Environmental Emergencies

Pregunta	Respuesta
Thermoregulation	Health loss - health production Regulated by hypothalamus
Thermoregulation 5 types	Evaporation - loss of water thorugh sweat radiation - emission of infrared conduction - direct transfer of health to a cooler object convection - direct transfer of heat to convective currents of air or water
Physiological response to hypothermia	initial increase in metabolic rate as temp continues to decrease, decreased in metabolic rate, hr, rr , LOC
Pathophysiology of hypothermia	cardiac - reduced co and hypoptension arrthymias haemostatic derangement - increased blood viscosity and reduced peripheral circulation kidnery derangement - volume loss, dehydration endocrine - glycogen stores are diminished with shivering hepatic derangement - decreased clearance due to reduced circulation
Assessment 3 aims:	1- detect hypothermia 2 - determine severity 3 - detect hypothermia
Osbourne J waves	j reflections at QRS and ST junctions commonly present in temps below 35 degress disappear with rewarming of body
Management	prevention of further heat loss, gentle handline, rewarming
Rewarming	passive - endogenous heat production, with blankets active external - warm blankets, bear hugger active core - heat to cavities, warmed IV fluid
Heat Illness	core temp above 41 degrees leads to protein denaturing, loss of energy producing processed and loss of cell membrance function result: rhabdomylosis, PO, DIC, CVS mild - life threatening
Heat exhaustion	Dehydration and intravascular fluid depletion, electrolyte loss Mild CNS dysfunction, postural hypotension
Heat stroke	1 - exertional - exercise in a thermally stressful environment 2 - classic - impaired thermostatic mechanisms in a hot environment
Heat Stroke	above 40. 5 degress loss of thermoregulation CNS dysfunction if untreated - rhabdomyolosis, acute renal failure, CNS damage
Heat stroke management	airway and breathing fluid and electrolyte balance cooling
Serotonin syndrome	combinatino of two or more drugs, one is an SSRI causes high body temperature
Neuroleptic malignant syndrome	reaction to neuroleptic drugs characterised by fever risk factors: male, dehydration, agitation
NMS aetiology	Haloperidol common cause, also metoclopramide
NMS clinical features and treatment	clinical features: fever, CNS dysfunction, rigidity, seizures treatment: withdrawal of drug, dantrolene
Malignent hyperthermia	triggered by inhalational anaesthetics and muscle relaxants genetic suseptibility
Drowning	interruption of oxygen supply to the brain form of asyphyxia due to aspiration of fluid Loc is usually withint 3 minutes of submersion
Pathophysiology of drowning	hypoxemia of multiple organs and acidosis CNS damage involuntary laryngospasm triggered by liquid myocardial electrical instability, MI
Mammalian diving reflex	young children, suddenly immersed in cold water, apnea, bradycardia, vasoconstriction
Near drowning prognosis	alert or mildyunwell comatose or CPR fixed and dilated pupils cold-water drowning had neuroprotective effects
Resuscitation of a drowning victim	Primary and secondary survey response airway chin lift and jaw thrust flat on back improved survival , exception if there is airway compromise

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	Creado por Elizabeth Then hace alrededor de 6 años