Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
153 Cards in this Set
- Front
- Back
|
Signs and symptoms (from ingestion or injection)
of drug overdose of OPiates? |
Slow, shallow respiration
cyanosis weak pulse, Hypotension Miosis Nausea vomiting |
|
|
What is the treatment for Opiate poisoning?
|
M/t ABC
Remove (lavage) Acitvated charcoal If unconscious (Narcan) .01mg/kg IV Consult /medevac |
|
|
What is the max dose of Narcan (Naloxone)?
|
10mg
|
|
|
What are some S/Sx of ingested Barbiturates?
|
Sleepiness
Mental confusion Flaccid muslces Hypotension Absent reflexes Hypothermia/hyperthermia |
|
|
Treatment for OD of barbituates/
|
M/T ABCs, may need to Intubate
Delay absorption (AC) Gastric lavage No specific antidote V/S monitoring Elevate head 15degrees ET suction |
|
|
What are some Anticholinergic agents?
|
Atropine (PO, IM)
Plants Antihistamines Antiparkinsonians Antispasmodics Cyclic antidepressants Skeletal muslce relaxants OTC meds |
|
|
S/Sx of Anticholinergic Agents?
|
Dilated pupils
Blussinr of vision Inc. HR Hot, dry, red skin (Red, HOT, MAD syndrome) Hallucinations Aggressive behavior i |
|
|
Treatment plan for Anticholierngic a60 migents?
|
ABCs
Remove with Gastric lavage within 1hr ingestion AC and follow with saline caharsis |
|
|
(T)What is the Antidote for Anticholinergic Agents?
|
Physostigimine salicylate, IV .5-2.0mg initial Over 5 ming CNS improvment in 5-15min.
REpeat dose may be necesary every 30-60 May aggravate dysrhyhmias and Szs, MO eval MEDEVAC |
|
|
What is the S/Sx of Organophosphate ingestion? (DUMBELS)
|
Diarrhea
Urinary incontience Miosis Bronchorrhea Excitation with muslce fasciculation Lacrimation Szs |
|
|
(T) What are some mild S/Sx of Organophosphate ingestion?
|
Anorexia
Dizziness Weakness Anxiety Substernal discomfort Tremors |
|
|
What are some serious S/Sx of Organophosphate ingestion?
|
Pinpoint, Non reactive pupils
Pul Edema Cyanosis Loss of sphincter control Convulsions coma HEart block |
|
|
What is the treatment plan for Organophospate?
|
Atropine Sulfate, 2mg IM and repeat every 3-8min until signs of toxicity are controlled
Pralidoxime (2-PAM) with max atopinge admin, 1gm in aqueous sol. slow IV ABCs Decontaminate the skin and mucous Lavage or emesis |
|
|
Pt comes in with signs of N/V, Nervousness, Dilated pupils, blurred vision, chills, fever, Mania. What is your dx of this patient?
|
Amphetamines OD
|
|
|
Treatment of Amphetamines OD?
|
ABCs, Remove drug by Ipecac emesis (A.C.)
Diazepam 5mg IV repeat and titrate to decease autonomic CNS |
|
|
(T)What are the SMDR/IDC responsibilities of OD or posioning?
|
Id the nearest Posion Control Center and post its phone number conspicously in sickbay and on the outside of the antidote locer
|
|
|
What is your first line treatment for pt with general symptoms from poisoning?
|
Treat immediate life threatening first (ABCs)
|
|
|
What med do we treatment to prevent vasodilatation?
|
epinephrine
|
|
|
What is the normal intake and output for urine?
|
intake (2500 ml/d)
Output (1400-2300ml/d) |
|
|
(T) What is the quickest method to rid the body of ingested substance remaining in the stomach?
|
Emesis
|
|
|
How would you induce vomitting if needed?
|
15-30cc of Ipecac f/o by 1-2 glasses of room temp water
|
|
|
(T) What are some contraindications for inducing vomiting?
|
if pt is drowsy, unconscious or convusling
Ingestion of corrosives, convulsants(tricyclics), petroleum distillates. |
|
|
When would you instill Gastric lavage?
