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PHTLS CH 22 PART 2 Exam Questions and Answers 2024/2025( A+ GRADED 100% VERIFIED).
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PHTLS CH 22 PART 2the risk of ultraviolet bums to skin and eyes increases. This risk is greatly enhanced at higher
altitudes. Solar
keratitis is insidious during the exposure phase, with corneal burns occurring within 1 hour, but
not becoming apparent until 6
to 12 hours after exposure - ANS Management of snow blindness is based on symptoms,
which include excessive tearing, pain, redness, swollen eye
lids, pain when looking at light, headache, a gritty sensation in
the eyes, and decreased (hazy) vision
Topical ophthalmic anesthetic drops,
if available, may be used to provide symptomatic relief
Major Cold-Related Disorders
Localized Cutaneous Cold Injury
Cold injuries occur at peripheral sites on the body and are classified as either freezing (e.g.,
frostbite) or nonfreezing (e.g., immersion foot) injuries. - ANS frostbite, potentially
the most serious form of freezing injury because of the risk of
limb loss, is the primary injury of concern in this section
Nonfreezing Cold Injury
Nonfreezing cold injury (NFCI), a syndrome also called immersion foot and trench foot, results
from damage to peripheral tissues caused by prolonged (hours to days) wet/cold exposure -
ANS NFCI does not involve freezing of tissue but may coexist with
freezing injury such as frostbite
Trench
foot occurs primarily in military personnel during infantry
operations and is related to the combined effects of prolonged
cold exposure and restricted circulation in the feet; it does not
involve immersion in water - ANS immersion foot is caused by pro
longed immersion of extremities in moisture that is cool to cold. causing
Soft-tissue injury occurs to the skin of the feet,known as maceration
NFCI is classified in four degrees of severity, as follows
Minimal. Hyperemia or engorgement caused by an increase in blood flow to the feet and slight
sensory change will remain 2 to 3 days after injury. Condition is self-limited, and no signs of
injury remain after 7 days. Occasionally, cold sensitivity will remain
Mild. Edema, hyperemia, and slight sensory change remain 2 to 3 days after injury. Seven days
after injury,anesthesia is found on the plantar surface of the foot and tips of the toes and lasts 4
to 9 weeks. Blisters and skin loss are not observed. Amputation is possible
, when walking does not cause pain - ANS Moderate. Edema, hyperemia, blisters, and mottling
are present 2 to 3 days after injury. At 7 days, anesthesia to touch is present to both dorsal and
plantar surface
and toes. Edema persists 2 to 3 weeks, and pain and hyperemia last up to 14 weeks. Some
blister sloughing occurs, but no loss of deep tissue. Some patients will
have permanent injury.
Severe. Severe edema, blood forced into surrounding
tissues (exti-avasation), and gangrene are present 2 to3 days after injury. Complete anesthesia
of the entire foot remains at 7 days, with paralysis and muscle wasting in the affected
extremities. The injury goes beyond the foot into the lower leg. This severe injury produces
significant tissue loss, resulting in auto amputation(non surgical amputation of dead tissue).
Gangrene is a constant risk until tissue loss is complete. The patient
is expected to have prolonged convalescence and permanent disability.
CFCI MANAGEMENT
Cover the Injured part or extremity with a loose, dry, sterile dressing; protect it from the cold; and
begin passive rewarming of injured tissue during transport. The affected area may be
aggravated by the weight of a blanket. No active rewarming is necessary. - ANS . As needed,
treat the patient for
dehydration with a bolus of IV fluids, and reassess. Depending
on length of transport, severe pain may develop during passive
rewanning as tissues begin to reperfuse, and it may be necessary
to manage the discomfort with adequate opiate analgesia (e.g.,
begin with 5 mg morphine IV as needed
Freezing Cold Injury
On the continuum of further peripheral cold tissue exposure
beginning with frostnip (no tissue loss), frostbite ranges from
mild to severe tissue destruction and possibly the loss of tissue
due to intense vasoconstriction - ANS The most susceptible body
parts for frostbite are those tissues with large surface-to-mass
ratios, such as the ears and nose or areas farthest from the body's
core, such as the hands, fingers, feet, toes, and male genitalia
-anastomosis (connections) that easily shunt blood away during vasoconstriction
When an extremity is cooled to 59°F (15°C), maximal vasoconstriction and minimal blood flow
occur. If cooling continues to 50°F (IO°C), vasoconstriction is interrupted ted by periods of
cold-Induced vasodilation (ClVD), known as the "hunting response," and an associated increase
in tissue temperature caused by an increase in blood flow - ANS CIVD recurs in 5- to
10-minute cycles to provide some protection from the cold
Tissue does not freeze at 32°F (0°C) because cells contain electrolytes and other solutes that
prevent tissue from freezing until skin temperature reaches approximately 28°F - ANS In cases
of below-freezing temperatures, when the extremities are
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