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Prevention and Management of Heat-Related Illness
PREVENTION AND MANAGEMENT OF HEAT-RELATED ILLNESS Federal Bureau of Prisons Clinical Guidance DECEMBER 2017 Federal Bureau of Prisons (BOP) Clinical Guidance is made available to the public for informational purposes only. The BOP does not warrant this guidance for any other purpose, and assumes no responsibility for any injury or damage resulting from the reliance thereof. Proper medical practice necessitates that all cases are evaluated on an individual basis and that treatment decisions are patient- specific. Consult the BOP Health Management Resources Web page to determine the date of the most recent update to this document: http://www.bop.gov/resources/health_care_mngmt.jsp Federal Bureau of Prisons Prevention and Management of Heat-Related Illness Clinical Guidance December 2017 TABLE OF CONTENTS 1. PURPOSE AND OVERVIEW ......................................................................................................................1 2. PATHOPHYSIOLOGY...............................................................................................................................1 3. RISK FACTORS FOR HRI ........................................................................................................................2 4. SYMPTOMS AND SIGNS ..........................................................................................................................3 5. EVALUATION.........................................................................................................................................5 6. TREATMENT..........................................................................................................................................6 -
Differentiating Between Anxiety, Syncope & Anaphylaxis
Differentiating between anxiety, syncope & anaphylaxis Dr. Réka Gustafson Medical Health Officer Vancouver Coastal Health Introduction Anaphylaxis is a rare but much feared side-effect of vaccination. Most vaccine providers will never see a case of true anaphylaxis due to vaccination, but need to be prepared to diagnose and respond to this medical emergency. Since anaphylaxis is so rare, most of us rely on guidelines to assist us in assessment and response. Due to the highly variable presentation, and absence of clinical trials, guidelines are by necessity often vague and very conservative. Guidelines are no substitute for good clinical judgment. Anaphylaxis Guidelines • “Anaphylaxis is a potentially life-threatening IgE mediated allergic reaction” – How many people die or have died from anaphylaxis after immunization? Can we predict who is likely to die from anaphylaxis? • “Anaphylaxis is one of the rarer events reported in the post-marketing surveillance” – How rare? Will I or my colleagues ever see a case? • “Changes develop over several minutes” – What is “several”? 1, 2, 10, 20 minutes? • “Even when there are mild symptoms initially, there is a potential for progression to a severe and even irreversible outcome” – Do I park my clinical judgment at the door? What do I look for in my clinical assessment? • “Fatalities during anaphylaxis usually result from delayed administration of epinephrine and from severe cardiac and respiratory complications. “ – What is delayed? How much time do I have? What is anaphylaxis? •an acute, potentially -
Motion Sickness: Definition
Clinical and physiological characteristics of cybersickness Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy (Human Physiology) School of Biomedical Sciences and Pharmacy Faculty of Health and Medicine University of Newcastle, Australia This research was supported by an Australian Government Research Training Program (RTP) Scholarship. 1 STATEMENT OF ORIGINALITY I hereby certify that the work embodied in the thesis is my own work, conducted under normal supervision. The thesis contains no material which has been accepted, or is being examined, for the award of any other degree or diploma in any university or other tertiary institution and, to the best of my knowledge and belief, contains no material previously published or written by another person, except where due reference has been made. I give consent to the final version of my thesis being made available worldwide when deposited in the University’s Digital Repository, subject to the provisions of the Copyright Act 1968 and any approved embargo. Alireza Mazloumi Gavgani 2 ACKNOWLEDGMENT OF AUTHORSHIP I hereby certify that the work embodied in this thesis contains published paper/s/scholarly work of which I am a joint author. I have included as part of the thesis a written declaration endorsed in writing by my supervisor, attesting to my contribution to the joint publication/s/scholarly work. Alireza Mazloumi Gavgani 3 STATEMENT OF COLLABORATION I hereby certify that some parts of the work embodied in this thesis have been done in collaboration with other researchers. I have included as part of the thesis a statement clearly outlining the extent of collaboration, with whom and under what auspices. -
Environmental Issues in Sports Medicine Jeremiah Penn, MD Sanford Orthopedics and Sports Medicine Bismarck, ND Lecture Objectives
