BLAST/DROWNING/ENVI

BLAST INJURIES

refers to the injuries sustained from a blast wave from high explosives that can cause multisystem trauma

CODE WHITE

In an emergency room, we have something called “____ _____” and it means high alert or there are blasts that occurred in an institution or a specific place

PRIMARY

Injury from over-pressurization force (blast wave) impacting the body surface

SECONDARY

Injury from projectiles (bomb fragments, flying debris)

TERTIARY

Injuries from displacement of victim by the blast wind

QUATERNARY

All other injuries from the blast

STOP, DROP, AND ROLL

best way to put a f ire out from the person

EYE INJURIES

Can result from direct blow, foreign bodies, or inadvertent scratching

ENUCLEATION OF THE EYE

removal of the entire globe and its intraocular content to save the eyeball and the eyesight

GLAUCOMA

Increased IOP is called

NEAR DROWNING

refers to surviving, temporarily, at least the physiologic effects of decreased oxygen in blood and acidosis that result from submersion in fluid

HYPOXEMIA & ACIDOSIS

are the primary problems in the victims of near drowning

FRESHWATER ASPIRATION

changes in the character of the lung surfactant result in exudation of protein rich plasma in the alveoli

SALWATER ASPIRATION

the hypertonicity of sea water exerts an osmotic force, which pulls fluid from pulmonary capillaries into the alveoli

PNEUMONIA

Particulate matter such as sand or mud, chemical irritants, gastriccontents, that can be aspirated along water may result in

DRY NEAR DROWNING

victim doesn't aspirate fluid but suffers respiratory obstruction or asphyxia

WET NEAR DROWNING

victim aspirates fluid and suffers asphyxia or secondary changes due to fluid aspiration

SECONDARY NEAR DROWNING

victim suffers recurrence of respiratory distress (usually aspiration pneumonia or pulmonary edema) within minutes or 1 to 2 days after a near-drowning accident

HEAT EXHAUSTION

• inadequacy or the collapse of peripheral circulation due to volume and electrolyte depletion

• if untreated, may lead to heat stroke

HEAT STROKE

• a medical emergency defined as the combination of hyperpyrexia (40.6 C) and neurologic symptoms

• caused by a shutdown or failure of the heat-regulating mechanisms of the body

ACUTE TUBULAR NECROSIS

a complication of heatstroke

FROSTBITE

a trauma due to exposure to freezing temperatures that cause actual freezing of the tissue fluids in the cell and intracellular spaces, resulting in vascular damage

FROSTNIP

• there is a history of gradual onset

• skin appears red

• numbness and /or pain sensation

SUPERFICIAL FROSTBITE

• damage is limited to skin and subcutaneous tissues

• skin appears white and waxy

• on palpation, the skin will feel stiff, but the underlying tissue will be pliable, soft and have its normal bounce

• sensation is absent

DEEP FROSTBITE

• skin will appear white, yellow-white, or mottled blue-white

• on palpation, the surface will feel frozen. and the underlying tissue will feel frozen and hard

• affected part is completely insensitive to touch

98.6 F TO 104 F (37 C TO 40 C)

In managing of frostbite, rewarm with a temperature of _________ in fairly large, tepid water bath where the part can be fully immersed without touching the side or bottom

20-30 MINUTES

In managing of frostbite, rewarming procedure may take…

WHIRLPOOL BATH

• one of the management of frostbite, it is for the affected extremity

• to aid circulation, debride dead tissue, and help prevent infection

ESCHAROTOMY

• one of the management of frostbite, it is the incision through the eschar

• to prevent further tissue damage, allow for normal circulation, and permit joint motion

FASCIOTOMY

• one of the management of frostbite, it is the incision in the fascia to release pressure on the muscles, nerves, blood vessels

• to treat compartment syndrome

HYPOTHERMIA

a condition in which the core (internal) temperature of the body is less than95°F (35°C) as a result of exposure to cold

SHIVERING, PERIPHERAL VASOCONSTRICTION, RAISING THE BASAL METABOLIC RATE

In response to a decreased core temperature, the body will attempt to produce or conserve more heat by:

32.2 C

Subsequent assessments in hypothermia, where shivering may be suppressed if temperature falls below?

VENTRICULAR FIBRILLATION

Subsequent assessments in hypothermia, where a very cold heart is susceptible to?

COLD DIURESIS

Subsequent assessments in hypothermia, where an increase in urinary output due to peripheral vasoconstriction

FRUITY OR ACETONE ODOR BREATH

Subsequent assessments in hypothermia, where it is due to metabolizing fat as a result of decreased insulin levels

PNSS

Liquid of choice in managing hypothermia is?

PASSIVE EXTERNAL REWARMING

• Remove all wet or cold clothing, and replace with warm clothing

• Provide insulation by wrapping the patient in several blankets

• Provide warm fluids to drink

ACTIVE EXTERNAL REWARMING

• Provide external heat like warm hot water bottles to armpits, groin, neck

• Warm water immersion

ACTIVE CORE REWARMING

• Inhalation of warmed, humidified oxygen by mask or ventilator

• Warmed IV fluids

• Warmed gastric lavage

• Peritoneal dialysis with warmed standard dialysis solution

• Warm mediastinal irrigation through open thoracotomy

• Cardiopulmonary Bypass