|
Ingestion of CNS depressants
Collection of gastric contents for analysis Administration of antidotes (conventiant) |
|
|
What are some complications of NG lavage?
|
Aspiration
Cyanosis Gastric erosion Epistaxis Esophageal tears Larynospasm Mediastinitis |
|
|
A means to cleanse or purge, what is this method?
|
Catharsis
|
|
|
What specific drug is for Methemoglobinemia (iron OD)?
|
Methylene blue
|
|
|
What is the antidote for Hydrofluoric acid?
|
Calcium gluconata
|
|
|
What soothes irritated tissues and precipitaes heavy metals as well as blocking absorption?
|
Demulcents
|
|
|
What are some characteristics of Poisoning by acids?
|
Ph < 7.0
sour tasting when mixed with water |
|
|
If a large enough area is affected from poisoning, what may be caused?
|
hypovolemic shock (burns)
|
|
|
What are some presentin symptoms of acid poisoning?
|
Severe pain in mouth, throat and upper GI
Hematemesis Marked thirst Dysphagia Metabolic acidosis shock |
|
|
What are some treatments for ingested of acid poisoning?
|
Assess airway
Small NG tube to remove acid by aspiration, contraindicated with esopheageal perforation(hematemesis) Dilure immediately with 200ml of milk or water |
|
|
What is the treatment for Eye contact with acid poisoning?
|
Water 10-20 minutes
Ph <7.0 Pain control Patch and send to opthalmology ASAP |
|
|
What is the treatment of choice for hydrofluoric acid?
|
Benign appearance--tremendous pain
Irrigate and apply calcium gluconate paste IV calcioum gluconate if pain not resolved Death reported with contact 2.5%BSA |
|
|
What product is in common cleaning products, has a soapy feeling and Ph 12 or greater and can damage tissue for days?
|
Alkali poisoning
|
|
|
What are some S/Sx of alkali poisoning?
|
Ingested: Pain, V/D, Systemic
Skin: Pain, blisters, Delayed, Chronic dermitits Eye: Conjunctival edeam, Corneal destruction or worse than acid in the eye |
|
|
what is the tx for ingested alkali?
|
Airway
Dilute endoscopy |
|
|
What is the treatment for eye contact of alkali substance?
a. irrigate 20min, test ph, patch b. irrigate 60sec, test ph , patch, pain c. irrigate 30min, test ph, patch , pain, medevac d. irrrigate 10-20min, test ph, patch |
c.
|
|
|
What type gas comes from bacterial action of sewage and has a rotten egg order similar to cyanide?
a. sulfuric acid b. hypergen sulfide c. hydrogen sulfide gas d. phosphrous sulfide gase |
hydrogen sulfide gas
|
|
|
What are some S/Sx of hydrogen sulfide gas?
|
LOC
Chest pain/brady Pharyngitis/N/V conjunctivits Dyspnea/cyanosis/hemoptysis Pul Edema (delayed) |
|
|
Treatment for Hydrogen sulfide gas ?
|
FRESH AIR
ABC antidoe: SODIUM NITRITE 300mg IV, slow infusion Bedrest 3-4days Consider HBO |
|
|
What are some S/Sx of hydrocabons?
|
Resp:coughing, choking, gasping
CNS: dizziness, slurred speech, ataxia, lethargy Peripheal nervous system: foot and wrist drop with numbness and parasthesia Gi: mouth/throat pain, abd pain, N/V/D |
|
|
What are some hepatic issues of hydrocarbons?
|
liver tenderness, jaundice (48-96 hrs after exposure)
|
|
|
Treatment for hydrocarbons?
|
FRESH AIR
ABC O2 skin contact: remove clothing Decon skin |
|
|
Treatment for Hydrocarbons ingestion?
|
Lavage is dangerous
USE ET tube to prevent aspiration Observe for 2-4 days (pul. edema) If feverish, use BSA |
|
|
What is the defintive treatment for severe exposure to CO poisoning?
|
HBO therapy for 90 min tx session
|
|
|
What is the most used and abused drug and is CNS depressant?
