Environmental Emergencies

Question 1

Heat cramps
describe
s/s 5
casue 1
tx 4
teach 2

Answer 1

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

Question 2

Heat exhaustion
s/s 12
1 tx

Answer 2

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

Question 3

Heat Stroke
Describe
s/s 7
tx-8
and two considerations

Answer 3

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

Question 4

how to cool heat stroke?

Answer 4

Remove clothing, wet sheet, fan, icepacks to glabrous surfaces

Question 5

increased risk factors for heat related emergencies
4

Answer 5

Age very young and old
Environment-hot humid
preexisting conditions
drugs-stimulants and hallucinogens

Question 6

Frostbite description

Answer 6

tissue freezing, vasoconstriction, cell membranes are destroyed and edema

Question 7

one thing to remember about frostbie

Answer 7

Remove jewelry because swelling will happen during thawing

Question 8

How to treat frostbite 2
consider 4

Answer 8

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

Question 9

Process of frostbite

Answer 9

Blisters form in a few hours and need to be debrided

Question 10

Deep frost bite vs superficial

Answer 10

deep- mm, bone, tendon, white and hard, moltting, gang green
superficial-waxy pale yellow to blue and molted

Question 11

Hypothermia described

Answer 11

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

Question 12

MIld hypothermia
Degrees
s/s
tx

Answer 12

93-95 degrees shivering lethargy confusion mild heart rate changes
passive rewarming-warm blankets get out of wet clothes.

Question 13

Mod hypothermia

Answer 13

86-93
ridgid bradycardia from hypotension, bradypenia
Active external rewarming-heat lamps bear hugger

Question 14

Severe hypothermia

Answer 14

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

Question 15

Hypothermia outcomes 5

Answer 15

Kidney failure, clots, dysR, hypoxia metabolic acidosis

Question 16

Rewarming risk
and tx

Answer 16

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

Question 17

Submersion Injuries
aspiration?
about and largest population

Answer 17

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

Question 18

what poisons should not be removed with water?

Answer 18

powdered lime of mustard gas

Question 19

Protocall for poison

Answer 19

brush off dry substance before using water and protect self

Question 20

What to remember about gastric lavage

Answer 20

LG OG for pills with big holes can only do w/I 30 mins and not with harmful chemicals

Question 21

Hymenopteran stings
about-3
how to remove
one more thing

Answer 21

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

Question 22

One s/s of immersion injury

Answer 22

pink-froathy sputum

Question 23

Snake bite

Answer 23

CroFab tx don’t tourniquet dont suck
-Allergic reactions and Clots
-peds get same dose as adults

Question 24

Three things snake venom can do

Answer 24

Neurotoxic
hemolytic
vascular toxic

Question 25

what does a snake bite look like?

Answer 25

swelling discoloration blistering

Paresthesia, lymphadenapathy N/V

Question 26

Snake venom
Observation period
s/s

Answer 26

8 hrs
edema, tachy, blurred vision, HA, Chills, paresthesias, hypotension, mm twitching, metallic taste in mouth

Question 27

What is the wilderness rule of 3?

Answer 27

3 hours w/o shelter, 3 days w/o water
3 weeks w/o food, 3 months w/o contact

Question 28

What diseases are from tick bites?

Answer 28

Lyme disease and rocky mountain spotted fever

Question 29

get a tick out

Answer 29

use tweezers nothing else and clean with soap and water

Question 30

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?

Answer 30

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

Question 31

Rocky mountain spotted fever
bacteria name
incubation perios
rash
one more thing
tx

Answer 31

rickettsia rickettsia
2-14 days
pink macular rash on palms, wrists, soles feet, ankle, w/i 10days
can be fatal w/o tx
Doxycycline

Question 32

tx bites

Answer 32

cleaning irrigation, debridement, tetanus, prophylaxis, analgesics, prophylactic antibiotics
leave puncture wounds open, splint wounds, laceration may be needed report to police

Question 33

When to use GL?

Answer 33

Bleach, asprin, iron, try anti D