Environmental Issues in Sports Medicine Jeremiah Penn, MD Sanford Orthopedics and Sports Medicine Bismarck, ND Lecture Objectives Identify common environmental illnesses Describe prevention of environmental illness Describe treatment for life-threatening and non-emergent environmental illness Mt Everest 29,029 ft above sea level First climbed by Edmund Hillary and Tenzing Norgay on May 29, 1953 Number of summits in 1975: 15 Number of summits in 1995: 83 Number of summits in 2004: 330 Number of summits in 2010: 513 Introduction Outdoor sports are increasing in popularity Participants are becoming more “extreme” Family physicians need to be able to recognize and treat these problems in their patient population Environmental Illness Heat related Illness Cold injury Altitude UV Light Lightning Heat related Illness Heat edema Heat rash Heat syncope Heat cramps Heat exhaustion Heat stroke Human Heat Loss Convection Conduction Evaporation Radiation Chicago Marathon 2007 Wet Bulb Globe Temperature Developed by USMC in 1956 at Parris Island, SC Takes into account temperature, humidity, wind speed, and solar radiation WBGT = 0.7Tw + 0.2Tg + 0.1Td Wet Bulb Globe Temperature Category Temperature (°F) Flag 1 <79.9 None 2 80 – 84.9 Green 3 85 – 87.9 Yellow 4 88 – 89.9 Red 5 ≥90 Black Heat Index Chart Developed by RG Steadman in 1979 Takes into account temperature and relative humidity Much easier to calculate, don’t need special equipment Heat Edema Transient venodilation to facilitate core heat loss Normal body temperature -
Neurological and Neurourological Complications of Electrical Injuries
REVIEW ARTICLE Neurologia i Neurochirurgia Polska Polish Journal of Neurology and Neurosurgery 2021, Volume 55, no. 1, pages: 12–23 DOI: 10.5603/PJNNS.a2020.0076 Copyright © 2021 Polish Neurological Society ISSN 0028–3843 Neurological and neurourological complications of electrical injuries Konstantina G. Yiannopoulou1, Georgios I. Papagiannis2, 3, Athanasios I. Triantafyllou2, 3, Panayiotis Koulouvaris3, Aikaterini I. Anastasiou4, Konstantinos Kontoangelos5, Ioannis P. Anastasiou6 1Neurological Department, Henry Dunant Hospital Centre, Athens, Greece 2Orthopaedic Research and Education Centre “P.N. Soukakos”, Biomechanics and Gait Analysis Laboratory “Sylvia Ioannou”, “Attikon” University Hospital, Athens, Greece 31st Department of Orthopaedic Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece 4Medical School of Athens, National and Kapodistrian University of Athens, Athens, Greece 51st Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece 61st Urology Department, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece ABSTRACT Electrical injury can affect any system and organ. Central nervous system (CNS) complications are especially well recognised, causing an increased risk of morbidity, while peripheral nervous system (PNS) complications, neurourological and cognitive and psychological abnormalities are less predictable after electrical injuries. PubMed was searched for English language clinical observational, retrospective, -
Case Report Myelopathy and Amnesia Following Accidental Electrical Injury
Spinal Cord (2002) 40, 253 ± 255 ã 2002 International Spinal Cord Society All rights reserved 1362 ± 4393/02 $25.00 www.nature.com/sc Case Report Myelopathy and amnesia following accidental electrical injury J Kalita*,1, M Jose1 and UK Misra1 1Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow, India Objective: Documentation of MRI and neurophysiological changes following accidental electrical injury. Setting: Tertiary care referral teaching hospital at Lucknow, India. Results: A 30-year-old lady developed amnesia and spastic paraparesis with loss of pin prick sensation below the second thoracic spinal segment following electrocution. Her spinal MRI was normal and cranial MRI revealed T2 hyperintensity in the right putamen. Peroneal, sural and electromyography were normal. Tibial central sensory conduction time was normal but central motor conduction time to lower limbs and right upper limb was prolonged. Conclusion: Neurophysiological study and MRI may help in understanding the pathophy- siological basis of neurological sequelae following electrical injury. Spinal Cord (2002) 40, 253 ± 255. DOI: 10.1038/sj/sc/3101275 Keywords: electrical injury; MRI; evoked potential; myelopathy; amnesia Introduction Rural electri®cation has received great attention from across the road. Her hands were wet, the road was the government for improving agricultural and small ¯ooded with water and the wire was conducting AC of scale industry development in India. This has inherent 11 000 V. Immediately, she had fallen down and the hazards because of the ignorance of villagers and poor wire stuck to her chest. The current ¯ow was maintenance of electrical cables. This results in several discontinued after about 5 min and she was discovered electrical accidents caused by the touching of live wires. -
Title: Drowning and Therapeutic Hypothermia: Dead Man Walking
