176" data-oc="true" style="top: 176px; left: 151px;"}  ::: ::: {#te_2.t.s2_2 data-top="176" data-oc="true" style="top: 176px; left: 170px;"} Immerse in cool water bah ::: ::: {#tf_2.t.s1_2 data-top="190" data-oc="true" style="top: 190px; left: 151px;"}  ::: ::: {#tg_2.t.s2_2 data-top="190" data-oc="true" style="top: 190px; left: 170px;"} Apply ice packs to groins and [[[axilla]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-5264-5264" data-cha-target-name="concept-5264" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"5264","data-concept-text":"axilla","data-ppo-id":"-5264","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"5264","ppoid":"-5264","text":"axilla"}"} ::: ::: {#th_2.t.s1_2 data-top="205" data-oc="true" style="top: 205px; left: 151px;"}  ::: ::: {#ti_2.t.s2_2 data-top="205" data-oc="true" style="top: 205px; left: 170px;"} Peritoneal lavaging ::: ::: {#tj_2.t.s1_2 data-top="219" data-oc="true" style="top: 219px; left: 132px;"}  ::: ::: {#tk_2.t.s2_2 data-top="219" data-oc="true" style="top: 219px; left: 151px;"} Treatment of heatstroke: ::: ::: {#tl_2.t.s1_2 data-top="234" data-oc="true" style="top: 234px; left: 151px;"}  ::: ::: {#tm_2.t.s2_2 data-top="234" data-oc="true" style="top: 234px; left: 170px;"} Closely monitor temperature, ::: ::: {#tn_2.t.s1_2 data-top="248" data-oc="true" style="top: 248px; left: 151px;"}  ::: ::: {#to_2.t.s2_2 data-top="248" data-oc="true" style="top: 248px; left: 170px;"} control shivering: administer drugs to control shivering chlorpromazine ::: ::: {#tp_2.t.s2_2 data-top="262" data-oc="true" style="top: 262px; left: 170px;"} ( ::: ::: {#tq_2.t.s2_2 data-top="262" data-oc="true" style="top: 262px; left: 174px;"} Thorazine) IV, ::: ::: {#tr_2.t.s1_2 data-top="277" data-oc="true" style="top: 277px; left: 151px;"}  ::: ::: {#ts_2.t.s2_2 data-top="277" data-oc="true" style="top: 277px; left: 170px;"} monitor for rhabdomyolysis: check [[[urine]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-6521-6521" data-cha-target-name="concept-6521" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"6521","data-concept-text":"urine","data-ppo-id":"-6521","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"6521","ppoid":"-6521","text":"urine"}"} for color (dark tea color), amount, ::: ::: {#tt_2.t.s2_2 data-top="291" data-oc="true" style="top: 291px; left: 170px;"} pH, and myoglobin ::: ::: {#tu_2.t.s1_2 data-top="306" data-oc="true" style="top: 306px; left: 132px;"}  ::: ::: {#tv_2.t.s2_2 data-top="306" data-oc="true" style="top: 306px; left: 151px;"} Education: Avoid future problems. Proper hydration during hot weather and ::: ::: {#tw_2.t.s2_2 data-top="320" data-oc="true" style="top: 320px; left: 151px;"} exercise. Early signs and interventions for heat-related stress ::: ::: {#tx_2.t.s1_2 data-top="349" data-oc="true" style="top: 349px; left: 76px;"}  ::: ::: {#ty_2.t.s2_2 data-top="349" data-oc="true" style="top: 349px; left: 94px;"} Utilize the table below to differentiate the symptoms of heat cramps, heat exhaustion, & heat ::: ::: {#tz_2.t.s2_2 data-top="364" data-oc="true" style="top: 364px; left: 94px;"} stroke. ::: ::: {#t10_2.t.s2_2 data-top="408" data-oc="true" style="top: 408px; left: 94px;"} Heat Cramps ::: ::: {#t11_2.t.s2_2 data-top="408" data-oc="true" style="top: 408px; left: 258px;"} Heat Exhaustion ::: ::: {#t12_2.t.s2_2 data-top="408" data-oc="true" style="top: 408px; left: 421px;"} Heat Stroke ::: ::: {#t20_2.t.s4_2 data-top="437" data-oc="true" style="top: 437px; left: 402px;"}  ::: ::: {#t21_2.t.s5_2 data-top="437" data-oc="true" style="top: 437px; left: 421px;"} Emergency ::: ::: {#t13_2.t.s4_2 data-top="452" data-oc="true" style="top: 452px; left: 76px;"}  ::: ::: {#t14_2.t.s5_2 data-top="452" data-oc="true" style="top: 452px; left: 94px;"} Lowest heat ::: ::: {#t1c_2.t.s4_2 data-top="452" data-oc="true" style="top: 452px; left: 239px;"}  ::: ::: {#t1d_2.t.s5_2 data-top="452" data-oc="true" style="top: 452px; left: 258px;"} Moderate heat ::: ::: {#t22_2.t.s4_2 data-top="457" data-oc="true" style="top: 457px; left: 402px;"}  ::: ::: {#t23_2.t.s5_2 data-top="457" data-oc="true" style="top: 457px; left: 421px;"} Altered mental ::: ::: {#t15_2.t.s5_2 data-top="471" data-oc="true" style="top: 471px; left: 94px;"} severity ::: ::: {#t1e_2.t.s5_2 data-top="471" data-oc="true" style="top: 471px; left: 258px;"} severity ::: ::: {#t24_2.t.s5_2 data-top="476" data-oc="true" style="top: 476px; left: 421px;"} status (confused - ::: ::: {#t16_2.t.s4_2 data-top="491" data-oc="true" style="top: 491px; left: 76px;"}  ::: ::: {#t17_2.t.s5_2 data-top="491" data-oc="true" style="top: 491px; left: 94px;"} Severe muscle ::: ::: {#t1f_2.t.s4_2 data-top="491" data-oc="true" style="top: 491px; left: 239px;"}  ::: ::: {#t1g_2.t.s5_2 data-top="491" data-oc="true" style="top: 491px; left: 258px;"} Altered mental ::: ::: {#t25_2.t.s5_2 data-top="495" data-oc="true" style="top: 495px; left: 421px;"} [[[coma]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-12968-12968" data-cha-target-name="concept-12968" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"12968","data-concept-text":"coma","data-ppo-id":"-12968","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"12968","ppoid":"-12968","text":"coma"}"}) ::: ::: {#t18_2.t.s5_2 data-top="510" data-oc="true" style="top: 510px; left: 94px;"} contraction in ::: ::: {#t1h_2.t.s5_2 data-top="510" data-oc="true" style="top: 510px; left: 258px;"} status (anxiety) ::: ::: {#t26_2.t.s4_2 data-top="514" data-oc="true" style="top: 514px; left: 402px;"}  ::: ::: {#t27_2.t.s5_2 data-top="514" data-oc="true" style="top: 514px; left: 421px;"} Hot and dry ::: ::: {#t19_2.t.s5_2 data-top="529" data-oc="true" style="top: 529px; left: 94px;"} exerted muscles ::: ::: {#t1i_2.t.s4_2 data-top="529" data-oc="true" style="top: 529px; left: 239px;"}  ::: ::: {#t1j_2.t.s5_2 data-top="529" data-oc="true" style="top: 529px; left: 258px;"} Ashen, pale skin ::: ::: {#t28_2.t.s4_2 data-top="534" data-oc="true" style="top: 534px; left: 402px;"}  ::: ::: {#t29_2.t.s5_2 data-top="534" data-oc="true" style="top: 534px; left: 421px;"} Hypotension ::: ::: {#t1a_2.t.s4_2 data-top="548" data-oc="true" style="top: 548px; left: 76px;"}  ::: ::: {#t1b_2.t.s5_2 data-top="548" data-oc="true" style="top: 548px; left: 94px;"} Thirst ::: ::: {#t1k_2.t.s4_2 data-top="548" data-oc="true" style="top: 548px; left: 239px;"}  ::: ::: {#t1l_2.t.s5_2 data-top="548" data-oc="true" style="top: 548px; left: 258px;"} Extreme thirst ::: ::: {#t2a_2.t.s4_2 data-top="553" data-oc="true" style="top: 553px; left: 402px;"}  ::: ::: {#t2b_2.t.s5_2 data-top="553" data-oc="true" style="top: 553px; left: 421px;"} Tachypnea ::: ::: {#t1m_2.t.s4_2 data-top="568" data-oc="true" style="top: 568px; left: 239px;"}  ::: ::: {#t1n_2.t.s5_2 data-top="568" data-oc="true" style="top: 568px; left: 258px;"} [[[Fatigue]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-11476-11476" data-cha-target-name="concept-11476" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"11476","data-concept-text":"Fatigue","data-ppo-id":"-11476","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"11476","ppoid":"-11476","text":"Fatigue"}"}, weakness ::: ::: {#t2c_2.t.s4_2 data-top="572" data-oc="true" style="top: 572px; left: 402px;"}  ::: ::: {#t2d_2.t.s5_2 data-top="572" data-oc="true" style="top: 572px; left: 421px;"} [[[Tachycardia]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-12196-12196" data-cha-target-name="concept-12196" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"12196","data-concept-text":"Tachycardia","data-ppo-id":"-12196","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"12196","ppoid":"-12196","text":"Tachycardia"}"} ::: ::: {#t1o_2.t.s4_2 data-top="587" data-oc="true" style="top: 587px; left: 239px;"}  ::: ::: {#t1p_2.t.s5_2 data-top="587" data-oc="true" style="top: 587px; left: 258px;"} Hypotension ::: ::: {#t2e_2.t.s4_2 data-top="592" data-oc="true" style="top: 592px; left: 402px;"}  ::: ::: {#t2f_2.t.s5_2 data-top="592" data-oc="true" style="top: 592px; left: 421px;"} Temperature ::: ::: {#t1q_2.t.s4_2 data-top="606" data-oc="true" style="top: 606px; left: 239px;"}  ::: ::: {#t1r_2.t.s5_2 data-top="606" data-oc="true" style="top: 606px; left: 258px;"} Tachycardia ::: ::: {#t2g_2.t.s5_2 data-top="611" data-oc="true" style="top: 611px; left: 421px;"} \> 105.8 ::: ::: {#t1s_2.t.s4_2 data-top="625" data-oc="true" style="top: 625px; left: 239px;"}  ::: ::: {#t1t_2.t.s5_2 data-top="625" data-oc="true" style="top: 625px; left: 258px;"} Temperature ::: ::: {#t2h_2.t.s4_2 data-top="630" data-oc="true" style="top: 630px; left: 402px;"}  ::: ::: {#t2i_2.t.s5_2 data-top="630" data-oc="true" style="top: 630px; left: 421px;"} weakness ::: ::: {#t1u_2.t.s5_2 data-top="645" data-oc="true" style="top: 645px; left: 258px;"} elevation 99.6 to ::: ::: {#t1v_2.t.s5_2 data-top="664" data-oc="true" style="top: 664px; left: 258px;"} 105.8 ::: ::: {#t1w_2.t.s4_2 data-top="683" data-oc="true" style="top: 683px; left: 239px;"}  ::: ::: {#t1x_2.t.s5_2 data-top="683" data-oc="true" style="top: 683px; left: 258px;"} Weak thready pulse ::: ::: {#t1z_2.t.s5_2 data-top="703" data-oc="true" style="top: 703px; left: 258px;"} Profuse sweating ::: ::: {#t1y_2.t.s1_2 data-top="707" data-oc="true" style="top: 707px; left: 239px;"}  ::: ::: ::: ::: ::: ::: {style="width: 640px; height: 829px;"} ::: ::: ::: ::: ::: ::: ::: {.e2INc1YuVeWZdIdivy+8wg==.tw-m-auto.!tw-p-8.!tw-rounded-none.tw-border-b-2.tw-border-b-gray-20.last:tw-border-b-0 style="min-height: 829px; width: 100%;"} ::: {.tw-m-auto style="width: 640px;"} ::: {data-testid="SSI_VIEWPORT_ROTATION_TEST_ID-0"} ::: {data-html-viewer-page="3"} ::: {data-frozen="true"} ::: {#html-prev-3 data-width="640" data-height="829" data-oc="true" style="display: none !important;"} ::: {.html-preview-text data-height="829" data-width="640" data-oc="true"} ::: {#pg3 data-oc="true" style="z-index: -1; background-image: url("/api/v1/documents/215530894/content/unlocked/background/3/");"} ::: ::: {data-block="true" data-originaltag="{"tagName":"div","attribs":{"data-slice-no":"0","class":"ch-page-slice","data-alt-height":"829","data-top":"0","style":"width: 640px; height: 829px; position: relative;"}}" data-props="{"dataAttribs":{"data-slice-no":0},"altHeight":"829","top":"0","style":"width: 640px; height: 829px; position: relative;","sliceNo":0}"} ::: {.ch-page-slice data-slice-no="0" data-top="0" data-alt-height="829" style="width: 640px; height: 829px; position: relative;"} ::: {data-slice-bg="true" style="position: absolute; width: 640px; height: 829px; overflow: hidden;"} ![](./MOC%20III%20EXAM%204%20STUDY%20GUIDE.docx_files/saved_resource(2)){.tw-pointer-events-none} ::: ::: {#t1_3.t.s1_3 data-top="178" data-oc="true" style="top: 178px; left: 76px;"}  ::: ::: {#t2_3.t.s2_3 data-top="178" data-oc="true" style="top: 178px; left: 94px;"} Frostbite ::: ::: {#t3_3.t.s1_3 data-top="192" data-oc="true" style="top: 192px; left: 94px;"}  ::: ::: {#t4_3.t.s3_3 data-top="192" data-oc="true" style="top: 192px; left: 113px;"} True tissue freezing that results in the formation of ice crystals in the tissues and cells. ::: ::: {#t5_3.t.s3_3 data-top="207" data-oc="true" style="top: 207px; left: 113px;"} (Causes really more of ::: ::: {#t6_3.t.s2_3 