|
Ethanol (grain alcohol)
|
|
|
What do we want to r/o with alcolhol symptoms?
|
hypoglycemia
|
|
|
What is the difference from ethanol S/Sx and isopropyl?
|
similar but effects are longer andCNS depression is more profound due to acetone formation in the liver
Nystagmus N/V/Hematemesis, ABD pain |
|
|
What do we not do when pt respiratory is depressed for alcohol intoxication?
|
DO NOT INDUCE VOMITING
|
|
|
What does Methanol do to the body?
|
Forms formaldeyde and formic acid
Highly toxic S/S won't appear for 12-18 hrs |
|
|
What are some S/Sx of methanol ingestion?
|
CNS depressed
V/N Abd pain Confusion, HA , vertigo** visual disturbances** coma, seizures Hypotesion and brady cardia (late) |
|
|
What is the treatment for methanol ingestiong?
|
IV
Prevent metabolite formation Correct metabolic acidosis Fluids and sodium Bicarb Medevac |
|
|
(t)What is another name for fish poisoning?
|
Ciguatera
Caused by Ciguatoxin |
|
|
what causes the fish to become toxic?
|
produced by singel cell organism (dinoflagellates)
|
|
|
What fish must you avoid that might be toxic?
|
Puffers, trunk or box fish, thorn fish, trigger fish, file fish, parrot fish, porcupine
|
|
|
(T) what is the prevention of fish poisoning?
|
Avoid Red Tide phenomenon
|
|
|
What are some S/Sx of ciguatoxin?
|
Onset 15 min-6hrs
Numbness and tingling of face and lips that spread Bizarre dysestheisias Metallic taste **** blurry vision dizziness Muscle weakness |
|
|
What is the treatment for fish poisoning (ciguatera)?
|
Remove the fish from the stomach
ABC Mannitol (caution) Atropine Calcium gluconate |
|
|
(t)what species of snakes fall under Crotalidae:
|
Pit vipers
Rattlesnakes Cottonmouths (water moccasins) Copperheads |
|
|
(t)what snakes falll under Elapidae?
|
corals
mambas cobras |
|
|
What is another name for the gila monster?
|
Helodermae
|
|
|
What are the chief proteins of poison in snakes?
|
Hemotoxin
Neurotoxin |
|
|
What type of toxin does the crotalidae inject?
|
Hemotoxic venom
|
|
|
(T) What are some S/Sx of crotalidae "pit vipers"?
|
Edeam and localized pain within 10min
Ecchymosis progressing to petechiae and hemorrhagic vessiculation Weakness, diaphoresis, faintness Metallic or rubber taste in mouth**** |
|
|
What toxin does the Elapidae inject?
|
neurotoxin
|
|
|
Elapidae bite may be asymptomatic for up to when?
|
12 hrs
|
|
|
What are some characteristcs (signs) of a hydrophidae bite?
|
Euphoria, anxiety, "thick tongue" and Hypersalivation
Ascending paralysis, ocular and facial paralysis, ptosis, and papillary changes |
|
|
what is the treatment for reptile envenomation?
|
No standard
Determine what type of bite and specie Supportive therapy Treat local and systemic effects Immobilize the extrimity at heart level Wash with ater Do not manipulate |
|
|
What type of compression bandage can we place on a snake bite?
|
Austrialian compression immoblization technique
|
|
|
(T) What are some special considerations fro hydrophidae bites?
|
Antivenom in all cases
Immobilize all cases MEDEVAC Marine life venom, deactivated with very hot water (slide 178) S/S often delayed |
|
|
What is another name for Widow spiders?
|
Latrodectus
|
|
|
Another name for Recluse spider?
|
Loxosceles
|
|
|
S/Sx of the widow spiders?
|
Numbing pain, blanching and edeam
Muslce spams (chac) most abdonmial in nature**** Nausea, salivation, sweating Fear of death (pavor mortis) |
|
|
Treatment for Widow spiders?
|
If severe-complete bedrest
Supportive therapy Tetanus if indicated Anti serum if available |
|
|
What spider has venom of cytotoxin?