Title: Drowning and Therapeutic Hypothermia: Dead Man Walking Author(s): Angela Kavenaugh, D.O., Jamie Cohen, D.O., Jennifer Davis MD FAAP, Department of PICU Affiliation(s): Chris Evert Children’s Hospital, Broward Health Medical Center ABSTRACT BODY: Background: Drowning is the second leading cause of death in children and is associated with severe morbidity and mortality, most often due to hypoxic-ischemic encephalopathy. Those that survive are often left with debilitating neurological deficits. Therapeutic Hypothermia after resuscitation from ventricular fibrillation or pulseless ventricular tachycardia induced cardiac arrest is the standard of care in adults and has also been proven to have beneficial effects that persist into early childhood when utilized in neonatal birth asphyxia, but has yet to be accepted into practice for pediatrics. Objective: To present supportive evidence that Therapeutic Hypothermia improves mortality and morbidity specifically for pediatric post drowning patients. Case Report: A five year old male presented to the Emergency Department after pool submersion of unknown duration. He was found to have asphyxial cardiac arrest and received bystander CPR, which was continued by EMS for a total of 10 minutes, including 2 doses of epinephrine. CPR continued into the emergency department. Upon presentation to the ED, he was found to have fixed and dilated pupils, unresponsiveness, with a GCS of 3. Upon initial pulse check was found to have return of spontaneous circulation, with sinus tachycardia. His blood gas revealed 6.86/45/477/8/-25. He was intubated, given 2 normal saline boluses and 2 mEq/kg of Sodium Bicarbonate. The initial head CT was normal. -
Instructor's Guide
Course Outline pg.1 Heat-Related Illnesses A Risk Easy to Battle Training Hazard Area: Extreme Temperatures Training Topic: Heat-related illnesses: recognition, prevention and treatment Target Industries: Construction and general industries Goal: To train students to recognize, prevent and treat heat-related illnesses resulting in fewer illnesses and deaths from working in extreme heat Learning Objectives: Students will learn: 1) the signs and symptoms of heat stroke, heat exhaustion, heat cramps, hyponatremia and dehydration; 2) how to prevent heat-related illnesses when working in extreme heat indoors or outdoors; 3) how to treat heat-related illnesses; 4) employers and managers – how to develop and implement a heat acclimatization plan and reduce their employees’ risks of developing heat-related illnesses Languages: English and Spanish Course Materials: Table 1 in the Appendix Course Deliver Methods: Informal tabletop flip chart, formal PowerPoint presentations, short videos, worksheets, handouts and game. Can be taught in three separate sections: Recognition, prevention and treatment. Environment: Can be taught indoors or outdoors utilizing different course materials Evaluation Materials: Pre and post assessments, class examinations and class evaluations Class Length: 20 – 60 minutes or longer depending on materials and method used Handouts: Three handouts: NOAA’s National Weather Service Heat Index Chart, NOAA’s National Weather Service Heat Index Chart for Low Humidity and Are You Hydrated? – urine color chart. Promotional Material: Two 8 x 10 flyers in English and Spanish to promote the training classes. Workplace Posters: 1) Three 11 x 17 posters that can also be printed 8 x 10 Topics: Reminding workers to cool down frequently to avoid heat-related illnesses, reminding workers to prevent heat-related illnesses and reminding workers to stay hydrated to prevent heat-related illnesses. -
Treatment of Equine Gastric Impaction by Gastrotomy R
EQUINE VETERINARY EDUCATION / AE / april 2011 169 Case Reporteve_165 169..173 Treatment of equine gastric impaction by gastrotomy R. A. Parker*, E. D. Barr† and P. M. Dixon Dick Vet Equine Hospital, University of Edinburgh, Easter Bush Veterinary Centre, Midlothian; and †Bell Equine Veterinary Clinic, Mereworth, UK. Keywords: horse; colic; gastric impaction; gastrotomy Summary Edinburgh with a deep traumatic shoulder wound of 24 h duration. Examination showed a mildly contaminated, A 6-year-old Warmblood gelding was referred for treatment of 15 cm long wound over the cranial aspect of the left a traumatic shoulder wound and while hospitalised developed scapula that transected the brachiocephalicus muscle a large gastric impaction which was unresponsive to and extended to the jugular groove. The horse was sound medical management. Gastrotomy as a treatment for gastric at the walk and ultrasonography showed no abnormalities impactions is rarely attempted in adult horses due to the of the bicipital bursa. limited surgical access to the stomach. This report describes The wound was debrided and lavaged under standing the successful surgical treatment of the impaction by sedation and partially closed with 2 layers of 3 metric gastrotomy and management of the post operative polyglactin 910 (Vicryl)1 sutures in the musculature and complications encountered. simple interrupted polypropylene (Prolene)1 skin sutures, leaving some ventral wound drainage. Sodium benzyl Introduction penicillin/Crystapen)2 (6 g i.v. q. 8 h), gentamicin (Gentaject)3 (6.6 mg/kg bwt i.v. q. 24 h), flunixin 4 Gastric impactions are rare in horses but, when meglumine (Flunixin) (1.1 mg/kg bwt i.v. -
