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 fire out from the person

EYE INJURIES

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

FLUSH WITH CLEAN WATER

WHAT TO DO: If eye is irritated due to dust or debris?

FLUSHED WITH A COPIOUS AMOUNT OF WATER

WHAT TO DO: If chemical exposure to the eye, it should be?

BANDAGE OR EYE SHIELD

WHAT TO DO: If with bleeding, protect both eyes with?

PLASTIC GLASS WITH STERILE BANDAGES AROUND

WHAT TO DO: If with penetrating eye injury, cover the eyes with?

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

SALTWATER 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, gastric contents, 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

SODIUM BICARBONATE

In managing near drowning, it is given for acidosis

HEAT EXHAUSTION

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

• if untreated, may lead to heat stroke

ICED SALINE LAVAGE, COOL FLUID PERITONEAL DIALYSIS OR COOL FLUID BLADDER IRIGATION

In managing heat stroke, if temperature fails to decrease, initiate core cooling by

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

SUPINE WITH FEET SLIGHTLY ELEVATED

WHAT TO DO: If patient has a heat exhaustion or heat stroke, what appropriate position

38.9 C

In managing heat exhaustion & heat stroke, reduce the internal core temperature to ___ (in celcius) as rapidly as possible

EVAPORATIVE COOLING

In managing heat exhaustion & heat stroke, it is the most efficient way

NECK, GROIN, AXILLAE, SCALP

In managing heat exhaustion & heat stroke, apply ice packs to

3-4 HOURS

In managing heat exhaustion & heat stroke, monitor and record the core temperature continually during cooling process to avoid hypothermia; hyperthermia may recur spontaneously within _____

POTASSIUM CHLORIDE, SODIUM BICARBONATE, DIAZEPAM

In managing heat exhaustion & heat stroke, administer medications: ___ for hypokalemia; ______ ___________ to correct metabolic acidosis; and ________ for seizures

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

WARM HAND OVER THE CHILLED AREA

In managing frostbite, frostnip may be treated by placing

DEFINITIVE WARMING

In managing frostbite, leave the frostbitten area alone until __________ _______ is undertaken

REFREEZING

In managing frostbite, __________ of a partially thawed extremity reverses ice crystal formation in tissues and increases tissue damage and loss

37C-40C

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

SLOW REWARMING

In managing frostbite, ____ _________ is less effective and may increase tissue damage

DRY HEAT

In managing frostbite, ___ ____ is not recommended for rewarming

20-30 MINUTES

In managing of frostbite, rewarming procedure may take

WARM TO TOUCH AND PINK OR FLUSHED

In managing frostbite, rewarming is complete when the area is

RUB OR MASSAGE

In managing frostbite, do not ___ __ _______ a frostbitten extremity, the ice crystals in the tissue will lacerate delicate tissues

OPIODS, ANTIBIOTICS, TETANUS PROPHYLAXIS

In managing frostbite, administer these drugs if indicated

LARGE BLISTERS

In managing frostbite, _____ ________ may develop in 1 hour to a few days after rewarming; these should not be broken

STRICT ASEPTIC TECHNIQUE

In managing frostbite, use ______ _______ _________ during dressing change

FOOT CRADLE

In managing frostbite, use a ____ ______ to prevent contact with bedding if feet are involved to prevent further tissue injury

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

HOURLY ACTIVE MOTION

In managing frostbite, encourage ______ ______ ______ of the affected digits to promote maximum restoration of function and to prevent contractures.

TOBACCO

In managing frostbite, advise patient not to use _______ because of the vasoconstrictive effects of nicotine, which further reduce the already deficient blood supply to injured tissues

HYPOTHERMIA

a condition in which the core (internal) temperature of the body is less than 95°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

30 C

In primary assessment and interventions in hypothermia, if body temperature falls below __ _, the heart sounds may not be audible even if the heart is still beating

BP READINGS

In primary assessment and interventions in hypothermia, __ ________ may be extremely difficult to hear because cold tissue conducts sound waves poorly

PUPIL REFLEXES

In primary assessment and interventions in hypothermia, _____ ________ may be blocked by a decrease in cerebral blood flow, so pupils may appear fixed and dilated

SLOW OR SLURRED

In subsequent assessments in hypothermia, speech is

32.2 C

In 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, PLR

In managing hypothermia, start IV with ____, ___ is not recommended

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