data-top="207" data-oc="true" style="top: 207px; left: 231px;"} localized ::: ::: {#t7_3.t.s3_3 data-top="207" data-oc="true" style="top: 207px; left: 280px;"} effect, injury is localized to wherever may have been ::: ::: {#t8_3.t.s3_3 data-top="221" data-oc="true" style="top: 221px; left: 113px;"} exposed to extreme temperature or potentially was not prevented from being exposed- ::: ::: {#t9_3.t.s3_3 data-top="235" data-oc="true" style="top: 235px; left: 113px;"} example toes, fingers, tip of nose) ::: ::: {#ta_3.t.s1_3 data-top="250" data-oc="true" style="top: 250px; left: 113px;"}  ::: ::: {#tb_3.t.s3_3 data-top="250" data-oc="true" style="top: 250px; left: 132px;"} Accompanied by initial pain, numbness, pallor of affected area ::: ::: {#tc_3.t.s1_3 data-top="264" data-oc="true" style="top: 264px; left: 113px;"}  ::: ::: {#td_3.t.s3_3 data-top="264" data-oc="true" style="top: 264px; left: 132px;"} Deep frostbite requires aggressive management in a medical facility ::: ::: {#te_3.t.s1_3 data-top="293" data-oc="true" style="top: 293px; left: 94px;"}  ::: ::: {#tf_3.t.s2_3 data-top="293" data-oc="true" style="top: 293px; left: 113px;"} Superficial ::: ::: {#tg_3.t.s3_3 data-top="293" data-oc="true" style="top: 293px; left: 172px;"} : Pale to blue skin to mottled, crunchy ski, tingling, numbness or burning ::: ::: {#th_3.t.s1_3 data-top="308" data-oc="true" style="top: 308px; left: 113px;"}  ::: ::: {#ti_3.t.s3_3 data-top="308" data-oc="true" style="top: 308px; left: 132px;"} Big blisters ::: ::: {#tj_3.t.s3_3 data-top="308" data-oc="true" style="top: 308px; left: 193px;"} formation. Handle blisters with care -- do NOT squeeze, [[[massage]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-11671-11671" data-cha-target-name="concept-11671" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"11671","data-concept-text":"massage","data-ppo-id":"-11671","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"11671","ppoid":"-11671","text":"massage"}"}, rub ::: ::: {#tk_3.t.s3_3 data-top="322" data-oc="true" style="top: 322px; left: 132px;"} these areas. Anything that causes that friction force can cause more tissue injury. ::: ::: {#tl_3.t.s3_3 data-top="337" data-oc="true" style="top: 337px; left: 132px;"} Usually swelling can occur with thawing (defrosting) remove any jewelry that could ::: ::: {#tm_3.t.s3_3 data-top="351" data-oc="true" style="top: 351px; left: 132px;"} ultimately become a tourniquet when swelling begins to occur. ::: ::: {#tn_3.t.s1_3 data-top="366" data-oc="true" style="top: 366px; left: 94px;"}  ::: ::: {#to_3.t.s2_3 data-top="366" data-oc="true" style="top: 366px; left: 113px;"} Deep ::: ::: {#tp_3.t.s3_3 data-top="366" data-oc="true" style="top: 366px; left: 140px;"} : ::: ::: {#tq_3.t.s1_3 data-top="380" data-oc="true" style="top: 380px; left: 113px;"}  ::: ::: {#tr_3.t.s3_3 data-top="380" data-oc="true" style="top: 380px; left: 132px;"} Involves muscle, [[[bone]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-5132-5132" data-cha-target-name="concept-5132" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"5132","data-concept-text":"bone","data-ppo-id":"-5132","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"5132","ppoid":"-5132","text":"bone"}"}, [[[tendon]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-5116-5116" data-cha-target-name="concept-5116" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"5116","data-concept-text":"tendon","data-ppo-id":"-5116","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"5116","ppoid":"-5116","text":"tendon"}"} ::: ::: {#ts_3.t.s1_3 data-top="394" data-oc="true" style="top: 394px; left: 113px;"}  ::: ::: {#tt_3.t.s3_3 data-top="394" data-oc="true" style="top: 394px; left: 132px;"} White, hard, insensitive to touch ::: ::: {#tu_3.t.s1_3 data-top="409" data-oc="true" style="top: 409px; left: 94px;"}  ::: ::: {#tv_3.t.s3_3 data-top="409" data-oc="true" style="top: 409px; left: 113px;"} Tx: ::: ::: {#tw_3.t.s3_3 data-top="409" data-oc="true" style="top: 409px; left: 134px;"} rewarming (for both superficial and deep)-- immersing that extremity in a ::: ::: {#tx_3.t.s3_3 data-top="423" data-oc="true" style="top: 423px; left: 113px;"} temperature-controlled circulating water that is usually around 98.6 to 104 degrees F, ::: ::: {#ty_3.t.s3_3 data-top="438" data-oc="true" style="top: 438px; left: 113px;"} debride blisters will cover with sterile dressing, avoid heavy blankets & clothing ::: ::: {#tz_3.t.s3_3 data-top="438" data-oc="true" style="top: 438px; left: 518px;"} , ::: ::: {#t10_3.t.s3_3 data-top="452" data-oc="true" style="top: 452px; left: 113px;"} analgesia (oral NSAIDS, or IV for severe frostbite) if treatment is unsuccessful requires ::: ::: {#t11_3.t.s3_3 data-top="467" data-oc="true" style="top: 467px; left: 113px;"} amputation, can lead to gangrenous necrosis ::: ::: {#t12_3.t.s3_3 data-top="467" data-oc="true" style="top: 467px; left: 336px;"}. ::: ::: {#t13_3.t.s1_3 data-top="510" data-oc="true" style="top: 510px; left: 76px;"}  ::: ::: {#t14_3.t.s2_3 data-top="510" data-oc="true" style="top: 510px; left: 94px;"} [[[Hypothermia]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-11581-11581" data-cha-target-name="concept-11581" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"11581","data-concept-text":"Hypothermia","data-ppo-id":"-11581","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"11581","ppoid":"-11581","text":"Hypothermia"}"} ::: ::: {#t15_3.t.s1_3 data-top="525" data-oc="true" style="top: 525px; left: 94px;"}  ::: ::: {#t16_3.t.s3_3 data-top="525" data-oc="true" style="top: 525px; left: 113px;"} Core temperature ::: ::: {#t17_3.t.s3_3 