Environmental Emergencies

Question 1

How do we cool down?

Answer 1

Conscious actions
Vasodilation
Sweating

Question 2

What is hypothermia?

Answer 2

Low body temperature

Core body temp

Question 3

What are the predisposing factors for hypothermia in NZ?

Answer 3

Cold environment
Age (elderly and young (SA to weight ratio in young, body fat and mobility in young)
Drugs and alcohol (vasodilator and LOC)
Medical problems (usually affecting mobility)

Question 4

What are the effects of mild hypothermia?

Answer 4

33-35 degrees
Cool and constricted
Shivering
Drowsy
Confused

Question 5

What are the effects of moderate hypothermia?

Answer 5

30-33 degrees
Very cold to touch
Altered LOC
Stopped shivering
Falling HR and BP

Question 6

What are the effects of severe hypothermia?

Answer 6

below 30 degrees
comatose
fixed unreactive pupils
Low cardiac output
Cardiac arrest

Question 7

How do we manage hypothermia?

Answer 7

Remove cold/wet clothes
dry patient
warm blankets
do not use survival blankets

Question 8

What is hyperthermia?

Answer 8

Temp >39 degrees
Usually occurs with exertion in a hot environment
Always associated with dehydration and hypovolemia

Question 9

What are the effects of hyperthermia?

Answer 9

Damages proteins directly
Progressive
Effects are most prominent about 40 degrees

Question 10

What are the symptoms of hyperthermia?

Answer 10

Muscle cramps
Nausea/vomiting
Stop sweating (hypovolemic)
Weak and rapid pulse 
Hypotensive
Falling LOC
Seizures
Can result in death

Question 11

How do we manage hyperthermia?

Answer 11

Call for ICP backup
Uncover them
Wet their body and hair
Ice pack in groin and axillae (take them out if they start shivering)

Question 12

What causes the bends?

Answer 12

Divers at depth breath air at increased pressure. Nitrogen dissolved in the blood increases. This is proportional to depth and length of time.
As they surface it comes out. If they surface quickly the nitrogen can form bubbles. These bubbles get trapped in the tissues which cause severe pain

Question 13

What are the symptoms of the bends?

Answer 13

Joint pain
Muscular pain
Abnormal breathing and O2 levels
Altered LOC

Question 14

How do we manage the bends?

Answer 14

Avoiding transport at altitude
Call for ALS back up
Position patient flat
Give oxygen via non-rebreather

Question 15

What is drowning?

Answer 15

All patients who have an altered level of consciousness or abnormal breathing after being immersed in liquid.

Question 16

What does drowning do to the body?

Answer 16

Impairs breathing, hypoxia and altered LOC

Question 17

How do we manage drowning?

Answer 17

ABCs
Place on side if unconscious but pulse/breathing
Usually vomit
Give high flow oxygen (BVM or non rebreather)
Warm them
Must be transported as impaired oxygenation can progress in 12-18 hours

Question 18

How do we warm up?

Answer 18

Conscious actions (putting on more clothes etc)
Vasoconstriction
Shivering
Goosebumps