A P 1 Case Study 5 Maddie Fitz Patrick PDF

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Maddie FitzPatrick

Lost in the Desert: The Situation Mark Palen, a white, 35-year-old male weighing approximately 70 kilogram (kg) started a three-hour drive across the desert on US 95 from Yuma, Arizona, to Blythe, California. He set out at 7 AM on what was expected to be a very hot July day. He anticipated that it would take him about three hours to reach Blythe—plenty of time to make his 11 AM appointment with Sarah, his fiancée. When he failed to appear by noon, Sarah became concerned and called the highway patrol. By 12:30 PM, Search and Rescue Officer Maria Arroyo, who was patrolling nearby, reported finding an abandoned car on the side of the road with a damaged radiator that matched Sarah’s description of Mark’s vehicle. Maria noticed shoe prints leading into the desert toward some low mountains in the distance. At that point Maria called for helicopter assistance, consulted her GPS, and relayed the exact coordinates to base. Later, while recovering in the hospital, Mark will relate these details about his experience: Since he was a newcomer to desert areas, he saw no need to bring UV A/B sunblock or extra water on his trip from Yuma to Blythe. Mark recalled seeing a coyote dart out between two bushes and he seemed to recollect hitting the animal. The area was so isolated that his cell phone was useless. He waited by the car for a while but then, about 10 AM, as the sun climbed, he saw a large body of water in the distance, possibly, he thought, the Colorado River. After he had walked some distance, Mark became confused and could not find his way back to the highway. Eventually he became very hot and threw away his shirt and hat. By 1:30 PM Henry Morningstar, paramedic and a member of the helicopter crew, reported a shirtless, hatless man wandering down a desert wash. The local radio station reported at about the same time that the air temperature was hovering at 105°F in the shade (and there was darned little of that). The relative humidity was less than 5%. Mark was still conscious but clearly delirious. Henry also noted that Mark was weak, nauseous, disoriented, and complained of a headache. His blood pressure was quite low— 70/50—and he was not sweating despite the oppressive heat. His body temperature was also high— 105°. The paramedic also noted first degree burns on his face and back. Suddenly, Susan Liu, the pilot, reported that they had lost radio contact with the hospital. It was all up to Henry now! Given the conditions, Henry must decide very quickly what to do to save Mark’s life. Instructions: Gather information from credible medical resources (including your textbook) to answer the questions below. Answer the questions as best you can on your own. Then, you will form small groups, discuss the situation and create better answers as a group.

This case study was modified from: http://www.sciencecases.org/thermoregulation/thermoregulation.asp Copyright © 1999–2005 by the National Center for Case Study Teaching in Science.

Maddie FitzPatrick

Lost in the Desert: The Assignment Revised F17

Questions: (include appropriate references in each answer, add space as needed) Part I: Diagnosis and Treatment of Heat Injury 1. List all of the pertinent symptoms that you need to make a proper diagnosis of Mark’s heat injury. Mark experienced weakness, nausea, disorientation, and complained of a headache. He also had low blood pressure—70/50—and was not sweating despite the oppressive heat. He had a high body temp of 105° along with first degree burns on his face and back (symptoms from case study above). 2. Consider the final symptoms and what specifically caused each of them. Describe the order of the physiological events that created each of these symptoms. Note: the physiology of one symptom may be the cause of others. Sun (UV rays) caused the first degree burns on Marks face (Human A&P, page 179). Low blood pressure was caused by dehydration (blood rushing to the skin in attempt to cool down), which also caused Mark to not sweat (not enough fluid in the body to secrete sweat). Dehydration also caused the headache, weakness, nausea and disorientation with little blood flow to the brain. Heat caused an increase in enzyme activity, which caused his body temp to continue to rise (Human A&P, page 932). (https://www.health.harvard.edu/a_to_z/heat-stroke-hyperthermia-a-to-z) 3. Classify this type of heat injury and explain which specific symptoms lead you to that diagnosis/classification. (2 pts) Heat Stroke is caused by a long exposure of elevated temperatures. In this case, the body isn’t able to cool itself efficiently causing increase in enzyme activity, which also causes the internal body temperature to increase (Human A&P, page 932). His high body temperature, altered mental state along with headache and nausea led to a heat stroke diagnosis. (https://www.mayoclinic.org/diseases-conditions/heat-stroke/symptoms-causes/syc-20353581) 4. Based on your diagnosis, what immediate treatment would you provide for Mark? Explain why this is the best treatment. Get Mark into a cool place with shade and apply ice packs to places with an abundance of blood vessels to help cool the body faster (armpits & groin region). If he wasn’t in the desert, he could take a cold bath/shower to help remedy the symptoms. The best treatment is cooling the patient as quickly as possible as they are over heating which can be detrimental to their health. (https://www.mayoclinic.org/diseases-conditions/heat-stroke/symptoms-causes/syc-20353581) (https://www.mayoclinic.org/diseases-conditions/heat-stroke/diagnosis-treatment/drc-20353587) 5. Will Mark now have a greater or lesser chance of experiencing this type of heat injury again in the future? Explain your answer.

Maddie FitzPatrick

Mark will have a greater chance of experiencing this type of heat injury in the future because a heat stroke can breakdown muscle and damage tissue which helps protect you in the first place. (https://www.health.harvard.edu/a_to_z/heat-stroke-hyperthermia-a-to-z) Part II: Effects on the Skin: 6.Mark’s skin would have looked red within the first hour of his adventure. Two days later, Mark’s skin is red from the sunburn and begins to blister. a. What caused Mark’s skin to turn red within the first hour? The blood rushing into the dermis causing the blood vessels to swell/dilate so that heat could be released though his skin (Human A&P, page 162 & 930-931). b. Classify the degree of the final sunburn. Mark ended up with a second-degree sunburn as blistering was involved, effecting the epidermis and dermis of the skin (Human A&P, page 179). 7. What vitamin will Mark have in greater concentrations in his body as a result of these events? Vitamin D (Human A&P, page 164). 8. Will this incident increase Mark’s chances of contracting skin cancer? Explain your answer. Any unprotected sun exposure/UV radiation could lead to higher chances of contracting skin cancer (Human A&P, pages 180&181). Part III: Additional Questions 9. Since you have lost contact with the Hospital, you are not authorized to start an IV and you need to re-hydrate the patient. On board the helicopter is a 4-liter container of bottled water, 4 quarts of GatorAde, and 2 2-liter bottles of coke. Describe each of these drinks in terms of isotonic, hypertonic and/or hypotonic and then explain which one you would give to Mark to drink and why? -

Water is hypotonic compared to the blood Gatorade is hypotonic compared to the blood Coke is hypertonic compared to the blood

Mark should be given Gatorade to rehydrate and restore electrolytes as it’s less hypotonic compared to the water. If water is given to Mark the water can cause the cells to swell (rehydrating cells too quickly) and burst and if coke is given it could cause the cells to shrink (Human A&P, page 79 & 1001). Bonus. Recall that Mark thought he saw the Colorado River. What is this phenomenon called and what causes it? A mirage, which is an optical illusion caused by the refraction of light from the sky by heated air, which makes the appearance of water in a desert or on a hot road. (https://www.merriam-webster.com/dictionary/mirage)...