Chapter 30: Environmental Emergencies Flashcards
Discuss
Most common environmental factor to worry about?
Temperature; hot and cold.
Discuss
Higher risk populations
Children, elderly, chronic ilness, young adults who overexert themselves
Discuss
Human factors that determine response to environment
Physical condition, age, nutrition/dehydration, alcohol
Discuss
What is considered hypothermia?
Core temp below 95 degrees
Discuss
What are the four stages of hypothermia (temp, appearance, cardiopulmonary status, level of consciousness)?
- 93-95
- Shivering, foot stamping
- Peripheral vasoconstriction, tachypnea
- Withdrawn
- 89-92
- Loss of coordination, muscle stiffness
- Progressing bradypnea, bradycardia
- Confused, lethargic, sleepy
- 80-88
- Coma
- Weak pulse, arrhythmias, very slow respirations
- Unresponsive
- <80
- Apparent death
- Cardiac arrest
- Unresponsive
Discuss
What modifications must you make to assessing pulse of cold pt?
Check carotid for 30-45 seconds to determine if there is a pulse
Discuss
What’s frostnip?
Skin is freezing but deeper tissue unaffected, usually not painful
Discuss
What’s immersion foot?
Prolonged exposure to cold water. Don’t rub it to get it warm
Discuss
What should EMT do with a pt so cold they’re in cardiac arrest?
Don’t rewarm because it can lead to cardiac arrhythmias, let the rewarm in hospital
Discuss
What should EMT keep in mind while transporting hypothermic pt?
Pt very sensitive to bumps etc causing cardiac arrest
Discuss
What qualifies as heat exposure?
Hyperthermia is a core of 101 or higher
Discuss
What’s a heat cramp?
Painful muscle spasms after vigorous exercise
Discuss
What’s heat exhaustion and S/S?
Hypovolemia from excessive sweating. S/S: Shock: PCC skin, weakness, decreased LOC
Discuss
What’s heat stroke and S/S?
Body’s compensation mechanisms, like sweating, are overwhelmed. Body can no longer cool itself. S/S Red hot dry skin, pt no longer sweating, falling LOC.
Discuss
How to treat heat stroke?
AGRESSIVELY COOL PT. Do whatever it takes, cold packs in groin and axilla, dousing in water, etc.
Discuss
Tx for pt with decompression sickness?
Give O2, place in left lateral recumbent position with head down, transport to recompression facility
Discuss
Categories of lighting injuries
- Mild: loss of consciousness, amnesia, confusion, tingling, other nonspecific signs and symptoms. Burns if any are usually superficial.
- Moderate: Seizures, resp. arrest, asystole that spontaneously resolves, superficial burns.
- Severe: Cardiopulmonary arrest. Many of these pt’s don’t survive.
Discuss
What type of toxin is black widow venom and who receives antivenin?
It’s neurotoxic, but most people only need relief from pain as the cramps etc will subside in about 48 hrs. Antivenin reserved for children (esp < 5) and elderly.
Discuss
What kind of toxin is brown recluse venom?
Cytotoxic. Causes severe local tissue damage, ulcer, with effects developing over hours and days. Rarely causes systemic problems.
Discuss
What are hymenoptera?
Bees, wasps, ants, and hellow jackets
Discuss
What are pit vipers?
Rattlesnakes, copperheads, and cottonmouths, with triangular shaped, flat heads.
Discuss
S/S envonemation from pit viper
Sever burning/pain at injury site, swelling and ecchymosis, spreading. Venom destroys local tissue and interferes with clotting mechanism systemically.
Discuss
Tx for pit viper envonemation?
Calm the pt (decreasing movement limits spread). Document time of bite and boundaries of affected area. Clean area with soap and water. Do not apply ice. Splint extremity.
Discuss
What’s the effect of coral snake venom?
Neurotoxin causing paralysis of nervous system.
Discuss
Tx for coral snake bite
Calm pt, flush area with warm soapy water to remove surface venom. Don’t apply ice. Splint extremity. Let hospital know it’s a coral snake bite.
Discuss
What are coelenterates?
Jellyfish, coral, man-of-war, etc
Discuss
Tx for coelenterate sting?
Limit spread of toxin by limiting movement. Inactivate nematocysts by applying vinegar. Remove remaning tentacles with credit card. Pain may respons to immersion in hot water for 30 minites (110-115 F). Transport.
