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25 Cards in this Set
- Front
- Back
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Why do beta blockers sometimes cause heat dysregulation?
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They impair sweating
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Heat exhaustion should be treated with [water, gatorade].
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Water is usually sufficient, unless severe as from a marathon
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Tx for heat cramps
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rehydration
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What is heat syncope caused by?
What must be ruled out? |
vasodilation pooling blood in venous system
rule out hypoglycemia, arrhythmia, stroke, seizure, other causes of syncope |
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What drugs cause decoupling of oxidative phosphorylation?
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aspirin, cyanide, hydrogen sulfide, arsenic
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T/F The presence of sweating excludes heat stroke
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false
you can sweat up to the point where sweating stops, so this is not a reliable indicator |
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What distinguishes heat stroke from other heat illnesses
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altered mental status, primarily
triad = hyperthermia, anhidrosis, CNS sx (note: anhidrosis is not a requirement) |
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What is the mortality of heat stroke?
What is the mortality of hypothermia? |
60-70% heat stroke
30-40% hypothermia |
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What is the treatment for seizures or shivering in heat stroke?
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benzos
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What is the treatment for heat stroke?
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1. cool using wet sheets, cool mist; do NOT immerse in ice bath b/c it's difficult to monitor and you may overshoot
2. IVF ROOM temperature fluids 3. ICU admit |
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Goal temperature for cooling from heat stroke
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102 F
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T/F Intraperitoneal cold fluid lavage is used in the treatment of heat stroke
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false - there is no analogy to hyperthermia treatment
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What is the dangerous physiologic mechanism in heat stroke?
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decoupling of oxidative phosphorylation
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What is the epidemiology of drowning wrt age?
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bimodal: toddler, teen
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Which is worse for drowning, fresh or salt water? Why?
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saltwater is worse; it causes osmosis of body water into alveoli
freshwater causes resorbtion of fluid into the interstitium |
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Drowning resusciation uses the standard BLS/ACLS protocol. What should you be looking for as you resuscitate?
What should you do if you see it? |
signs of pulmonary injury:
tachypnea low sats (they may continue on a downward trend) --prepare to intubate if you see these --ICU observation 24 h for any abnormal sign --PEEP --note: home observation 24h is mandatory if discharged with completely normal exam |
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Highest mortaility envenomation in U.S.
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hymenoptera
up to 120 deaths per year |
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A local reaction from hymenoptera sting can be ? cm from sting site
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10 cm
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? % of deaths from hymenoptera stings occur with 30 minutes
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50%
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T/F A history of large local reactions predisposes a patient to a future anaphylactic reaction
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false
a mild reaction involving anything but skin DOES put patient at higher risk |
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Why would you give epi to a local cutaneous reaction with no sign of anaphylaxis
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if the sting were near the airway and swelling could compromise it
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6 steps of treatment for sting anaphylaxis
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1. ABC - resuscitation
2. epi IM (same time as ABC) 3. crystalloid 4. H1 and H2 blockers (benadryl, zantac) 5. steroids if severe 6. observe for improvement vs progression |
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What are the advantages and disadvantages of IV epi for sting anaphylaxis?
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adv: IM, SQ may not work b/c of edema
dis: can cause v tach give 1/2 amp of IV epi, give in 50 mcg increments, assess response |
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Black widow venom is [cytotoxic, neurotoxic]. symptoms?
Brown recluse venom venom is [cytotoxic, neurotoxic]. symptoms? |
black widow: neurotoxic: acute abdomen, boardlike rigidity, muscle spasm
brown recluse: cytotoxic: huge necrotic ulcer |
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T/F Use a tourniquet for a snake bite.
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True, but only a venous/lymphatic tourniquet; make sure it doesn't cut off pulse.
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