|
Recluse
|
|
|
(t) What is the typical presentation of a Reluse bite?
|
Erythemic halo with a central lesion with a discernable white ring within 1-3 days.****
Aching puritis, blistering, bleeding within 2-8 hrs |
|
|
When would you see an Eschar form with brown recluse bite?
|
5-7 days
|
|
|
How long after the initial bite of recluse spider does systemic effects start and how should Sx present?
|
24-72 hrs
Cyanosis fever, chills N/V Joint pain Maculopapular rash Weakness , malaise |
|
|
What are some treatments for recluse bite?
|
Cool compresses/ elevation
Antibiotics of sec. infection Daily wound care Late debridement vs early |
|
|
what is another name for the Hobo, Northwestern brown spider?
|
Tegenaria
|
|
|
What are some characteristics of Tangenaria?
|
Found in temperature regions
10-15mm build funnel like webs bites cause necrotic lesions |
|
|
(T) What are some S/Sx of the Tangenaria spider?
|
HA, nausea, vomiting
weakness, lethargy Visual disturbances, memory loss Lesion similary to recluse |
|
|
(T) What is one of the most dangerous spiders in the world?
|
Atrax(funnel web spiders) Hadronyche
|
|
|
(T) What are some signs and Symptoms of Atrax spider?
|
Wheal formation, local erythema, local sweating and piloerection****
intense pain at bite perioral tingling, N/V, salivation, lacrimation dyspnea, Pul. edeam Central and peripheal neurologic syndrome Death reported btw 15min-3days |
|
|
What is the only known therapy to improve survival from a atrax bite?
|
Anti-venom
ALso Australian compression immobilization technique |
|
|
How are scorpion S/Sx valued?
|
scale 1-4
|
|
|
If patient has pain/parethesias remote from site, what grade of bite is this?
|
II
|
|
|
What S/Sx falls under Grade III scropion bite? (one of the following)
|
Somatic skeletal neuromusclar dysfunction (jerking, restlessness, involuntary shaking
CN dysfunction( blurred vision, wandering eye, hypersalivation, dysphagia, tongue faciculations, upper airway dysfunction, slurred speech |
|
|
What are some treatments for Atrax bite?
|
ABC
Support ICE Tetanus Hospializations if needed for antivenom |
|
|
(T) What are the three subgroups of stinging insects?
|
Apidae
Vesidae Formicidae |
|
|
What is the best method insects stings?
|
preparedness
|
|
|
Fire ants cause what type of reaction?
|
painful, pruritic swelling,, that initial whealing effect followed by sterile pustules that umbilicate on an erythematous base in 24 hrs
|
|
|
For severe reactions of insects stings, what is the treatment?
|
ABC
IV Epi (1:1000) .3-.5 mg IM stat Benadryl 50mg IM H2 blocker MEDEVAC |
|
|
What are some S/Sx of nemocyts or coelenterate?
|
Urticarial wheal
pain, puritis Fever, chills Muslce pain, body spasms Vertigo, ataxia Delirium, syncope N/V |
|
|
What are some complications of Marine urgents (coelenterate)?
|
Hypotension, dysrhythmias
Pul. edema, hemolysis, renal failure Hypertension, Intercranial hemorrhage |
|
|
what are some treatments for coelenterates?
|
Meat tenderizer with Papain
vinegar rinse Scrape with dull knife use sea water, not fresh water |
|
|
What would treatment for muslce spams if injected by coelenterates?
|
calcium gluconate
|
|
|
(T) What is the treatment of choice for Octopi and cone shell venom injection?
|
ABC
Soak area in HOT water 113-122 F for 90 min**** pressure immoblization dressing local wound care and tetanus |
|
|
What is a characteristic S/Sx of sea urchins?
|
"BLACK and Blue" puncture wound
Deep throbbing pain Rarely: dizziness, numbness, paralysis bronchospasm, hypotension |
|
|
What is the treat for sea urchins?
