0071643192.pdf

ENVIRONMENTAL EMERGENCIES MECHANISM OFTOXICITY ■ Special stinger apparatus punctures skin and introduces venom →severe local sym ...

ENVIRONMENTAL EMERGENCIES TREATMENT ■ Immerse in 5% acetic acid (vinegar)to inactivate nematocysts. Alterna- tives include: ■ Im ...

ENVIRONMENTAL EMERGENCIES ■ Irrigate copiously. ■ Consider antibiotics. ■ Tetanus prophylaxis A 50-year-old male presents to the ...

ENVIRONMENTAL EMERGENCIES ■ Local petechiae or ecchymosis ■ Bullae (may be hemorrhagic) ■ Systemic toxicity ■ Oral paresthesias ...

ENVIRONMENTAL EMERGENCIES Elapidae Family Envenomation is characterized by minimal local reaction with marked systemic neurotoxi ...

ENVIRONMENTAL EMERGENCIES ■ Antivenom(see Table 13.5) ■ For all eastern coral snake bites (even if asymptomatic!) ■ Otherwise, i ...

ENVIRONMENTAL EMERGENCIES PREVENTION OFHEATILLNESS ■ Keep hydrated (drink solutions which help replete electrolytes) ■ Wear loos ...

ENVIRONMENTAL EMERGENCIES ■ Nausea and vomiting ■ Core temperature is typically normal, but may be elevated (<40°C). DIAGNOSI ...

ENVIRONMENTAL EMERGENCIES ■ Adjuncts: ■ Place ice packs to groin, axillae, and neck. ■ Cooling blanket ■ If refractory, consider ...

ENVIRONMENTAL EMERGENCIES PATHOPHYSIOLOGY ■ ↓Core body temperature →peripheral vasoconstriction (to decrease con- vection) and ↓ ...

ENVIRONMENTAL EMERGENCIES SYMPTOMS/EXAM ■ Transient numbness and tingling, resolves with rewarming ■ Affected skin appears firm, ...

ENVIRONMENTAL EMERGENCIES ■ Debridement of skin overlying hemorrhagic blister may result in marked desiccation of the underlying ...

ENVIRONMENTAL EMERGENCIES Hypothermia is clinically defined as mild, moderate, or severe. ■ Mild hypothermia (32°– 35 °C): ■ Exc ...

ENVIRONMENTAL EMERGENCIES ■ Dry clothes ■ Move from cold environment ■ Active external rewarming: ■ For severe hypothermia witho ...

ENVIRONMENTAL EMERGENCIES COMPLICATIONS ■ Coagulopathy ■ Acidosis ■ Cardiac arrhythmias ■ Rhabdomyolysis An 18-month-old female ...

ENVIRONMENTAL EMERGENCIES ■ Paresthesias ■ Seizure ■ Thermal source contact burns ■ Size does not correlate with underlying tiss ...

ENVIRONMENTAL EMERGENCIES LIGHTNING INJURY Lightning is a unidirectional currentofextremely high voltage. Fortunately the durati ...

ENVIRONMENTAL EMERGENCIES ■ Asystole often resolves spontaneously butif apnea persists →“secondary death” from hypoxia and (comm ...

ENVIRONMENTAL EMERGENCIES DIAGNOSIS ■ Typically obvious based on clinical presentation ■ ECG and cardiac monitor ■ Useful labs i ...

ENVIRONMENTAL EMERGENCIES ■ Erythropoietin production is ↑within 2 hours of ascent →↑red cell mass and↑O 2 carrying capacity. ■ ...