Heat
At what temperature do we begin to consider an antipyretic? What is an antipyretic?
100.4
Tylenol (Acetamenophen)
True or False
In water ventilations and CPR are just as effective as on land and should both be prioritized
False
What is temperature mild hypothermia?
What are our next actions?
>93 F
Warm blankets, warm environment, warm fluids
What is Altitude sickness and how do you treat it?
The higher you go, the less pressure = less effective gas exchange. The faster you go, the worse it gets. Treatment = decent.
You have a pt that reports that they were bitten by an unknown snake. Upon arrival, what are your next steps?
Get a description of the snake/ offending creature, and or get a picture. The more information the better for identifying it.
Draw with a marker the affected site and area along with the time. Splint the limb.
At what temperature do we begin passive cooling and what actions should we pursue?
103
Take off excess clothing, remove from environment, cool the new environment, wet towels, add fluids.
When working with a dead drowning, what is our approach to CPR? Do still follow the CAB protocol?
Drowning CPR: ABC
Normal CPR: CAB
What is temperature moderate hypothermia?
What are our next actions?
86-93 F
Warm packs to neck, armpits, groin (wrap in a towel to keep pt from getting burns)
Warm fluids
What are the signs and symptoms for HAPE?
What does it stand for?
What is our initial treatment?
Shortness of breath while at rest, tachycardia, tachypnea, Crackles upon listening to lung sounds.
Late stage = pink frothy sputum and audible gurgling sounds without auscultation.
Treatment: O2 placement and descent from altitude along with rest for pt.
True of False?
Antivenom can not only save, but also reverse the effects of venom on the pt?
False
It will neutralize the venom and stop further swelling and cell death.
At what temperature do we begin active cooling? What are our actions?
105
Take off excess clothing, remove from environment, cool the new environment, add fluids, place cold packs in armpits, groin, and along the neck.
When you recover a buried (head and chest below snow) avalanche victim with no apparent injuries, what are your next steps?
Transport pt to the nearest medical facility for evaluation
What is temperature severe hypothermia?
What are our next actions?
<86 F
Same actions as moderate hypothermia.
What are the signs and symptoms for HACE?
What does it stand for?
What are our initial treatments?
High Altitude Cerebral Edema
Lack of appetite, nausea, vomiting, decreased level of consciousness and stupor, truncal ataxia (drunken sailor = wide-based, uncoordinated movements). Roughly 12 hours after onset of symptoms, the patient will likely become nonambulatory.
Desent from the altitude. (Pt may also have taken Decadron, an anti-inflammatory medication, to reduce Edema)
You expose the pt affected area and see 2 half moon (Circumfrential bite marks). Was this from a venomous snake?
What venomous snakes do we have here in Utah?
No. Show picture of fang marks and circumferential bites.
1/3 of snake bites do not actually envenomate (dry bites). Smaller/ younger snakes will more likely envenomate. This will help calm the pt. (A calm pt will spread venom less quickly)
Utah Venomous snakes are all sub-species of rattlesnake. They are most active at dawn and dusk.
https://www.worldatlas.com/animals/the-venomous-snakes-of-utah.html
What is the difference between heat cramps, heat exhaustion, and heat stroke?
Heat cramps is the cramping of the muscles while working out in hot climates. Causing the spasming, tightening, pain of muscles. The happens due to the body sweating out nutrients. (drink Gatorade)
Heat exhaustion is where the body gets tired and sweats from the heat. (no altered mental status)
Heat stroke is the altered status and lack of sweat
When performing CPR on an avalanche victim, what are criteria for ending CPR?
Continue until pt is warmed to a core until 86 degrees fariehhgit.
Was the arrest due to pt trauma or hypothermia?
In Severe Hypothermic Cardiac Arrest, how are our actions different from a normal cardiac arrest?
- more likely to be successful after rewarming
If cardiac arrest is assumed to be due to hypothermia, do not rewarm pt and transport to Primary childrens or UofU/ IMC for ECMO
Handle pt gently (risk of precipitate dysrhythmias)
Above what height do we normally see Altitude sickness
To what height do we descend?
above 8,000
descend to below 3,300
The pediatric pt was bitten by a rattlesnake and is showing decompensating signs and symptoms. What hospitals would be most appropriate?
Which hospitals carry antivenom?
Call Poison Control and confirm hospital stock.
Primary Childrens is best for peds
The only confirmed hospital in utah that carries antivenom is UofU.
- Crofab
- ANAVIP
At what temp does a FireFighter mask melt
Daily Double
500
In a cardiac arrest due to Hypothermia/ Avalanche, and in a difficult area to manage, how do we move the pt and keep effective compressions on the chest?
CPR may be done, with starting and stopping in 5 minute incriments due to dynamic scene safety (such as weather), prolonged transport, or difficult rescue; with the pt suspected of being severely hypothermic (<26 C).
How long do we assess for a pulse in a hypothermic cardiac arrest pt?
30-45 seconds
A heartbeat may be very weak and or very slow if pt was submerged in cold water. (mammalian diving reflex)
Bonus: How tall are the mountains in wasatch fire district?
Mountain height:
Heber (Strawberry: 10,000)
Midway (9,500)
Jordanelle (9,500)
Signs and Symptoms of Envenomation?
dizzy, nausea, swelling, metallic taste, headache, vomiting, hypotension, chills, discoloration.