Environmental Emergencies

Question 1

What does the Hypothalamus do?

Answer 1

Regulates body temperature
- uses central (aortic arch/ carotids) and peripheral chemoreceptors

Question 2

Thermal Gradient

Answer 2

Warm temps will always move towards cooler temps
- Gain heat when it is warm outside
- Lose heat when it is cold outside

Question 3

How to regulate body temperature (2 ways)

Answer 3

• Behavioral
• Physiologic

Question 4

Behavioral way to regulate body temp

Answer 4

Conscious effort to change the temp sensation
- COLD: Move to warm area, add clothing
- HOT: Remove clothing, move to air conditioning

Question 5

Physiologic way to regulate body temp

Answer 5

Body’s response to change in temp
- COLD: Shivering, constricting of blood vessels
- HOT: Sweating, dilating of blood vessels

Question 6

Heat Production: how does the body produce heat?

Answer 6

• Body produces heat mainly through metabolism
• Shivering increase heat production
  
  • stops when core temp drops below 90

Question 7

Heat Conservation: how does the body preserve heat?

Answer 7

Peripheral Vasoconstriction:
- Shunts warm blood to vital organs

Piloerection:
- Goose bumps
- Traps warm air at skin surface

Question 8

How does the body cool itself off?

Answer 8

Skin:
- Vasodilation: warm blood to skin surface
- Sweating: Evaporation

Cardiovascular system:
- increased in heart rate and strength of contraction

Respiration:
- Eliminated heat through exhalation

Question 9

How heat can be lost or gained

Answer 9

• Radiation
• Convection
• Conduction
• Evaporation
• Respiration

Question 10

Radiation

Answer 10

Transfer heat from one surface to another without direct contact

Question 11

Convection

Answer 11

Body heat lost to surrounding air, which becomes warmer, leaving skin cooler

Question 12

Conduction

Answer 12

Heat lost through direct physical touch

Question 13

Evaporation

Answer 13

Sweating or wet skin evaporates into air

Question 14

Respiration

Answer 14

Warmed air is exhaled and cool air is inhaled

Question 15

Hypothermia (Predisposing factors)

Answer 15

Young:
- LG surface area of skin, shivering mechanism not fully developed, less body fat, less adaptive behaviors

Old:
- Loss in metabolism, poor vessel constriction

Medical Conditions:
-Shock, TBI/ Stroke, Burns, etc
- Decrease body’s ability to regulate temperature
- Decrease body ability to clot

Drugs/ Med:
- May impair heat generating or heat conserving properties

• Duration of exposure, clothing, activity level

Question 16

STAGES of Hypothermia

Answer 16

• Mild
• Moderate
• Severe

Question 17

MILD Hypothermia

Answer 17

• 95- 91.4
• Skin cold to touch
• Confusion (inadequate perfusion)
• Shivering ceases around 90 degrees
• Heart rate slows

Question 18

MODERATE Hypothermia

Answer 18

• 89.6- 85.2
• Coma
• Hypotension
• Bradycardia
• Slow breathing

Question 19

SEVERE Hypothermia

Answer 19

• 82.4- 71.6
• Cyanosis
• Unresponsive
• Irregular Pulses
• Cardiac Arrest possible

Question 20

Frostbite

Answer 20

• Freezing of body tissues
• Usually to exposed tissues
  
  • Hands
  • Feet
  • Ears, nose, cheeks

Question 21

Superficial Frostbite

Answer 21

• Loss of sensation, cold feeling
• Usually tingles when rewarmed

Question 22

Deep Frostbite

Answer 22

• Skin and tissue frozen
• May have blisters
• Can result in tissue loss

Question 23

Cold Emergency Treatment

Answer 23

• Remove from environment/ prevent heat loss
• Remove wet clothing
• Handle gently

Question 24

Rewarming (2)

Answer 24

-Passive (shivering patient)
- Active (patient has stopped shivering because internal body temp is below 90)

Question 25

Passive rewarming

Answer 25

• SHIVERING PATIENT
• Mild hypothermia
• Wrap in warm blanket
• Warm ambulance

Question 26

Active rewarming

Answer 26

• PATIENT STOPPED SHIVERING TEMP BELOW 90
• Moderate to severe
• passive plus:
  -Hot packs to groin, armpits, neck
  
  • Do not put heat packs on extremities

Question 27

Frostbite treatment

Answer 27

• Remove from environment
• Never allow to refreeze
• Immerse in warm water

Question 28

Heat Cramps

Answer 28

• Cramping to large muscle groups
• EX: abs, glutes, thighs
• Prob due to profuse sweating and loss of electrolytes

TREATMENT:
- Move to shade and relax
- Give low glucose electrolyte solution

Question 29

Heat Exhaustion

Answer 29

• Body has maximized its heat-dissipating mechanisms
• Patient will be dizzy, nauseated or fatigued
• Skins will be SWEATY, and normal to cool in temp

TREATMENT:
- Move to cool area
- Cool patient
- Remove or loosen clothing
- Give low glucose electrolyte
- Supine position
- May give oral fluids

Question 30

Heat Stroke

Answer 30

• Life threatening Hyperthermia
• Body overheats to where heat regulating mechanisms break down
• ALOC or unresponsive
• Skins HOT, moist or dry

TREATMENT:
- MUST COOL PATIENT
- Remove reasonable clothing
- Cool packs to groin, armpits, neck
- Cool with room temp water
- Keep patient moist

Question 31

Rattlesnake SS

Answer 31

• Distinct puncture marks
• Swelling of area
• Pain

TREATMENT:
- Keep extremity at level with heart
- Mark swelling
- Keep patient warm

Question 32

Black Widow SS

Answer 32

• Dull ache
• Muscle spasms
• Nausea/ vomiting

Question 33

Brown Recluse SS

Answer 33

• Serious bite
• Does not heal, lead to large ulcers
• Most don’t know they were bitten

Question 34

Marine stings: Jellyfish, stingray, sculpin

Answer 34

• treat with heat as tolerated

Question 35

Direct strike

Answer 35

Usually fatal

Question 36

Contact Strike

Answer 36

Strikes object patient is touching

Question 37

Side Strike

Answer 37

Current jumps to person/ most common

Question 38

Ground Strike

Answer 38

• Energizes ground

Question 39

Lightening Strikes

Answer 39

• Burns common, but not serious source of injury
• Watch for breathing and pulses
• Check for injuries
  
  • People tend to get thrown during strike