Skin Anatomy
How many different sections is the skin divided into?
3: Epidermis(outer), dermis(middle), hypodermis(deepest)
True or False: all frostbite is the same severity
False: Frostbite, similar to burns, is graded based on the depth of tissue damage.
True of False: You should rub skin affected by frostbite to rewarm it
False, the skin is fragile and this could cause more damage
True or False: If you place a tourniquet and it doesn't control the bleeding, a second tourniquet should be placed distal to the initial one.
False, the second tourniquet should be placed proximal(closer to the core) to the initial tourniquet.
What part of the skin contains blood vessels, hair follicles, sweat glands, nerves, and sebaceous glands?
Dermis
True or False: All patients with hypothermia with be shivering
False: Patients stop shivering once their body temperature drops to a certain point. The extent of this varies by person.
True or False: You should start CPR on hypothermic patients that still have a pulse but are severely bradycardic.
False, starting CPR on these patients could precipitate ventricular fibrillation.
True or False: You should place a bite block in the mouth of a patient have a seizure so they don't bite their tongue.
False, never place anything in the mouth of a seizing patient.
True or False: Skin assists in vitamin D production when exposed to sunlight
True
Name 3 possible ECG findings in severe hypothermia
Bradycardia
Asystole
Ventricular fibrillation
What is the first step you should take when encountering a patient who is actively being exposed to the cold?
Remove them from the cold environment.
From 20 weeks gestation until 4 weeks postpartum.
What is responsible for skin tone/color?
Melanin, this is found in the epidermis.
List the 4 cold death criteria
1. Patient is frozen solid
2. Ice in the airway
3. Signs of predation
4. Head submerged under water >60 minutes for adult or >90 minutes for child
Where are the 3 locations where hot packs should be placed while rewarming hypothermic patients?
Axillae, groin, and thorax
While working a cardiac arrest, your team decides to place the Lucas device. You clip in both sides and push the plunger down but hear 3 fast beeps. What does this mean adn what should you do next?
The patient is too small for the Lucas device. Remove it and resume manual compressions immediately.
What component of skin is responsible for its flexibility and strength?
Collagen(protein)
Differentiate between typical signs and symptoms of mild-moderate and severe hypothermia
Mild-moderate: Temp 86-95, possibly normal mental status, usually will be shivering
Severe: Temp <86, altered mental status, poor muscle control/stiffness, usually no shivering
You arrive on scene of a "man down." You find a patient that appears to have traumatic injuries on the side of the road and it is below freezing outside. The patient is pulseless and not breathing. You are unsure of how long the patient has been there but note no obvious signs of predation and he is not frozen. Does he meet cold death criteria? What are your next steps?
No he does not. The cardiac arrest should be treated as a hypothermic arrest. CPR should be initiated while actively warming the patient. 1 shock can be administered if indicated.
You are on scene with a patient in respiratory arrest. The patient does not have a gag reflex so you decide to place an I-Gel. The patient has a significant amount of stomach contents coming up into the airway. Name and describe the technique that should be used to effectively place the I-Gel.
SALAD technique: Suction Assisted Laryngoscopy and Airway Decontamination