Environmental

Question 1

Thermogenesis

Answer 1

Creation of body heat via metabolism, shivering, and vasoconstriction.

Question 2

Heat illness

Answer 2

An increase in core body temperature due to inadequate thermolysis

Question 3

Thermolysis

Answer 3

The release of heat and energy from the body via vasodilation and sweating

Question 4

4 methods of heat transfer

Answer 4

Radiation: transfer of heat via waves.
Conduction: transfer of heat via physical contact.
Convection: transfer of heat via air moving across the body
Evaporation: transfer of heat via liquid to gas conversion.

Question 5

Heat cramps

Answer 5

Acute, involuntary muscle pains due to profuse sweating and sodium loss. 
Normal mentation 
Slightly elevated temperature 
Cool, moist skin
Severe muscle cramping

Question 6

Heat exhaustion

Answer 6

Milder form of heat illness. Generally either water or sodium depleted.
Normal mentation or mild confusion
Usually mildly elevated temperature
Pale, cool, moist skin
Muscle cramping may or may not be present.

Question 7

Heat stroke

Answer 7

Severe disturbance in thermoregulation. 2 forms are classic (absent sweating) and exertional (profuse sweating)
Altered mentation, delerium, seizures
Temperature > 40.5 Celsius 
Dry and hot skin (unless exertional)
No muscle cramping.

Question 8

Superficial frost bite

Answer 8

White, waxy skin firm to palp. Usually numb or tingly sensation that turns to painful once warmed up.
Rewarm injured part with body heat. Don’t use radiant or dry heat.
Do not rub injured area
Cover with a dry sterile dressing
Elevate injured area.

Question 9

Deep frostbite

Answer 9

White, yellow-white, or mottled blue-white skin that is hard, cold, and without sensation. Treatment depends on if the injury has been partially thawed.
If not thawed: keep frozen and away from heat sources, pad injury, transport.
If thawed: rewarm before transport in water between 35-40 degrees (takes about 10-30 minutes) until deep red or bluish. Dry injury and apply dressing. Transport.

Question 10

Hypothermia

Answer 10

Decrease in core body temperature starting at 35.5 degrees.
Mild hypothermia: 34 degrees
Moderate hypothermia: 30-34 degrees
Severe hypothermia: less than 30 degrees

Question 11

Mild hypothermia treatment

Answer 11

Remove wet clothing; dry patients skin, use warm blankets, place in warm ambulance.

Question 12

Moderate hypothermia treatment

Answer 12

Passive and active rewarming of truncal areas. Heating blankets; hot packs to groin, neck, armpits; hot air; warm IV fluids (39-40.5 degrees for fluids). Carefully monitor for after drop

Question 13

Severe hypothermia treatment

Answer 13

Active internal rewarming. Warm IV fluids; warm, humid O2;

Question 14

Hypothermia treatment in patient not breathing and/or pulseless

Answer 14

Less than 30 degrees: CPR, single defib shock for VT/VF, IV (withhold IV meds), transport
Greater than 30 degrees: CPR, administer IV meds (at longer intervals), repeat defib for VT/VF as temperature rises, transport to hospital to provide active internal warming.

Question 15

Important questions to ask about diving history

Answer 15

Onset (ascent or descent); type of diving; equipment (tanks, contents); site and temperature of water; number of dives in last 72 hours along with depth, bottom time, and surface interval; safety stops; attempted in-water decompression; complications; pre and post dive activities

Question 16

Diving injuries during descent

Answer 16

Barotrauma or “squeeze” due to pressure imbalance. Usually affects ears, sinuses, and sometimes teeth

Question 17

Injuries at depth while diving

Answer 17

Nitrogen narcosis: mimics intoxication

Shallow water blackout: hyperventilating before diving resulting in loss of consciousness.

Question 18

Injuries during ascent while diving

Answer 18

Barotrauma: ascending while holding breath resulting in trauma to lungs. Can lead to pulmonary overpressurization syndrome.
Arterial gas embolism: can occur due to POPS resulting in an air emboli.
Decompression sickness: bubbling of tissues due to change in gas pressure. Causes severe pain

Question 19

Acute mountain sickness

Answer 19

Occurs due to rapid ascent to high altitude (>2,438m)
Headache combined with any of the 3 symptoms: fatigue or weakness, NV or loss of appetite, dizziness or lightheaded, difficulty sleeping.

Question 20

High altitude pulmonary edema

Answer 20

Dyspnea at rest, cough, weakness or decreased exercise performance, chest tightness or congestion, central cyanosis, rales or wheezing in at least one lung field, tachypnea, tachycardia due to being at high altitudes.

Question 21

High altitude cerebral edema

Answer 21

Change in mental status and/or ataxia in person with AMS, or change in mental status with ataxia in person with AMS. Occurs due to prolonged (>24 hrs) exposure to high altitude.