Environmental Hazards

Bites

100

What do you clean human bite wounds with?

Povidine - Iodine

200

Two most common pathogens from a human bite

Streptoccus sp., Staphlyococcus aureus 

Bonus (50 pts) - Should you leave hand wounds open?

300

Common pathogens in dog bites

a-Hemolytic Streptococci, Staph. aureus, and Less Often, Pasteurella multocida

Bonus (50 pts) - should the wound be left open?

400

Two options for the first line treatment of human bites (must get both)

Second or Third Gen Cephalosporin

Dicloxacillin + Ampicillin or Penicillin

Bonus (100 pts) - What should be added in diabetic patients?

500

What are the treatment options for dog bites? (most common pathogens)

Cephalexin, Dicloxicillin or Amoxicillin-Clavulanate, Erythromycin or TMP-SMX In Penicillin Allergic Patient in infections that occur >24 hours

Penicillin VK, TMP-SMX, Ciprofloxacin, or Clarithromycin In Penicillin-Allergic Patient, Is Indicated For Wound Infections Occurring > 24 Hours & Pasteurella multocida

Allergic Reactions

100

What is Madison allergic to?

Cats

200

First line treatment of anaphylaxis

EpiPen

Bonus (50 pts) - What two other things can you use?

300

What is the most common type of allergic reaction?

IgE mediated - Hypersensitivity reaction to a foreign antigen

400

Name 7 of the most common things people are allergic to. 

Food… Eggs, Milk, Peanuts, Shellfish, Soy, Tree Nuts, Wheat

Drugs… Antibiotics, Aspirin, Muscle Relaxants, Nonsteroidal, Opiates, Anesthetics (Novocain, Xylocaine, Benzocaine)

Insect Venom… Hymenoptera Group… Honeybees, Yellow Jackets, Hornets, Wasps, Fire Ants

Latex

Radiocontrast Media… from X-Rays

500

Name one s/s of anaphylaxis in each of the following categories:

Skin

Respiratory

GI

CV

Neuro

Skin - Swelling, Flushing, Pruritus

Respiratory - Dyspnea, Wheezing, Upper Airway Angioedema, Rhinitis, Bronchospasm

Gastrointestinal - Nausea, Vomiting, Diarrhea, Cramping Pain

Cardiovascular - Tachycardia, Hypotension, Chest Pain, Cardiac Collapse, Cardiac Arrest

Neurological - Headache, Dizziness, Seizures, Premonition of Impending Doom 

Submersion

100

Name five risk factors for drowning

•Age < 5 years old

•Drugs… Particularly Alcohol

•Inadequate Swimming Skills

•Exhaustion

•Hyperventilation Before Underwater Swimming

•Trauma

•Accidental… Cervical Spine Injuries, Head Injuries

•Nonaccidental… Child Abuse

•Underlying Illnesses

•Hypoglycemia

•Seizures

•Myocardial  Infarction

•Cardiac Dysrhythmias

•Depression… Suicide Attempt

•Lack of Supervision

•Hypothermia

200

What three GENERAL things to you want to check first when a patient presents to the ED due to submersion injury?

•Airway Patency

•Adequacy of Cervical Spine Immobilization

•Mental Status

300

Treatment of submersion injury

100% O2

Treat Bronchospasm with albuterol 

400

When is intubation indicated?

•pO2 < 60 mmHg in Adults or…

•< 80 mmHg in Children While On High-Flow Oxygen

500

Name 4 factors that can indicate a good outcome in a submersion injury patient. 

•Duration of Both Submersion and Resuscitation

•Short Submersion Time

•Basic and / or Advanced Life Support at Scene

•No Trauma

•Older Child > 3 y/o or Adult

•Water Temperature… 41°-50°F / 5-10°C 

•Submersion Duration < 25-60 minutes

•Cardiac Arrest Requiring < 25 minutes Advanced Life Support

Spiders

100

Treatment of black window spider bites

Ice, Narcotic Analgesics

Benzodiazepines… Relieve Muscle Spasms

Antivenom

Bonus (50 pts) - where is antivenom derived from? 

200

Treatment of brown recluse spider bite

•Compresses Locally

•Antihistamines… for Pruritus

•Parenteral Corticosteroids… Prevent Hemolysis

300

Name 4 immediate s/s of black widow spider bite

•Local… Dull, Muscle Cramping

•Upper Extremity Bite… Chest Pain

•Lower Extremity or Genitalia Bite…

•Nausea, Vomiting, Cramps

•Abdominal Pain with Rigid Abdomen,  Simulates “Acute Abdomen”

•Differentiating Feature… Abdominal Rigidity with Little or No Tenderness

400

Name 3 s/s of brown recluse spider bite

•Lesion With… Halo of Vasoconstriction, then…

•Central Bleb… Classic Bull’s­ Eye Lesion, with Volcano Hole

•Progressive Localized Ischemic Necrosis

•Fever, Chills, Petechial Rash, Nausea, Vomiting, Weakness

•May Progress to Hemolysis, Shock, Renal Failure, Disseminated Intravascular Coagulation

500

Name 4 s/s of systemic black widow spider bite effects

•Leads to Neurotoxic Effects, Diffuse CNS and Peripheral Nervous Excitation

•Diffuse Muscle Pain and Stiffness

•Dizziness and Restlessness

•Profuse Sweating… Uniquely Focal To One Area, and Weakness

•Difficulty in Speaking and Ptosis

Grab Bag

100

What is the causative organism for cat scratch dx?

Bartonella henselae

200

Fill in the blanks:

Red touches yellow ______

Red touches black _____

Kill a fellow

You're ok, Jack

300

Treatment of cat scratch disease

Do not I&D

Most resolve on their own

Refractory - TMPMSMX, Gentamicin, Ciprofloxacin, Erythromycin

400

When do you give tetanus prophylaxis?

<3 doses or unknown

clean/minor wounds - if last dose was >10 years

other wounds - if last dose was >5 years

500

What is the scientific name of black widow & brown recluse spider?

BW - Latrodectus mactans

BR - Loxosceles reclusa