Most Common Robotic Bariatric Procedures: Review and Technical Aspects Pablo A
Acquafresca et al. Ann Surg Innov Res (2015) 9:9 DOI 10.1186/s13022-015-0019-9 REVIEW Open Access Most common robotic bariatric procedures: review and technical aspects Pablo A. Acquafresca1, Mariano Palermo1*, Tomasz Rogula2, Guillermo E. Duza1 and Edgardo Serra1 Abstract Since its appear in the year 1997, when Drs. Cadiere and Himpens did the first robotic cholecystectomy in Brus- sels, not long after the first cholecystectomy, they performed the first robotic bariatric procedure. It is believed that robotically-assisted surgery’s most notable contributions are reflected in its ability to extend the benefits of minimally invasive surgery to procedures not routinely performed using minimal access techniques. We describe the 3 most common bariatric procedures done by robot. The main advantages of the robotic system applied to the gastric bypass appear to be better control of stoma size, avoidance of stapler costs, elimination of the potential for oro- pharyngeal and esophageal trauma, and a potential decrease in wound infection. While in the sleeve gastrectomy and adjustable gastric banding its utility is more debatable, giving a bigger advantage during surgery on patients with a very large BMI or revisional cases. Keywords: Bariatric surgery, Robotic surgery, Gastric by pass, Sleeve gastrectomy, Gastric band Background laparoscopy and robotic laparoscopy is now a controver- Since its appear in the year 1997, when Drs. Cadiere and sial topic that concerns patients and surgeons alike. Himpens did the first robotic cholecystectomy in Brussels To date, the robotic technique is reported to be at least [1], the da Vinci™ Robotic Surgical System from Intuitive as safe and effective as the conventional approach for sev- Surgical, Inc., Sunny Vale, California (Fig. -
The Post-Mortem Appearances in Cases of Asphyxia Caused By
a U?UST 1902.1 ASPHYXIA CAUSED BY DROWNING 297 Table I. Shows the occurrence of fluid and mud in the 55 fresh bodies. ?ritfinal Jlrttclcs. Fluid. Mud. Air-passage ... .... 20 2 ? ? and stomach ... ig 6 ? ? stomach and intestine ... 7 1 ? ? and intestine X ??? Stomach ... ??? THE POST-MORTEM APPEARANCES IN Intestine ... ... 1 Stomach and intestine ... ... i CASES OF ASPHYXIA CAUSED BY DROWNING. Total 46 9 = 55 By J. B. GIBBONS, From the above table it will be seen that fluid was in the alone in 20 LIEUT.-COL., I.M.S., present air-passage cases, in the air-passage and stomach in sixteen, Lute Police-Surgeon, Calcutta, Civil Surgeon, Ilowrah. in the air-passage, stomach and intestine in seven, in the air-passage and intestine in one. As used in this table the term includes frothy and non- frothy fluid. Frothy fluid is only to be expected In the period from June 1893 to November when the has been quickly recovered from months which I body 1900, excluding three during the water in which drowning took place and cases on leave, 15/ of was privilege asphyxia examined without delay. In some of my cases were examined me in the due to drowning by it was present in a most typical form; there was For the of this Calcutta Morgue. purpose a bunch of fine lathery froth about the nostrils, all cases of death inhibition paper I exclude by and the respiratory tract down to the bronchi due to submersion and all cases of or syncope was filled with it. received after into death from injuries falling The quantity of fluid in the air-passage varies the water. -
Journal of Clinical Toxicology Iwai Et Al., J Clin Toxicol 2014, 4:6 ISSN: 2161-0495 DOI: 10.4172/2161-0495.1000218
linica f C l To o x l ic a o n r l o u g o y J Journal of Clinical Toxicology Iwai et al., J Clin Toxicol 2014, 4:6 ISSN: 2161-0495 DOI: 10.4172/2161-0495.1000218 Case Report Open Access Utility of Upper Gastrointestinal Endoscopy for Management of Patients with Roundup® Poisoning Kenji Iwai1, Masato Miyauchi2, Daisuke Komazawa1, Ryoko Murao1, Hiroyuki Yokota2, and Atushi Koyama1 1Department of Emergency and Critical Care Medicine, Iwaki Kyoritu General Hospital, Fukushima, Japan 2Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan *Corresponding author: Masato Miyauchi, Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan, Tel: +81-3-3822-2131; E-mail: [email protected] Received date: Nov 03, 2014, Accepted date: Dec 05, 2014, Published date: Dec 08, 2014 Copyright: © 2014, Miyauchi M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Introduction: Roundup® is a herbicide widely used in Japan in gardening and agriculture. When ingested, Roundup is highly toxic, but gastrointestinal decontamination, including gastric lavage, is not routinely performed after ingestion. Endoscopy may be useful in managing individuals with liquid herbicide poisoning, by identifying gastric residual contents, assessing mucosal damage and retrieving herbicide directly by aspiration. Case report: A 73 year old, 40 kg female with a history of depression was transported to our emergency room by ambulance 1 h after attempting suicide by ingesting 100 ml Roundup, which contains 48% glyphosate-potassium, and 52% surfactant and water.