Environmental Emergencies Flashcards
Heat cramps
describe
s/s 5
casue 1
tx 4
teach 2
severe cramps in lg mm groups fatigued by heavy work
brief and tend to follow heavy work or exercise.
N/tachy/pallor/weaness/diaphoresis
dehydrated
rest/hydrate with Na+ and water elevation massage
avoid strenuous activity for 12 hours and increase electrolytes
Heat exhaustion
s/s 12
1 tx
prolonged exposure to heat over hours or days
fatigue/N/V/extreme thirst/ anxiety/hypoten/tachy/high temp/ dilated pupils/mild confusion/ash color/diaphoresis
moist sheet/ambiant cooling/IV fluids
Heat Stroke
Describe
s/s 7
tx-8
and two considerations
serious results from failure of hypothalmic thermoregulation process.
diaphoresis, vasodilation, tachypenia, sweat glans stop functioning increase in temp rapidly
cerebral edema and hemorrhage from heat
ABC reducing core temp monitoring dysR, 100%O2, ECG monitoring, pulse ox. correct e and coagulation
Prevent shivering/ watch for rabdo-watch urine
how to cool heat stroke?
Remove clothing, wet sheet, fan, icepacks to glabrous surfaces
increased risk factors for heat related emergencies
4
Age very young and old
Environment-hot humid
preexisting conditions
drugs-stimulants and hallucinogens
Frostbite description
tissue freezing, vasoconstriction, cell membranes are destroyed and edema
one thing to remember about frostbie
Remove jewelry because swelling will happen during thawing
How to treat frostbite 2
consider 4
Immerse are in circulating water that is 98.6-104 and elevate
rewarming is very painful and don’t rub or put pressure
might take 90 days to see necrosis
tpa for thrombi
Process of frostbite
Blisters form in a few hours and need to be debrided
Deep frost bite vs superficial
deep- mm, bone, tendon, white and hard, moltting, gang green
superficial-waxy pale yellow to blue and molted
Hypothermia described
Core temp below 95
most heat is lost from head thorax and lungs and wet clothing increases heat loss by 5x and immersion in cold water by 25x
MIld hypothermia
Degrees
s/s
tx
93-95 degrees shivering lethargy confusion mild heart rate changes
passive rewarming-warm blankets get out of wet clothes.
Mod hypothermia
86-93
ridgid bradycardia from hypotension, bradypenia
Active external rewarming-heat lamps bear hugger
Severe hypothermia
below 96 Pupils fixed and dilated absent reflexes heart rate and respiratory rate VERY slow almost can’t detect -appear dead so they need to be warmed to 86 degrees before pronounced dead
Active Internal warming-warm fluids- chest tubes IV cath
Hypothermia outcomes 5
Kidney failure, clots, dysR, hypoxia metabolic acidosis
Rewarming risk
and tx
Afterdrop when cold blood returns to the system drops temp because cold blood moves and mixes with warm blood
can lead to shock
so warm core before extremities
Submersion Injuries
aspiration?
about and largest population
when a person becomes hypoxic from submersion in liquid
Rare because of laryngospasm but if happens it can lead to pulmonary edema and ARDS
children under 5 and boys 15-25
what poisons should not be removed with water?
powdered lime of mustard gas
Protocall for poison
brush off dry substance before using water and protect self
What to remember about gastric lavage
LG OG for pills with big holes can only do w/I 30 mins and not with harmful chemicals
Hymenopteran stings
about-3
how to remove
one more thing
Similar to allergic reactions depending on severity. bee family and ants
right away or can be delayed 48hrs
remove with straight line not tweezers because it may release more venom remove jewelry
One s/s of immersion injury
pink-froathy sputum
Snake bite
CroFab tx don’t tourniquet dont suck
-Allergic reactions and Clots
-peds get same dose as adults
Three things snake venom can do
Neurotoxic
hemolytic
vascular toxic
what does a snake bite look like?
swelling discoloration blistering
Paresthesia, lymphadenapathy N/V
Snake venom
Observation period
s/s
8 hrs
edema, tachy, blurred vision, HA, Chills, paresthesias, hypotension, mm twitching, metallic taste in mouth
What is the wilderness rule of 3?
3 hours w/o shelter, 3 days w/o water
3 weeks w/o food, 3 months w/o contact
What diseases are from tick bites?
Lyme disease and rocky mountain spotted fever
get a tick out
use tweezers nothing else and clean with soap and water
Lyme disease
How long must the tic be on?
What is the bacteria
how many days until symptoms
2 s/s
tx
after effects 2
how long can it last?
tick must be on for 36 hours
borrelia burgdorferi
7 days
flu-like symptoms
bulls-eye rash
amoxcicillin
arthritis and menigitis
can last months to years
Rocky mountain spotted fever
bacteria name
incubation perios
rash
one more thing
tx
rickettsia rickettsia
2-14 days
pink macular rash on palms, wrists, soles feet, ankle, w/i 10days
can be fatal w/o tx
Doxycycline
tx bites
cleaning irrigation, debridement, tetanus, prophylaxis, analgesics, prophylactic antibiotics
leave puncture wounds open, splint wounds, laceration may be needed report to police
When to use GL?
Bleach, asprin, iron, try anti D
