Environmental Emergencies - Heat Illness

Front 1

are cooling blankets effective in heat illness

Back 1

no

Front 2

How does one cool the patient

Back 2

immediatley derobed, may place ice packs in axilla and groin, lukewarm water over the patient and blowing room air prevents cutaneous vasoconstriction and minimizes shivering

Front 3

shivering may occur as a result of the cooling process...what meds decrease this

Back 3

25mg Chlorpromazine

100mg Meperidine

Front 4

when should cooling measures be D/Ced

Back 4

when temp falls below 39

Front 5

suboptimal methods for measuring core temperature are

Back 5

oral or tympanic thermometers

Front 6

avoid what is the patient on MDMA

Back 6

excess fluids which can worsen hypoatremia and cause sz

Front 7

rapid cooling measures should be initiated for any temperature greater than

Back 7

40.5

Front 8

unlike heat stroke most febrile states that produce AMS are associated with

Back 8

normal LFTs( reyes does this w/o fever)

Front 9

Diagnostic CK levels for rhabdo

Back 9

greater than 1000 (5 limits normal) as the rise begins 2-12 hours after muscle injury

Front 10

electrolyte patterns in heat illness

Back 10

hypernatremia, hypokalemia and hypoglycemia

Front 11

elderly patients may be taking what medication that decreases the ability to dissipate heat

Back 11

beta blocker

Front 12

in heat exhaustion core temperature is usually

Back 12

less than 40

Front 13

Dx heat stroke when

Back 13

core temp is greater than 40.5 or AMS with elevated temp

Front 14

best core temp measurement

Back 14

esophageal probe

rectal may be used but temp changes usually lag core temps

Front 15

relative bradycardia in someone with sus[ected heat stroke may indicate

Back 15

other dx such as typhoid fever or prescence of beta blockers or CCBs

excess tachypnea may imply salycilates

blurred vision and mydriasis may indicate anticholinergic toxicity

Front 16

heat stroke patien will most likely be sweating or not

Back 16

not

Front 17

what drugs impair central thermoregulation

Back 17

phenothiazines - Chlorpromazine, Phenergan (promethazine)

Front 18

increase heat production by uncoupling oxidative phosphorylation

Back 18

salicylates

Front 19

prolonged ecstasy may lead to

Back 19

heat stroke, SIADH (hypotonic hyponatremia)

Front 20

common in heat stroke but not in exhaustion

Back 20

diarrhea and vomiting

Front 21

heat cramps arec

Back 21

cramps in unacclimatized people who sweat freely and replace with water

Front 22

heat tetany

Back 22

caused by hyperventilation after brief exposure to extreme heat

Front 23

prickly heat

Back 23

aka heat rash, lichen tropicus, miliaria rubra is a macpap or vesicular erythematous pruritic rash found in areas of the body covered by cloth and caused by obstruction of sweat ducts

Front 24

conduction is

Back 24

heat exchange from object to object

Front 25

dominant mechanism of heat loss is

Back 25

evaporation of sweat

Front 26

describe heat acclimatization

Back 26

after daily exercise in a hot envoronment for 1-2 weeks, sweating increases, occurs at lower body temperatures and contains less NaCl

Front 27

in heat stroke which organ is particularly vulnerable to damage

Back 27

the brain

Front 28

heat stroke cellular damage depends more on

Back 28

the duration of exposure rather that the maximum core temperature