data-top="525" data-oc="true" style="top: 525px; left: 204px;"} \ 6 to 12 hrs old ::: ::: {#tj_9.t.s1_9 data-top="219" data-oc="true" style="top: 219px; left: 132px;"}  ::: ::: {#tk_9.t.s2_9 data-top="219" data-oc="true" style="top: 219px; left: 151px;"} Puncture wounds ::: ::: {#tl_9.t.s1_9 data-top="234" data-oc="true" style="top: 234px; left: 132px;"}  ::: ::: {#tm_9.t.s2_9 data-top="234" data-oc="true" style="top: 234px; left: 151px;"} Bites on hand on foot -- related anatomically by proximity of the [[[bone]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-5132-5132" data-cha-target-name="concept-5132" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"5132","data-concept-text":"bone","data-ppo-id":"-5132","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"5132","ppoid":"-5132","text":"bone"}"}, and also ::: ::: {#tn_9.t.s2_9 data-top="248" data-oc="true" style="top: 248px; left: 151px;"} related to [[[blood]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-5982-5982" data-cha-target-name="concept-5982" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"5982","data-concept-text":"blood","data-ppo-id":"-5982","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"5982","ppoid":"-5982","text":"blood"}"} flow to those areas ::: ::: {#to_9.t.s1_9 data-top="262" data-oc="true" style="top: 262px; left: 113px;"}  ::: ::: {#tp_9.t.s2_9 data-top="262" data-oc="true" style="top: 262px; left: 132px;"} Puncture wounds left open: dog or cat bite for high risk for infection ::: ::: {#tq_9.t.s1_9 data-top="277" data-oc="true" style="top: 277px; left: 113px;"}  ::: ::: {#tr_9.t.s2_9 data-top="277" data-oc="true" style="top: 277px; left: 132px;"} [[[Lacerations]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-7608-7608" data-cha-target-name="concept-7608" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"7608","data-concept-text":"Lacerations","data-ppo-id":"-7608","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"7608","ppoid":"-7608","text":"Lacerations"}"} loosely sutured: not too tight to not trap the [[[bacteria]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-8028-8028" data-cha-target-name="concept-8028" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"8028","data-concept-text":"bacteria","data-ppo-id":"-8028","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"8028","ppoid":"-8028","text":"bacteria"}"} ::: ::: {#ts_9.t.s1_9 data-top="291" data-oc="true" style="top: 291px; left: 113px;"}  ::: ::: {#tt_9.t.s2_9 data-top="291" data-oc="true" style="top: 291px; left: 132px;"} Wounds over joints splinted ::: ::: {#tu_9.t.s1_9 data-top="306" data-oc="true" style="top: 306px; left: 113px;"}  ::: ::: {#tv_9.t.s2_9 data-top="306" data-oc="true" style="top: 306px; left: 132px;"} Rabies prophylaxis ::: ::: {#tw_9.t.s2_9 data-top="306" data-oc="true" style="top: 306px; left: 232px;"} essential in management of animal bites ::: ::: {#tx_9.t.s1_9 data-top="320" data-oc="true" style="top: 320px; left: 113px;"}  ::: ::: {#ty_9.t.s2_9 data-top="320" data-oc="true" style="top: 320px; left: 132px;"} Initial injection of weight-based rabies immune [[[globulin]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-8954-8954" data-cha-target-name="concept-8954" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"8954","data-concept-text":"globulin","data-ppo-id":"-8954","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"8954","ppoid":"-8954","text":"globulin"}"} (RIG) around wound edges ::: ::: {#tz_9.t.s1_9 data-top="335" data-oc="true" style="top: 335px; left: 113px;"}  ::: ::: {#t10_9.t.s2_9 data-top="335" data-oc="true" style="top: 335px; left: 132px;"} Followed by a series of five IM injections of human diploid cell vaccine (HDCV): ::: ::: {#t11_9.t.s2_9 data-top="349" data-oc="true" style="top: 349px; left: 132px;"} Days 0, 3, 7, and 14 ::: ::: {#t12_9.t.s1_9 data-top="378" data-oc="true" style="top: 378px; left: 76px;"}  ::: ::: {#t13_9.t.s3_9 data-top="378" data-oc="true" style="top: 378px; left: 94px;"} Poisonings ::: ::: {#t14_9.t.s1_9 data-top="393" data-oc="true" style="top: 393px; left: 94px;"}  ::: ::: {#t15_9.t.s2_9 data-top="393" data-oc="true" style="top: 393px; left: 113px;"} Accidental or intentional, recreational exposure, occupational exposure ::: ::: {#t16_9.t.s1_9 data-top="407" data-oc="true" style="top: 407px; left: 94px;"}  ::: ::: {#t17_9.t.s2_9 data-top="407" data-oc="true" style="top: 407px; left: 113px;"} Can be ingested, inhaled, injected, splashed in the eye, or absorbed through the skin ::: ::: {#t18_9.t.s1_9 data-top="421" data-oc="true" style="top: 421px; left: 94px;"}  ::: ::: {#t19_9.t.s2_9 data-top="421" data-oc="true" style="top: 421px; left: 113px;"} Severity depends on type, concentrations, and route of exposure. ::: ::: {#t1a_9.t.s1_9 data-top="436" data-oc="true" style="top: 436px; left: 94px;"}  ::: ::: {#t1b_9.t.s2_9 data-top="436" data-oc="true" style="top: 436px; left: 113px;"} Consult poison control ::: ::: {#t1c_9.t.s1_9 data-top="450" data-oc="true" style="top: 450px; left: 94px;"}  ::: ::: {#t1d_9.t.s2_9 data-top="450" data-oc="true" style="top: 450px; left: 113px;"} Decontamination takes priority ::: ::: {#t1e_9.t.s1_9 data-top="465" data-oc="true" style="top: 465px; left: 94px;"}  ::: ::: {#t1f_9.t.s2_9 data-top="465" data-oc="true" style="top: 465px; left: 113px;"} Examples: acetaminophen, acids & alkalis, bleaches, carbon monoxide, cyanide, ethylene ::: ::: {#t1g_9.t.s2_9 data-top="479" data-oc="true" style="top: 479px; left: 