Chapter 31 Environmental Emergencies

Question 1

Key Terms

application of an external heat source to rewarm the body of a hypothermic patient

Answer 1

Active Rewarming

Question 2

Key Terms

gas bubble in the bloodstream. The plural is ___ ______. The more accurate term is “arterial gas embolism (AGE)”

Answer 2

Air Embolism

Question 3

Key Terms

application of heat to the lateral chest, neck, armpits, and groin of a hypothermic patient

Answer 3

Central Rewarming

Question 4

Key Terms

the transfer of heat from one material to another through direct contact

Answer 4

Conduction

Question 5

Key Terms

carrying away of heat by currents of air, water, or other gases or liquids

Answer 5

Convection

Question 6

Key Terms

a condition resulting from nitrogen trapped in the body’s tissues, caused by coming up too quickly from a deep, prolonged dive. A symptom of _____________ ________ is “the bends,” or deep pain in the muscles and joints

Answer 6

Decompression Sickness

Question 7

Key Terms

the process of experiencing respiratory impairment from submersion/immersion in liquid, which may result in death, morbidity (illness or other adverse effects), or no morbidity

Answer 7

Drowning

Question 8

Key Terms

the change from liquid to gas. When the body perspires or gets wet, evaporation of the perspiration or other liquid into the air has a cooling effect on the body

Answer 8

Evaporation

Question 9

Key Terms

an increase in body temperature above normal, which is a life-threatening condition in its extreme

Answer 9

Hyperthermia

Question 10

Key Terms

generalized cooling that reduces body temperature below normal, which is a life-threatening condition in its extreme

Answer 10

Hypothermia

Question 11

Key Terms

cooling or freezing of particular (local) parts of the body

Answer 11

Local Cooling

Question 12

Key Terms

covering a hypothermic patient and taking other steps to prevent further heat loss and help the body rewarm itself

Answer 12

Passive Rewarming

Question 13

Key Terms

sending out energy, such as heat, in waves into space

Answer 13

Radiation

Question 14

Key Terms

breathing. During ___________, body heat is lost as warm air is exhaled from the body

Answer 14

Respiration

Question 15

Key Terms

substances produced by animals or plants that are poisonous to humans

Answer 15

Toxins

Question 16

Key Terms

a toxin (poison) produced by certain animals such as snakes, spiders, and some marine life forms

Answer 16

Venom

Question 17

Key Terms

chilling caused by conduction of heat from the body when the body or clothing is wet

Answer 17

Water Chill

Question 18

Key Terms

chilling caused by convection of heat from the body in the presence of air currents

Answer 18

Wind Chill

Question 19

Critical Decision Making

Environmental emergencies provide a variety of situations in which an EMT must act. Some patients need to be cooled; others warmed. However, before you even get to treat the patient, you must make some safety decisions. Consider the following situations, and identify the safety hazards.

You are taking a walk while on vacation. You hear a sound from the water and see that several hundred feet out in the water a person is struggling to stay afloat.

Answer 19

The patient is several hundred feet out in the water. This is a long distance to swim. Even if you can swim out there, the patient might inadvertently pull you under. Call for help and look for a way to safely rescue the swimmer.

Question 20

Critical Decision Making

Environmental emergencies provide a variety of situations in which an EMT must act. Some patients need to be cooled; others warmed. However, before you even get to treat the patient, you must make some safety decisions. Consider the following situations, and identify the safety hazards.

You are ice skating with the family and hear screaming. Someone has fallen through the ice. A group of people have gathered around the hole, peering downward.

Answer 20

Someone has fallen through the ice, and the obvious risk is the one you should be worried about: you and the others breaking through and falling in as well. Clear the ice. Call for help. Look for devices such as ropes or sticks that can be used for a rescue.

Question 21

Critical Decision Making

Environmental emergencies provide a variety of situations in which an EMT must act. Some patients need to be cooled; others warmed. However, before you even get to treat the patient, you must make some safety decisions. Consider the following situations, and identify the safety hazards.

You are on a hiking path and hear screaming. A hiker has been bitten by a snake. He is in pain and holding his leg. He is sitting by an outcropping of rocks.

Answer 21

If there are reports that someone has already been bitten by a snake, then the snake (or other snakes) might still be around, especially around the rocks. The patient should be moved to a clearing where both you and the patient will have less chance of further bites.

Question 22

Short Answer

When is it appropriate to treat a cold emergency with active rewarming, and when should you perform passive rewarming?

Answer 22

Passive rewarming is always permitted. Active rewarming may be permitted if the patient is alert and responsive, medical direction orders it, and transport time will be great.

Question 23

Short Answer

List five situations in which a patient may be suffering from hypothermia along with another, more obvious medical condition or injury.

Answer 23

Situations in which a patient may be suffering from hypothermia in addition to another condition include alcohol ingestion, underlying illness, overdose or poisoning, major trauma, outdoor resuscitation, and decreased ambient temperature.

Question 24

Short Answer

Name the signs and symptoms of a late or deep localized cold injury.

Answer 24

Initially the skin of the affected area appears white and waxy. As the condition progresses to actual freezing, the skin turns mottled or blotchy, the color turns from white to grayish yellow, and finally changes to grayish blue. Swelling and blistering may occur.

Question 25

Short Answer

Describe the management of a patient suffering from heat emergency who has moist, pale, and cool skin.

Answer 25

A patient suspected of having a heat emergency with moist, pale, and cool skin should be managed as follows:

 - Remove the patient to a cooler environment.
 - Administer oxygen.
 - Remove clothing and cool the patient by fanning.
 - Put the patient in a supine position, keeping him at rest.
 - If the patient is responsive and not nauseated, give the patient water.
 - Apply moist towels over muscle cramps.
 - Transport.

Question 26

Short Answer

Describe the management of a patient suffering from a heat emergency who has hot, dry skin.

Answer 26

A patient suspected of having a heat emergency with hot, dry skin should be managed as follows:

• Remove the patient to the ambulance with air conditioner on high.
• Remove the patient’s clothing; apply cool packs to the neck, groin, and armpits. Fan aggressively.
• Administer oxygen.
• Transport immediately.

Question 27

Short Answer

Describe the proper care for a patient suffering from snakebite.

Answer 27

The proper care for a patient with a snakebite includes:

• Call medical direction.
• Treat for shock and conserve body heat.
• Keep the patient calm.
• Control bleeding at the bite marks, if any. Clean the fang marks with soap and water.
• Remove jewelry on the bitten extremity.
• Immobilize the bitten extremity, perhaps using a splint.
• Apply light constricting bands above and below the bite if ordered to do so by medical direction.
• Transport and continually monitor the patient’s vital signs.