|
HOT water
115-125 deg. F 30-90min vinegar added Remove spines antibiotics for secondary infection |
|
|
If patient is complaining of pain centrally (thorax), with edema, nausea, anxiety cramps, faciculations and it was about 30-90min ago, what type of creature caused this. Also pt has a laceration with minor puncture to the chest?
|
stingray infection
|
|
|
Treatment for stingray poisoning?
|
Hot water immersion
Debride Local anesthetic tetanus Wound care Antibiotic Medevac (possible) |
|
|
If pt is stung by a stone fish,what is thelikely treatment?
|
Give antivenom
also hot water immersion (30-90 min) clean/debride pain control tetanus anitbiotics |
|
|
what are some contributing factors of cold injuries?
|
systemic hypothermia
debilitated patients familial or acquired hypersensitivity to cold |
|
|
what type of drugs cause more problems with cold injuries?
|
morphine, thorazine, barbituates, CNS depressants
|
|
|
What is the most useful yardstick for hypothermia patients?
|
Body core temp.
|
|
|
What are some treatments for hypothermia patients?
|
Ext. re-warming
water bath--104107.6 Leave limbs out Wrap head and neck Be aware of other injuries |
|
|
How would you rewarm from within for hypothermic pts?
|
Heated humidifies oxygen (110-115deg)
use with other rewarming methods Fluids for blood pressure Thermal angel |
|
|
What are some diagnosing technique we can use to determine Cold uticaria?
|
Ice cube test
|
|
|
S/Sx of cold uticaria?
|
Wheals, Erythema, Pruritis, Edema, HA, Dyspnea, Tachycardia,
|
|
|
what meds can you use to treat Cold uticaria?
|
Cyproheptadine
Atarax |
|
|
What condition is caused by intermittent exposure to temperatures above freezing accompained by high humidity (32-35 deg F)?
|
chillblain/ Pernio
|
|
|
What are some S/Sx of Chilblain?
|
Red pruritic skin lesions
3-6 hrs exposure (resoves withoug sequale, Subcut vesicles with or without cyanosis) |
|
|
When is chilblain consdier Pernio?
|
after 12hrs to 3 days exposure
deep pain Eschars that slough Persistant pain |
|
|
What is Raynaud's phenomenon?
|
vasoconstriction of finger and toes to protect the core tempearture. Cause by cold or stress response
|
|
|
CWIS strikes a patient two fold, by what?
|
fungal/bacterial infections
Tissue and nerve damage |
|
|
What is the cause of CWIS?
|
Prolonged expsorure to cold
Wet, cold foot wear or immersionof feet Temp below 50deg.. Upper temps >12 hrs of exposure Temps < 32deg <12hrs |
|
|
(T)What are the two phase of S/Sx of Cold water immersion syndrome?
|
Hyperemic phase (hot with intense burning)
Vasospastic phase _ pale or cyanotic with dimished pulses |
|
|
What are some common S/Sx of CWIZS?
|
lead to blistering, swelling, redness, heat, ecchymosis, hemorrhage, and gangrene
|
|
|
(t)what are some characteristics of first degree frostbite?
|
Skin red and yields pressure
***white or yellowish plaque at site Edema is common |
|
|
Pt present with Skin color of deep reddish-purple, with blistering and vesicles are deep and contain blood?
|
3rd deg. frostbite
|
|
|
What temperature could cause 3rd deg frostbite?
|
extreme cold <-20de
|
|
|
Pt has thick freezing skin that is white and hard. Crystals will not move over bony prominence?
|
4th deg frostbite
|
|
|
What is the treatment for frostbite?
|
If chance to refreeze, DO NOT THAW
rewarm in immersing water (104-107.6) No walking after thawed No tobacco, EtOH. Whirl pool baths, 20min, twice a day 98.6deg Tetanus Pain control with analgesics |
|
|
What is the cause (etiology) of heat exhaustion?
|
Inadequate or colapse of peripheal circulation secondary to salt depletion and dehydration
1-2 L per hr usually occurs in those underlying dieases |
|
|
What are some S/Sx of heat exhuastion?
