Environmental emergencies Flashcards
What is homeostasis? and what is normal body tempertaure?
Is the normal state of balance of all the body’s systems and temp is 36.9 degrees celcius.
What is frostbite?
Ice crystals that form in the tissues, damaging blood vessels. Do not thaw if it freezes again. Trauma evident after rewarming.
What are symptoms of mild frostbite?
Pale, numb skin progressing to firm, hard, blue or obviously frozen skin
What are symptoms of severe symptoms?
Impossible to tell depth of injury until rewarming. Blisters and alot of PAIN.
What is hospital treatment for frostbite?
Submersion in 40 degree celcius water and liberal opiods for pain.
What is hypothermia?
Generalized core body temperature of less than 35C as a result of increased heat loss and decreased heat production.
What increases the chances of hypothermia?
Alcohol, CNS depressants, infection, endocrine diseases (diabetes,thyroid), brain dysfunction and burns.
What is mild hypothermia symptoms?
Happens at 34-35 degrees celcius. Increased sympaathetic tone, tachycardia, vasoconstriction and mydriasis. SHIVERING
What is moderate hypothermia symptoms?
Happens at 30-34 degrees celcius. Umbles, Bradycardia,Bradypnea and arrhythmias and miosis. SHIVERING STOPS
What is severe hypothermis symptoms?
Happens at 30 below, mimics death, unresponsive, fixed pupils, profound bradycardia,apnea and spontaneous v-fib. NO SHIVERING
What is the swiss staging system?
HT-1 - (mild) conscious and shivering
HT-2 - (moderate) shivering stops. Altered LOC
HT-3 - (Severe) Unconscious with signs of life
HT-4 - (Profound) No signs of life
HT-5 - (Dead) Irreversible hypothermia (frozen solid)
How long is a pulse check on a hypothermic patient?
30-45 seconds
Signs of cardiac instability in a hypothermic patient?
BP less than 90mmHg
Ventricular arrhythmias
Core temperature less than 28
What is convection?
Body heat is lost to air, it becomes warmer and it rises.
What is Evaporation?
Body heat causes perspiration which is lost from the body surface when changed from liquid to vapor.
What is radiation?
Body heat is lost to nearby objects without physically touching them.
What is conduction?
Body heat is lost to nearby objects through direct physical touch.
Why should you not rewarm the extremities?
Rewarming of the extremities causes vasodilation which causes high space shock that the heart can not compensate due to it’s low temperature. Can put the patient in V-fib
What is the lethal triad of death?
Hypothermia, Coagulopathy and Acidosis
What is heat cramps?
Muscle pain in abdomen and lower extremities due to dehydration and overexertion in a hot environment. Caused by excessive loss of salt and water.
What are symptoms of heat cramps?
Muscle twitching, Spasms, nausea, vomiting, weakness and diaphroetic.
What is heat exhaustion?
More severe condition with more serious fluid loss. Cramps will progress to exhaustion if untreated.
What is heat stroke?
Complete failure of the body’s temperature regulation mechanisms
Chronic development or acute
What is classic heat stroke? (Dry skin)
Generally seen in the very old and very young populations.
Can occur over hours or days
Higher mortality rate
What is exertional heat stroke? (Sweaty skin)
Acute rise in temperature due to high metabolism in the body and ineffective evaporative cooling.
Generally in young fit populations.
What are symptoms of heat stroke?
Altered LOC
Increased CBT
Lack of diaphroesis
N/V
SOB/ kussmaul’s type breathing
Treatment for heat stroke?
Remove from heat
Remove all clothing (passive cooling)
Mist body
Fan body to encourage evaporative cooling.
Ice packs to groin and axillary.
What are some heat stroke factors?
Age, general health (obesity and diabetes), fatigue and medications like anticholinergics (antihistamines, TCA’s) they impair the ability to sweat
What is drowning?
Death due to asphyxiation during immersion and doesn’t have to be water.
What is near drowning?
The process of drowning is interrupted or reversed prior to death.
Drowning in alberta is considered cold water and fresh water drowning.
What are the major causes of drowning?
Alcohol or drugs
What is dry drowning?
Occurs 10 - 20 %
Laryngeal spasm stops water from entering lungs, leading to anoxia
Have the best chance of resuscitation
What is wet drowning?
Occurs 80 -90 % of the time
Violent respiratory effort caused by panic of drowning fills the lungs with water.
What is secondary drowning?
Respiratory distress (usually pulmonary edema) that occurs from minutes to days after initial recovery.
What is barotrauma?
Pressure is increased 1 atmosphere every 33 minutes
How do lungs work when descending?
Compressed air in tanks keeps lungs expanded
How do lungs work when ascending?
Air expands, forcing the diver to exhale more to keep the lungs from overinflating.
What question to ask for diving emergencies?
Time under water, Number of dives, Depth of each dive and gas mixture in SCUBA tanks.
What is an air embolism?
Presence of air bubbles in the central circulation. Caused by a diver holding his breath and resulting in alveoli rupture.
What are symptoms of an air embolism?
Chest pain, SOB, pink and frothy sputum, vertigo, paresthesias, paralysis, seizures, tension pneumothorax and altered LOC
What is nitrogen narcosis?
Development of apathy and euphoria due to increased levels of dissolved nitrogen in the bloodstream.
Treatment for nitrogen narcosis?
Requires a gradual ascent.
What is depression sickness?
It’s more commonly called the bends.
An illness that occurs during or after rapid ascent
Commonly occurs with repetitive dives.
What are symptoms of decompression?
Torso rash
Pruritus
Pain in joints
Dizziness
Paralysis
SOB
Cardiovascular collapse