113px;"} glycol, iron, NSAIDs, TCAs, [[[ETOH]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-8691-8691" data-cha-target-name="concept-8691" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"8691","data-concept-text":"ETOH","data-ppo-id":"-8691","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"8691","ppoid":"-8691","text":"ETOH"}"}, benozs, [[[opiates]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-12260-12260" data-cha-target-name="concept-12260" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"12260","data-concept-text":"opiates","data-ppo-id":"-12260","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"12260","ppoid":"-12260","text":"opiates"}"}, cocaine, hallucinogens ::: ::: {#t1h_9.t.s1_9 data-top="508" data-oc="true" style="top: 508px; left: 94px;"}  ::: ::: {#t1i_9.t.s3_9 data-top="508" data-oc="true" style="top: 508px; left: 113px;"} [[[Activated charcoal]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-14754-14754" data-cha-target-name="concept-14754" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"14754","data-concept-text":"Activated charcoal","data-ppo-id":"-14754","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"14754","ppoid":"-14754","text":"Activated charcoal"}"}- ::: ::: {#t1j_9.t.s1_9 data-top="523" data-oc="true" style="top: 523px; left: 113px;"}  ::: ::: {#t1k_9.t.s2_9 data-top="523" data-oc="true" style="top: 523px; left: 132px;"} Most effective intervention. ::: ::: {#t1l_9.t.s1_9 data-top="537" data-oc="true" style="top: 537px; left: 113px;"}  ::: ::: {#t1m_9.t.s2_9 data-top="537" data-oc="true" style="top: 537px; left: 132px;"} Administer orally or via gastric tube within 60 minutes of poison ingestion ::: ::: {#t1n_9.t.s1_9 data-top="552" data-oc="true" style="top: 552px; left: 94px;"}  ::: ::: {#t1o_9.t.s2_9 data-top="552" data-oc="true" style="top: 552px; left: 113px;"} Contraindications: Diminished [[[bowel]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-6273-6273" data-cha-target-name="concept-6273" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"6273","data-concept-text":"bowel","data-ppo-id":"-6273","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"6273","ppoid":"-6273","text":"bowel"}"} sounds, Paralytic ileus, Ingestion of substance ::: ::: {#t1p_9.t.s2_9 data-top="566" data-oc="true" style="top: 566px; left: 113px;"} poorly absorbed by charcoal. ::: ::: {#t1q_9.t.s1_9 data-top="580" data-oc="true" style="top: 580px; left: 113px;"}  ::: ::: {#t1r_9.t.s2_9 data-top="580" data-oc="true" style="top: 580px; left: 132px;"} Many toxins adhere to charcoal and pass through the GI tract rather than being ::: ::: {#t1s_9.t.s2_9 data-top="595" data-oc="true" style="top: 595px; left: 132px;"} absorbed into circulation ::: ::: {#t1t_9.t.s1_9 data-top="609" data-oc="true" style="top: 609px; left: 94px;"}  ::: ::: {#t1u_9.t.s2_9 data-top="609" data-oc="true" style="top: 609px; left: 113px;"} Charcoal can absorb and neutralize [[[antibiotics]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-8192-8192" data-cha-target-name="concept-8192" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"8192","data-concept-text":"antibiotics","data-ppo-id":"-8192","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"8192","ppoid":"-8192","text":"antibiotics"}"}: do not give immediately before, or shortly ::: ::: {#t1v_9.t.s2_9 data-top="624" data-oc="true" style="top: 624px; left: 113px;"} after [[[charcoal]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-14754-14754" data-cha-target-name="concept-14754" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"14754","data-concept-text":"charcoal","data-ppo-id":"-14754","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"14754","ppoid":"-14754","text":"charcoal"}"}. ::: ::: {#t1w_9.t.s1_9 data-top="667" data-oc="true" style="top: 667px; left: 76px;"}  ::: ::: {#t1x_9.t.s2_9 data-top="667" data-oc="true" style="top: 667px; left: 94px;"} Enhance elimination ::: ::: {#t1y_9.t.s1_9 data-top="682" data-oc="true" style="top: 682px; left: 94px;"}  ::: ::: {#t1z_9.t.s2_9 data-top="682" data-oc="true" style="top: 682px; left: 113px;"} Cathartics (e.g., sorbitol) ::: ::: {#t20_9.t.s1_9 data-top="696" data-oc="true" style="top: 696px; left: 113px;"}  ::: ::: {#t21_9.t.s2_9 data-top="696" data-oc="true" style="top: 696px; left: 132px;"} Give with first dose of charcoal to stimulate intestinal motility/increase elimination ::: ::: {#t22_9.t.s1_9 data-top="711" data-oc="true" style="top: 711px; left: 94px;"}  ::: ::: {#t23_9.t.s2_9 data-top="711" data-oc="true" style="top: 711px; left: 113px;"} Whole-bowel irrigation ::: ::: {#t24_9.t.s1_9 data-top="725" data-oc="true" style="top: 725px; left: 94px;"}  ::: ::: {#t25_9.t.s2_9 data-top="725" data-oc="true" style="top: 725px; left: 113px;"} Giving cathartics, [[[bowel]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-6273-6273" data-cha-target-name="concept-6273" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"6273","data-concept-text":"bowel","data-ppo-id":"-6273","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"6273","ppoid":"-6273","text":"bowel"}"} irrigation can help increase the elimination of poisons ::: ::: ::: ::: ::: ::: {style="width: 640px; height: 829px;"} ::: ::: ::: ::: ::: ::: ::: {.e2INc1YuVeWZdIdivy+8wg==.tw-m-auto.!tw-p-8.!tw-rounded-none.tw-border-b-2.tw-border-b-gray-20.last:tw-border-b-0 style="min-height: 829px; width: 100%;"} ::: {.tw-m-auto style="width: 640px;"} ::: {data-testid="SSI_VIEWPORT_ROTATION_TEST_ID-0"} ::: {data-html-viewer-page="10"} ::: {data-frozen="true"} ::: {#html-prev-10 data-width="640" data-height="829" data-oc="true" style="display: none !important;"} ::: {.html-preview-text data-height="829" data-width="640" data-oc="true"} ::: {#pg10 data-oc="true" style="z-index: -1; background-image: url("/api/v1/documents/215530894/content/unlocked/background/10/");"} ::: ::: {data-block="true" data-originaltag="{"tagName":"div","attribs":{"data-slice-no":"0","class":"ch-page-slice","data-alt-height":"829","data-top":"0","style":"width: 640px; height: 829px; position: relative;"}}" data-props="{"dataAttribs":{"data-slice-no":0},"altHeight":"829","top":"0","style":"width: 640px; height: 829px; position: relative;","sliceNo":0}"} ::: {.ch-page-slice data-slice-no="0" data-top="0" data-alt-height="829" style="width: 640px; height: 829px; position: relative;"} ::: {data-slice-bg="true" style="position: absolute; width: 640px; height: 829px; overflow: hidden;"} ::: ::: {#t1_10.t.s1_10 data-top="75" data-oc="true" style="top: 75px; left: 113px;"}  ::: ::: {#t2_10.t.s2_10 data-top="75" data-oc="true" style="top: 75px; left: 132px;"} Cathartic such as Sorbitol these are giving together with the first dose of activate ::: ::: {#t3_10.t.s2_10 data-top="89" data-oc="true" style="top: 89px; left: 132px;"} [[[charcoal]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-14754-14754" data-cha-target-name="concept-14754" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"14754","data-concept-text":"charcoal","data-ppo-id":"-14754","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"14754","ppoid":"-14754","text":"charcoal"}"} to stimulate intestinal mobility and increase elimination ::: ::: {#t4_10.t.s1_10 data-top="103" data-oc="true" style="top: 103px; left: 113px;"}  ::: ::: {#t5_10.t.s2_10 data-top="103" data-oc="true" style="top: 103px; left: 132px;"} Avoid multiple doses of cathartic because it can lead to potentially fatal [[[electrolyte]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-6908-6908" data-cha-target-name="concept-6908" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"6908","data-concept-text":"electrolyte","data-ppo-id":"-6908","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"6908","ppoid":"-6908","text":"electrolyte"}"} ::: ::: {#t6_10.t.s2_10 data-top="118" data-oc="true" style="top: 118px; left: 132px;"} abnormalities ::: ::: {#t7_10.t.s1_10 data-top="132" data-oc="true" style="top: 132px; left: 113px;"}  ::: ::: {#t8_10.t.s2_10 data-top="132" data-oc="true" style="top: 132px; left: 132px;"} Bowel irrigation can be controversial, but it can be effective for swallowed objects ::: ::: {#t9_10.t.s2_10 data-top="147" data-oc="true" style="top: 147px; left: 132px;"} such as cocaine filled balloons or condoms and heavy metals such as lead and ::: ::: {#ta_10.t.s2_10 data-top="161" data-oc="true" style="top: 161px; left: 132px;"} mercury. There is a risk of electrolyte imbalances with this approach as well. ::: ::: {#tb_10.t.s1_10 data-top="220" data-oc="true" style="top: 220px; left: 76px;"}  ::: ::: {#tc_10.t.s2_10 data-top="220" data-oc="true" style="top: 220px; left: 94px;"} Hemodialysis/hemoperfusion ::: ::: {#td_10.t.s1_10 data-top="234" data-oc="true" style="top: 234px; left: 94px;"}  ::: ::: {#te_10.t.s2_10 data-top="234" data-oc="true" style="top: 234px; left: 113px;"} Reserved for severe acidosis from ingestion of toxic substances like [[[aspirin]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-12072-12072" data-cha-target-name="concept-12072" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"12072","data-concept-text":"aspirin","data-ppo-id":"-12072","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"12072","ppoid":"-12072","text":"aspirin"}"} ::: ::: {#tf_10.t.s1_10 data-top="248" data-oc="true" style="top: 248px; left: 94px;"}  ::: ::: {#tg_10.t.s2_10 data-top="248" data-oc="true" style="top: 248px; left: 113px;"} [[[Urine]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-6521-6521" data-cha-target-name="concept-6521" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"6521","data-concept-text":"Urine","data-ppo-id":"-6521","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"6521","ppoid":"-6521","text":"Urine"}"} alkalinization ::: ::: {#th_10.t.s1_10 data-top="263" data-oc="true" style="top: 263px; left: 113px;"}  ::: ::: {#ti_10.t.s2_10 data-top="263" data-oc="true" style="top: 263px; left: 132px;"} Phenobarbital and salicylate poisoning ::: ::: {#tj_10.t.s1_10 data-top="277" data-oc="true" style="top: 277px; left: 94px;"}  ::: ::: {#tk_10.t.s2_10 data-top="277" data-oc="true" style="top: 277px; left: 113px;"} Chelating agents ::: ::: {#tl_10.t.s1_10 data-top="292" data-oc="true" style="top: 292px; left: 113px;"}  ::: ::: {#tm_10.t.s2_10 data-top="292" data-oc="true" style="top: 292px; left: 132px;"} ↑ [[[Amphetamine]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-14076-14076" data-cha-target-name="concept-14076" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"14076","data-concept-text":"Amphetamine","data-ppo-id":"-14076","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"14076","ppoid":"-14076","text":"Amphetamine"}"} and quinidine excretion ::: ::: {#tn_10.t.s1_10 data-top="306" data-oc="true" style="top: 306px; left: 94px;"}  ::: ::: {#to_10.t.s2_10 data-top="306" data-oc="true" style="top: 306px; left: 113px;"} Antidotes ::: ::: {#tp_10.t.s1_10 data-top="321" data-oc="true" style="top: 321px; left: 113px;"}  ::: ::: {#tq_10.t.s2_10 data-top="321" data-oc="true" style="top: 321px; left: 132px;"} Very few available ::: ::: {#tr_10.t.s1_10 data-top="379" data-oc="true" style="top: 379px; left: 76px;"}  ::: ::: {#ts_10.t.s3_10 data-top="379" data-oc="true" style="top: 379px; left: 94px;"} Poisonings: Common Agents ::: ::: {#tt_10.t.s1_10 data-top="408" data-oc="true" style="top: 408px; left: 94px;"}  ::: ::: {#tu_10.t.s2_10 data-top="408" data-oc="true" style="top: 408px; left: 