|
Temp variable (>100deg)
Muslce cramps Persipration Oliguria, tachycardia, hypotensive Mental confusion HA , dizziness |
|
|
Treatment for Heat exhaustion?
|
Remove from heat
rest Elevate feet and massage legs treat for shock Aviod re-exposure P.O fluids No salt tablets IV fluids Pts absorb 50%ive fluids |
|
|
what are some S/Sx of heat cramps?
|
Skin moist, warm, cool
muscle twitching Temp varies No change in V/S Hx of Physical activity distingish from Hyponatremia |
|
|
Treatment for heat cramps?
|
cool area
massage IV, PO fluids--sports drinks rest |
|
|
What is a true medical emergency for heat injuries?
|
Heat stroke
|
|
|
What is a determining Sign or symptoms of pt having a heat stroke?
|
Eleveated core temp (106deg or higher)
Muscle twitching progessing to convulsions Cessation of seating (late sign) skin hot, dry and flushed HA, CNS disturbances LOC, Resp deep, then shallow |
|
|
When should you stop cooling a pt with heat stroke?
|
102.2 deg F
|
|
|
If temperature rises after recooling, control shivering and delirium with what?
|
Valium 25mg, IM or 5mg IV Q 10-15mins
O2 slowly administer chilled iv fluids Avoid circulatory overload Draw labs to send with pt 2 tiger CBC (purple top) |
|
|
What is drowning?
|
fluid induced asphyxia
|
|
|
What are some causes of drowning?
|
overexertion
panic rough water exhaustion cold water heat loss ETOH or drugs |
|
|
What are the sequence of events for drowning?
|
Hypoxiema
laryngospams Fluid apsiration ineffective circualtion Brain injury Brain death (5-10min) |
|
|
What are some complications of near drowning?
|
Pulmonary edema
Metabolic acidosis |
|
|
How would a pt present with near drowning?
|
Cyanotic
Trismus Wheezing Hypotension Cardiac arrest Tachypnic Apnic |
|
|
What is the treatment for near drowning?
|
ABC and first aid
CPR until body temp >89.6 O2 therapy Vigorous respiratory therpay IV with Sodium bicarb MEDEVAC |
|
|
(T) What are some considerations of Salt water Aspiration?
|
Affects aveloar surfactant
Draws water from the surrounding capillaries into the alveoli Creates pulmonary edema |
|
|
What is another name for Decompression Sickness?
|
Caisson disease, bends
|
|
|
What is the cause of bends (caisson disease)
|
Dissovled gases (nitrogen) saturate tissues from an increase in water pressure, escape as gas bubble during ascent
|
|
|
What are some Signs and symptoms of the bends?
|
Onset in 30min
Most will have symptoms within 6hrs severe pain in large joints Prickling/burning in skin Molttling/skin rashes SOB, "chokes" cough Visual disturbances HA COMA |
|
|
Treatment for the bends?
|
O2 6-10L NRB
Mild analgesic (ASA) IV LR vs NS Do NOT use Dextrose HBO therapy |
|
|
In all case of Pulmonary over inflation syndrome, what must be ruled out?
|
Arterial gas emboli
|
|
|
Signs and symptoms of Pulmonary over inflation?
|
sudden onset
Dizziness Paralysis or weakness Blurred vision Chest pain Parasthesias Concvulsions |
|
|
Treatment of Pulmonary over inflation?
|
Immediate recompression
ABC O2 5-10LPM mask MEDEVAC |
|
|
(T) What is the most common complaint of Pulmonary Embolism?
|
Hemopotysis
Other s/sx (abrupt onset, dyspnea, cough, |
|
|
Treatment for Pulmonary embolism?
|
O2 5-10L mask
IV (LR 1000cc/hr) Heparin 5000 units IV bolus Absoulte bedrest in the left Lateral Recumbent postion (left side down) MEDEVAC |
|
|
What is a hallmark symptom of Barotrauma?
|
pain
|
|
|
What is the most common type of barotrauma?
|
blocked Eustachian tube
|
|
|
What is treatment for sinus pressure when diving?
|
treat as severe sinusitis
Abstain from diving and swiming until healed |
