Page 210 - PJ MED OPS Handbook 8th Ed

2) Watch for hypotension and dysrhythmias
3) Maintain high suspicion for methemoglobinemia
i. SpO2 may appear normal but patient appears cyanotic and dyspneic – chocolate
brown blood
vi) Medications
1) Establish IV
2) Consider antibiotics for prophylaxis with airway and ingestion burns
3) Consider corticosteroids for airway edema
4) Consider aerosolized bronchodilators
5) Consider antihistamines
6) Consider 1% methylene blue for methemoglobinemia
i. Accelerates the reduction of methemoglobin to hemoglobin indicated for the
treatment of patients with methemoglobinemia
ii. Dose: 1mg/kg intravenously over 5 minutes. Repeat in 1 hour if needed
7) Consider pyridoxine (B6) for pulmonary edema, seizures
i. Hydrazine effects the CNS in a way that may prevent benzodiazepines from being
effective
ii. Consider use when inhalation of vapors has produced pulmonary edema and
seizures
iii. Dose: 25mg/kg, slow IV over 30-60 minutes if seizing
3. Decompression Sickness
a. The crew members wear pressurized suits. Suit pressure and flow of air is controlled by an
Environmental Controls and Life Support System (ECLSS). Each vehicle has its own unique
suit design. Individual suit removal and associated hands on training is covered in a separate
lesson
b. If the rescue team suspects DCS, they need to treat accordingly and coordinate transport to
MTF’s with chamber capabilities
4. Long-Duration Space Flight Physiology
a. Musculoskeletal System
i) Bone density decreases by 1.3–1.5% per month. Mitigated by exercise
1) Theoretical risk of kidney stones secondary to calcium excretion. Risk greatest in
6–12 months post-landing
ii) Muscle atrophy by 10–20% on short missions or as high as 50% on long missions without
exercise. Peak power decreases by 30–35%
iii) There is a 2–6cm increase in spinal length
iv) Signs/Symptoms:
1) Weakness, fatigue, poor coordination
2) Impaired physical ability
3) “Everything feels so heavy”
4) Movements are very slow and very deliberate
5) Soft tissue bumps and bruises
6) Risk of long bone fractures
7) Risk of herniated disks/spine injuries and pelvic fractures
v) Treatment:
1) Always provide assistance with ambulation

208 n Pararescue Medical Operations Handbook / 8th Edition