113px;"} Toxin-specific interventions per poison control center ::: ::: {#tv_10.t.s1_10 data-top="423" data-oc="true" style="top: 423px; left: 94px;"}  ::: ::: {#tw_10.t.s4_10 data-top="423" data-oc="true" style="top: 423px; left: 113px;"} Acetaminophen (seen with intentional overdoses) ::: ::: {#tx_10.t.s1_10 data-top="437" data-oc="true" style="top: 437px; left: 132px;"}  ::: ::: {#ty_10.t.s2_10 data-top="437" data-oc="true" style="top: 437px; left: 151px;"} [[[Malaise]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-13965-13965" data-cha-target-name="concept-13965" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"13965","data-concept-text":"Malaise","data-ppo-id":"-13965","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"13965","ppoid":"-13965","text":"Malaise"}"}, N/V, Liver failure within 1-2 days: ALT and AST high ::: ::: {#tz_10.t.s1_10 data-top="451" data-oc="true" style="top: 451px; left: 132px;"}  ::: ::: {#t10_10.t.s2_10 data-top="451" data-oc="true" style="top: 451px; left: 151px;"} Antidote: ::: ::: {#t11_10.t.s2_10 data-top="451" data-oc="true" style="top: 451px; left: 202px;"} N-acetylcysteine (Mucomyst) or [[[activated charcoal]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-14754-14754" data-cha-target-name="concept-14754" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"14754","data-concept-text":"activated charcoal","data-ppo-id":"-14754","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"14754","ppoid":"-14754","text":"activated charcoal"}"} ::: ::: {#t12_10.t.s1_10 data-top="466" data-oc="true" style="top: 466px; left: 94px;"}  ::: ::: {#t13_10.t.s4_10 data-top="466" data-oc="true" style="top: 466px; left: 113px;"} Acids or Alkalis ::: ::: {#t14_10.t.s2_10 data-top="466" data-oc="true" style="top: 466px; left: 196px;"} (bleach, lye, drain cleaner, detergent, ammonia) ::: ::: {#t15_10.t.s1_10 data-top="480" data-oc="true" style="top: 480px; left: 132px;"}  ::: ::: {#t16_10.t.s2_10 data-top="480" data-oc="true" style="top: 480px; left: 151px;"} Caustic burns and tissue destruction. If it is on the skin or dermal ::: ::: {#t17_10.t.s1_10 data-top="495" data-oc="true" style="top: 495px; left: 132px;"}  ::: ::: {#t18_10.t.s2_10 data-top="495" data-oc="true" style="top: 495px; left: 151px;"} Dilution with water or [[[milk]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-14895-14895" data-cha-target-name="concept-14895" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"14895","data-concept-text":"milk","data-ppo-id":"-14895","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"14895","ppoid":"-14895","text":"milk"}"} ::: ::: {#t19_10.t.s1_10 data-top="509" data-oc="true" style="top: 509px; left: 132px;"}  ::: ::: {#t1a_10.t.s2_10 data-top="509" data-oc="true" style="top: 509px; left: 151px;"} [[[Corticosteroids]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-13028-13028" data-cha-target-name="concept-13028" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"13028","data-concept-text":"Corticosteroids","data-ppo-id":"-13028","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"13028","ppoid":"-13028","text":"Corticosteroids"}"} for alkali burns ::: ::: {#t1b_10.t.s1_10 data-top="524" data-oc="true" style="top: 524px; left: 132px;"}  ::: ::: {#t1c_10.t.s2_10 data-top="524" data-oc="true" style="top: 524px; left: 151px;"} Gastric lavage for ingestion ::: ::: {#t1d_10.t.s1_10 data-top="538" data-oc="true" style="top: 538px; left: 170px;"}  ::: ::: {#t1e_10.t.s2_10 data-top="538" data-oc="true" style="top: 538px; left: 189px;"} Do not induce [[[vomiting]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-11634-11634" data-cha-target-name="concept-11634" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"11634","data-concept-text":"vomiting","data-ppo-id":"-11634","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"11634","ppoid":"-11634","text":"vomiting"}"} ::: ::: {#t1f_10.t.s1_10 data-top="567" data-oc="true" style="top: 567px; left: 94px;"}  ::: ::: {#t1g_10.t.s4_10 data-top="567" data-oc="true" style="top: 567px; left: 113px;"} ASA ([[[aspirin]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-12072-12072" data-cha-target-name="concept-12072" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"12072","data-concept-text":"aspirin","data-ppo-id":"-12072","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"12072","ppoid":"-12072","text":"aspirin"}"} is a salicylate that has antiplalet effects) ::: ::: {#t1h_10.t.s1_10 data-top="582" data-oc="true" style="top: 582px; left: 132px;"}  ::: ::: {#t1i_10.t.s2_10 data-top="582" data-oc="true" style="top: 582px; left: 151px;"} [[[Hemorrhage]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-7121-7121" data-cha-target-name="concept-7121" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"7121","data-concept-text":"Hemorrhage","data-ppo-id":"-7121","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"7121","ppoid":"-7121","text":"Hemorrhage"}"}, tachy, hyperthermic, [[[seizure]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-12152-12152" data-cha-target-name="concept-12152" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"12152","data-concept-text":"seizure","data-ppo-id":"-12152","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"12152","ppoid":"-12152","text":"seizure"}"}, acidosis ::: ::: {#t1j_10.t.s1_10 data-top="596" data-oc="true" style="top: 596px; left: 132px;"}  ::: ::: {#t1k_10.t.s2_10 data-top="596" data-oc="true" style="top: 596px; left: 151px;"} Tx: Charcoal, hemodialysis, acid-base support ::: ::: {#t1l_10.t.s1_10 data-top="611" data-oc="true" style="top: 611px; left: 94px;"}  ::: ::: {#t1m_10.t.s4_10 