Environmental Emergencies Flashcards
Decompression Sickness accurate history of a dive
- Depth of dive
- Air mixture
- Number of dives
- Interval between dives
Adult and pediatric decompression sickness treatment
- Transport supine
- Rule out tension pneumothorax
- Cardiac arrythmias
- 02: 15 LP regardless of spo2
- Normal saline: Adult 500mL Pediatric 10mL/kg max 250 mL
Non- fatal drowning: Adult and pediatric without hypotension
- Must transport
- CPAP (1- cm H20)
If hypotensive - NS 500 mL
Non- fatal drowning: Adult and pediatric. If hypotensive with Pulmonary Edema
- Push- Dose Epi 1:100,000
Heat Emergencies signs and symptoms
- AMS
- Seizures
- Hypotension
- Sweating may be absent
When treating heat stroke
“COOL FIRST, TRANSPORT SECOND”
All heat emergencies treatment
- Move pt to the back of the rescue
- Obtain temperature
- Remove excessive clothing
- Provide oral hydration
Heat cramps and heat exhaustion adult and pediatric
- Normal saline
Heat stroke with temperature >103 or altered mental status
- Ice packs
- Normal saline
Carbon monoxide exposure
- Chemical asphyxiant
- Colorless
- Odorless
- Tasteless
- Slightly less dense than air
- Toxic to humans when encountered in concentrations above 35 parts per million (ppm)
- Lower doses of CO can also be harmful due to a cumulative effect
- Patients exposed to carbon monoxide (smoke inhalation, etc.) require a full head to toe patient
examination including SpCO monitoring with the rainbow sensor (located on the EMS Captains’ and
Special Operations’ vehicles). - All rescuing crew members shall wear their SCBA if the patient is in a hazardous environment.
- Consider cyanide exposure.
Cyanide exposure treatment
- O2:15 LPM via NRB regardless of SpO2, unless the patient requires ventilatory support
*Cyanokit 5g with 200mL NS using the transfer spike - With the vial in the upright position, fill to the “fill line”
- Mix the solution by rocking or rotating the vial for 30 seconds. DO NOT SHAKE
- Use vented IV tubing and infuse as indicated below
- 5g IV/IO, infused over 10-15 minutes
5gtts/sec (broken infusion stream)
May repeat 1x prn
-The Cyanokit should be administered through a separate/dedicated IV/IO line
Organophosphate poisoning Mild symptoms
Runny nose, salivation, miosis, chest tightness, nausea, vomiting, tachy or bradycardia, muscle twitching, stomach cramps
Organophosphate poisoning Mild treatment
- Airway management
- Atropine 2mg IV/IO
If severe symptoms develop within 10 minutes
- Atropine 4mg IV/IO
If no atropine is available for severe organophosphate poisoning
- 1 DuoDote Injection into mid-lateral thigh
If severe symptoms develop within 15
minutes of Duodote administration
Administer 2 additional doses of DuoDote in rapid succession for a total of 3 DuoDote Injections
Organophosphate poisoning severe symptoms
Strange/confused behavior, severe difficulty breathing, secretions from the
lungs or airway, severe muscle twitching, urination, defecation, seizures, or unconsciousness
Organophosphate poisoning severe treatment
- ATROPINE 6mg IV/IO
Pediatric organophosphate treatment
- Airway management for excessive secretions
- For patients weighing 40-90 lbs (18-41 kg), administer ATROPINE 1 mg IV/IO
- If severe symptoms develop within 10 minutes, administer ATROPINE 2 mg IV/IO
- For patients weighing less than 40 lbs (18 kg or less), administer ATROPINE 0.05 mg/kg IV/IO.
Repeat every 20-30 minutes PRN for continued symptoms
Pediatric organophosphate treatment severe
- For patients weighing 40-90 lbs (18-41kg) AtroPen (1mg), administer 3 doses into mid-lateral
thigh in rapid succession OR ATROPINE 3mg IV/IO. - For patients weighing less than 40 lbs (18kg or less), ATROPINE: 0.05mg/kg IV/IO. Repeat every 20-30 minutes prn for continued symptoms
Infants organophosphate symptoms
- Symptoms are sometimes observed in healthy infants and children and are less reliable than other symptoms.
- Infants may become drowsy or unconscious, with muscle floppiness rather than muscle twitching, soon after exposure
Hazmat exposure and WMD priorities
Patient decontamination and personnel protection
Hazmat treatment adult and pediatric
1- Contact dispatch to ensure that the HazMat Team and or Special Operations
2- Medical treatment and patient preparation (decom), will be based on information obtained
3- The Special Operations Team will brief EMS treatment personnel on the identity, type, quantity, and hazard potential of the materials involved.
4- Protective measures for all personnel prior to patient contact.
5- Hazmat team will oversee the research, decon, and medical treatment.
5- Resuscitation can begin when safe to do so and when the patient presents no risk of secondary contamination
6- Pts will be transported in a properly prepared ground transport unit
7- If the number of patients overwhelms the amount of transport units, additional arriving units will be call
8- Early notification of the receiving emergency department
