Chapter 32- Environmental Emergencies Flashcards
Homeostasis
When all the body systems operate in balance
The following four factors will affect how a person deals with a cold or hot environment:
Physical condition
Age
Nutrition and hydration
Environmental conditions
Ambient temperature
The temperature of the surrounding environment
Heat loss can occur in the following five ways
Conduction Convection Evaporation Radiation Respiration
Conduction
The transfer of heat from contact
Convection
Occurs when heat is transferred to circulating air
Evaporation
The conversion of any liquid to a gas
Radiation
Causes heat loss, such as when a person stands in a cold room
Respiration
Breathing
The rate and amount of heat loss or gain by the body can be modified in three ways
- increase or decrease heat production
- move to an area where heat loss is decreased or increased
- wear the appropriate clothing for the environment
Hypothermia
Low temperature
Core temperature
The temp of the heart, lungs, and vital organs
Extent of hypothermia
Mild- 93.2F
Moderate-93.2-86F
Severe-86F or less
If the core temperature continues to fall to 80F what happens?
Vital signs begin to slow and cardiac dysrhythmias may occur as the blood pressure decreases.
No one is dead unless..
They are warm and dead
Frostbite
Damage to tissues as the result of exposure to cold; frozen body parts
Most serious local cold injury
Frostnip
When the skin may freeze whereas the deeper tissues are unaffected
Often affects the ears, nose, and fingers
Immersion foot
Occurs after prolonged exposure to cold water
When the ice thaws in a frozen extremity what happens?
Further chemical changes occur in the cell, causing permanent damage or cell death, called necrosis or gangrene
Frostbite can be identified by..
A hard, waxy feel of the affected tissues
Rough handling of a patient with hypothermia can cause what?
The heart to fibrillate
With a patient with moderate or severe hypothermia, your goal is to prevent further heat loss by:
- removing the patient immediately from the cold environment
- place the patient in the ambulance
- remove wet clothing
- cover the patient with blankets
- transport
Passive rewarming
Placing patient in warm environment
Removing wet clothing
Applying heat packs or hot water bottles to the groin, axillary, and cervical regions
Hyperthermia
A high core temperature, usually 101 or higher
Heat emergency can take the following three forms
Heat cramps
Heat exhaustion
Heat stroke (life threatening)
Heat cramps
Painful muscle spasms that occur after vigorous exercise
Heat cramps usually occur where?
Leg or abdominal muscles
Heat exhaustion
A heat emergency in which a significant amount of fluid and electrolyte loss occurs because of heavy sweating
Signs and symptoms of heat exhaustion
- dizziness, weakness, or syncope
- onset while working vigorously or exercising in a hot, humid, or poorly ventilated environment
- onset, even at rest, in the older and infant age groups in hot, humid, or poorly ventilated environments
- cold, clammy skin with ashen pallor
- dry tongue and thirst
- normal vital signs, although the pulse is often rapid and weak
Heat stroke
Most serious heat emergency
Occurs when the body is subjected to more heat than it can handle and normal mechanisms for getting rid of the excess heat are overwhelmed.
The first sign of heat stroke
Change in behavior
After the first sign of heat stroke, what else can happen?
The patient can become unresponsive very quickly and seizures may occur
One telltale sign of heat stroke is when the patient no longer perspires
Treating heat cramps
Remove patient from hot environment Administer high flow oxygen Rest the cramping muscles Replace fluids by mouth Cool the patient with cool water spray or mist, and add convection to the cooling method by manually or mechanically fanning the patient
Treating heat exhaustion
- Remove the patient from the hot environment
- Administer high flow oxygen
- If patient is fully alert, give water by mouth
- If nausea develops, secure and transport the patient on his or her left side
Treating for heat stroke
- move the patient out of the hot environment and into the ambulance
- set the air conditioning to maximum cooling
- remove the patient’s clothing
- administer high flow oxygen
- provide cold water immersion in an ice bath if possible
- cover the patient with wet towels or sheets
- aggressively and repeatedly fan the patient with or without dampening the skin
- rapid transport
Drowning
The process of experiencing respiratory impairment from submersion or immersion in liquid
Diving reflex
The slowing of the heart rate cause by submersion in cold water
Most serious water related injuries are associated with…
Dives with or without scuba gear
Air embolism
A condition involving bubbles of air in the blood vessels
Decompression sickness
Commonly called the bends
Occurs when bubbles of gas, especially nitrogen, obstruct the blood vessels
This condition results from too rapid an ascent from a dive, too long of a dive at too deep a depth, or repeated dives within a short period of time.
Most striking symptom of decompression sickness is…
Abdominal and/or joint pain so severe that the patient literally doubles up or “bends”
Symptoms of decompression sickness may not occur for…
Several hours
The only treatment outside what we could give in the field for decompression sickness is a…
Hyperbaric chamber
Hyperbaric chamber
A chamber or a small room that is pressurized to a level higher than atmospheric pressure
When gaining a SAMPLE history with diving emergencies, it is important to get
Depth of the dive
Length of time the patient was underwater
The time of onset of symptoms
Previous diving activity
Treatment for suspected air embolism or decompression sickness from scuba diving are:
- remove patient from the water
- administer oxygen
- consider the possibility of pneumothorax
- provide prompt transport to the ED or to the nearest decompression facility
Dysbarism injuries
Any signs and symptoms caused by the difference between the surrounding atmospheric pressure and the total gas pressure in various tissues, fluids, and cavities of the body
Acute mountain sickness
Caused by a diminished oxygen pressure in the air at altitudes above 5000 feet resulting in hypoxia
HAPE
Fluid collects in the lungs, hindering the passage of oxygen into the bloodstream
Occurs at altitudes of 8k or greater
HACE
Occurs in climbers and may accompany HAPE
Signs and symptoms include a severe, constant, throbbing headache; ataxia (lack of muscle coordination and balance); extreme fatigue; vomiting; and loss of consciousness
Black widow spider
Black with an hourglass marking on the abdomen
Contains a neurotoxin
Systemic symptoms of a black widow bite
Dizziness, sweating, nausea, vomiting, and rashes
Antivenin
A serum containing antibodies that counteract the venom
Brow recluse spider
Dull brown and have a dark, violin shaped mark on the back
Cytotoxic (causes severe local tissue damage)
Hymenoptera
Bees, wasps, yellow jackets, and ants
Out of the 115 kinds of snakes in the US, how many are venomous?
19
Examples of pit vipers
Rattlesnakes, copperheads, and cottonmouths
They have a triangular shaped, flat head
The venom of a pit viper not only destroys tissues locally, but…
Interfere with the body’s clotting mechanism and cause bleeding at various distant sites
Treatment of a snake bite from a pit viper
- calm the patient
- locate the bite area
- be alert for anaphylactic reaction to the venom and treat with an epinephrine injector
- do not give anything by mouth
- mark the skin with a pen over the area that is swollen
- if any signs of shock, give blanket and oxygen
- if snake has been killed, bring it with you to the hospital
- notify the hospital you are bringing a snake bite victim in, describe the snake to them
- transport ASAP
Coral snake venom
Causes paralysis of the nervous system
The sting of a scorpion is usually more…
Painful than it is dangerous, causing localized swelling and discoloration
Ticks commonly carry two infectious diseases:
Rocky Mountain spotted fever
Lyme disease
Both spread through the tick’s saliva which is injected into the skin when the tick attaches itself
Nematocysts
Large animals may discharge hundreds of thousands of them (animals such as jellyfish for example)