data-top="611" data-oc="true" style="top: 611px; left: 113px;"} Carbon Monoxide (colorless, odorless gas) ::: ::: {#t1n_10.t.s1_10 data-top="625" data-oc="true" style="top: 625px; left: 132px;"}  ::: ::: {#t1o_10.t.s2_10 data-top="625" data-oc="true" style="top: 625px; left: 151px;"} [[[Dyspnea]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-12291-12291" data-cha-target-name="concept-12291" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"12291","data-concept-text":"Dyspnea","data-ppo-id":"-12291","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"12291","ppoid":"-12291","text":"Dyspnea"}"}, headache, tachypnea, confusion, cyanosis, RF ::: ::: {#t1p_10.t.s1_10 data-top="640" data-oc="true" style="top: 640px; left: 132px;"}  ::: ::: {#t1q_10.t.s2_10 data-top="640" data-oc="true" style="top: 640px; left: 151px;"} Stop exposure and resp. support (ventilate as needed) ::: ::: {#t1r_10.t.s1_10 data-top="654" data-oc="true" style="top: 654px; left: 94px;"}  ::: ::: {#t1s_10.t.s4_10 data-top="654" data-oc="true" style="top: 654px; left: 113px;"} NSAIDS ::: ::: {#t1t_10.t.s1_10 data-top="668" data-oc="true" style="top: 668px; left: 132px;"}  ::: ::: {#t1u_10.t.s2_10 data-top="668" data-oc="true" style="top: 668px; left: 151px;"} [[[GI]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-6273-6273" data-cha-target-name="concept-6273" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"6273","data-concept-text":"GI","data-ppo-id":"-6273","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"6273","ppoid":"-6273","text":"GI"}"}, Renal and hepatic damage ::: ::: {#t1v_10.t.s1_10 data-top="683" data-oc="true" style="top: 683px; left: 132px;"}  ::: ::: {#t1w_10.t.s2_10 data-top="683" data-oc="true" style="top: 683px; left: 151px;"} Tx: Charcoal (surbatol), cathartics ::: ::: {#t1x_10.t.s1_10 data-top="697" data-oc="true" style="top: 697px; left: 94px;"}  ::: ::: {#t1y_10.t.s4_10 data-top="697" data-oc="true" style="top: 697px; left: 113px;"} Tricyclic [[[Anti-depressants]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-14088-14088" data-cha-target-name="concept-14088" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"14088","data-concept-text":"Anti-depressants","data-ppo-id":"-14088","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"14088","ppoid":"-14088","text":"Anti-depressants"}"} ::: ::: {#t1z_10.t.s1_10 data-top="712" data-oc="true" style="top: 712px; left: 132px;"}  ::: ::: {#t20_10.t.s2_10 data-top="712" data-oc="true" style="top: 712px; left: 151px;"} (Elavil, Sinequan, Tofranil, Pamelor) ::: ::: {#t21_10.t.s1_10 data-top="726" data-oc="true" style="top: 726px; left: 132px;"}  ::: ::: {#t22_10.t.s2_10 data-top="726" data-oc="true" style="top: 726px; left: 151px;"} Hypotension, SVT- supraventricular [[[tachycardia]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-12196-12196" data-cha-target-name="concept-12196" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-originaltag="{"tagName":"span","attribs":{"data-concept-id":"12196","data-concept-text":"tachycardia","data-ppo-id":"-12196","data-page-type":"UNLOCKED_DOC"}}" data-props="{"conceptId":"12196","ppoid":"-12196","text":"tachycardia"}"} ::: ::: ::: ::: ::: ::: {style="width: 640px; height: 829px;"} ::: ::: ::: ::: ::: ::: ::: {.e2INc1YuVeWZdIdivy+8wg==.tw-m-auto.!tw-p-8.!tw-rounded-none.tw-border-b-2.tw-border-b-gray-20.last:tw-border-b-0 style="min-height: 829px; width: 100%;"} ::: {.tw-m-auto style="width: 640px;"} ::: {data-testid="SSI_VIEWPORT_ROTATION_TEST_ID-0"} ::: {data-html-viewer-page="11"} ::: {data-frozen="true"} ::: {#html-prev-11 data-width="640" data-height="829" data-oc="true" style="display: none !important;"} ::: {.html-preview-text data-height="829" data-width="640" data-oc="true"} ::: {#pg11 data-oc="true" style="z-index: -1; background-image: url("/api/v1/documents/215530894/content/unlocked/background/11/");"} ::: ::: {data-block="true" data-originaltag="{"tagName":"div","attribs":{"data-slice-no":"0","class":"ch-page-slice","data-alt-height":"829","data-top":"0","style":"width: 640px; height: 829px; position: relative;"}}" data-props="{"dataAttribs":{"data-slice-no":0},"altHeight":"829","top":"0","style":"width: 640px; height: 829px; position: relative;","sliceNo":0}"} ::: {.ch-page-slice data-slice-no="0"} ::: {data-top="0" data-height="494"} ::: {.rel-slice style="position: relative; height: 495.329px; width: 100%;"} ::: {data-slice-bg="true" style="position: absolute; width: 640px; height: 495.329px; overflow: hidden;"} ![](./MOC%20III%20EXAM%204%20STUDY%20GUIDE.docx_files/saved_resource(10)){.tw-pointer-events-none} ::: ::: {#t1_11.t.s1_11 data-top="75" data-oc="true" style="top: 75px; left: 132px;"}  ::: ::: {#t2_11.t.s2_11 data-top="75" data-oc="true" style="top: 75px; left: 151px;"} Prolong QT interval leading to Torsades de Point,acidosis ::: ::: {#t3_11.t.s1_11 data-top="89" data-oc="true" style="top: 89px; left: 132px;"}  ::: ::: {#t4_11.t.s2_11 data-top="89" data-oc="true" style="top: 89px; left: 151px;"} low [[[K+]{style="display: inline-block; position: relative; top: -0.15em;"}]{data-cha-action-type="view-popover" data-cha-action-target-type="concept" data-cha-action-target-id="-7112-7112" data-cha-target-name="concept-7112" data-cha-location="inline" data-cha-interaction-type="hover" data-cha-js-event-type="hover" style="border: 0.15em solid rgb(55, 95, 255); background: transparent; border-radius: 0.3em; cursor: pointer; position: relative; top: 0.15em; display: inline-block; padding: 0px 0.15em; margin: -0.15em -0.3em; height: 1.25em;"}]{data-block="true" data-origi

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