Criado por Elizabeth Then
mais de 6 anos atrás
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Questão | Responda |
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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