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Non sense > Environmental Emergencies > Flashcards

Environmental Emergencies Flashcards

1
Q

Environmental emergencies can be?

A

Heat or cold is the only emergencies

Burns

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2
Q

Heat and cold make existing condition and injuries worse

A

Diabetes

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3
Q

What can complicate environmental emergencies? (4)

A

The weather

Terrain

Atmospheric pressure

The wind

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4
Q

What may also play a detrimental role in a patient who has an unrelated trauma or medical condition?

A

An adverse environment

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5
Q

Normal core body temperature?

A

36.9 degrees Celsius

Optimal temperature for chemical reactions in the body

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6
Q

What does increase heat do?

A

It speeds reactions until enzymes / reactions are denatured

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7
Q

What does decrease heat do?

A

Slows reaction until enzymes / reactions no longer work

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8
Q

Frostbite

A

A localized injury

Ice crystals form in the tissues, damaging blood vessels

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9
Q

Frostbite is made worse if what?

A

An extremity freezes, is thawed, and then freezes again

Area also becomes more prone to refreezing

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10
Q

Frostbite signs and symptoms (5)

A

Initially the extremity will appear white and waxy

As frostbite gets worse, skin becomes hard / frozen and there is loss of sensation

With rewarming, skin flushes purple and burgundy and swelling starts

Blisters begin to form

Following thawing, there is intense pain

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11
Q

When does necrosis occur?

A

The extremities turn black over the next few weeks

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12
Q

Frostbite treatments (4)

A

Treat hypothermia first before localized frostbite

Cover the extremity and handle gently

Do not break blisters or rub the affected area

Do not routinely try to rewarm frostbite in the field

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13
Q

Hypothermia

A

Core body temperature of less than 35 degrees Celsius

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14
Q

Three causes of hypothermia

A

Cold water immersion

Cold-weather exposure

Urban hypothermia

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15
Q

Urban hypothermia

A

Patient is indoors, but thermal autoregulation is decreased

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16
Q

What increases chances of hypothermia (7)

A

Alcohol

CNS depressants

Infection

Endocrine diseases (diabetes, thyroid)

Brain dysfunction

Burns

Any patients suffering shock

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17
Q

Mild hypothermia signs and symptoms (8)

A

Core body temperature between 34 and 35 degrees c

Shivering

A&Ox4

Pulse rapid deteriorates too slow and weak

BP normal deteriorates to hypotensive

Breathing rapid deteriorates too slow and shallow

Skin red deteriorates to pale, cyanotic, stiff

Pupils reactive deteriorates to sluggish

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18
Q

Moderate hypothermia signs and symptoms (9)

A

Core body temperature between 30 and 34 degrees Celsius

No shivering

Progressive loss of higher function / thinking

Pulse absent at peripheries

BP difficult to obtain

Breathing slow and shallow (>75% normal consumption of o2)

Muscles become rigid

Cardiac dysrhythmias appear

Pupils sluggish

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19
Q

Severe hypothermia signs and symptoms (9)

A

Core body temperature under 30 degrees Celsius

No shivering

Loss of consciousness

Pulse absent @ peripheries

Unable to obtain BP

Breathing appears agonal and unorganized

Muscles become rigid / no deep tendon reflexes

Cardiac dysrhythmias appear more parents more easily go into v-fib

Pupils inactive

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20
Q

Late / severe hypothermia mimic?

A

Death

Remember you must be warm to be dead

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21
Q

Hypothermia treatment (5)

A

Handle gently (severe hypothermia and movement can cause dysrhythmias)

Remove the patient from the cold environment, remove any wet clothing, and protect from further heat loss

High-flow oxygen, warm if possible

Warm IV fluids

Passive rewarming

22
Q

How long do you check pulse in hypothermia before beginning CPR?

A

30 to 45 seconds

If patient is in cardiac arrest begin as normal

An arrest patient in mild hypothermia is not a bad thing

23
Q

What do protocols call for during hypothermia?

A

Either half the dose at regular time frames, or twice the time frame on regular dose

24
Q

Heat cramps

A

Muscle pain in the abdomen or lower extremities due to dehydration and overexertion in a hot environment

Caused by excessive loss of salt and water

25
Q

Heat cramps signs and symptoms (6)

A

Muscle twitching

Spasm

Nausea

Vomiting

Weakness

Diaphoresis

26
Q

Heat cramps treatment (5)

A

Remove patient to cool environment

Oxygen

IV therapy

Some protocols can give electrolytes po only if no n / v

Transport

27
Q

Heat exhaustion

A

A more severe condition that cramps with more serious fluid loss

Cramps will progressed exhaustion if untreated

28
Q

Heat exhaustion signs and symptoms (8)

A

Pale skin

Increased diaphoresis

Hypotension

Headache

Weakness

Thirst

N / V

Increased CBT

29
Q

Heat exhaustion treatment (5)

A

Remove patient to cool environment

Oxygen

IV therapy

Nothing orally

Transport

30
Q

Heat stroke

A

A complete failure of the body’s temperature regulation mechanism

It is an extreme medical emergency

Chronic development or acute

31
Q

Heat stroke signs and symptoms (5)

A

Altered loc

Increased CBT

Lock of diaphoresis

N/V

SOB/Kussmaul’s type breathing

32
Q

Heat stroke treatment (6)

A

Remove the cool environment

Passive cooling

Oxygen

IV therapy

ECG

Transport

33
Q

What are four risk factors to environmental emergencies?

A

Age
Extremes of age - poor compensatory mechanism or meds that impair them

General health
Serious underlying medical conditions (obesity, diabetes)

Fatigue
Fatigue affects the body’s regulatory mechanism

Medications
meds May predispose patients to environmental conditions, especially heat. Anticholinergic (antihistamines, TCAs) impair the ability to sweat

34
Q

Drowning

A

Death due to asphixiation during immersion

Doesn’t have to be water

35
Q

Near drowning

A

The process of drowning is interrupted or reverse prior to death

36
Q

All drownings in Alberta are considered?

A

Cold water and fresh water drowning

37
Q

How many drownings involve drugs or alcohol?

A

75%

38
Q

Dry drowning (4)

A

Occurs 10 to 20% of the time

Laryngeal spasm stop water from entering the lungs, leading to anoxia

These patients have the best chance of resuscitation

Treatment applies also to buried victims

39
Q

Wet drowning (2)

A

Occurs 80 to 90% of the time

Violent respiratory effort caused by the panic of drowning fills the lungs with water

40
Q

Differences between fresh and saltwater drowning

A

Applies to long-term survival rather than pre-hospital care

41
Q

Secondary drowning (2)

A

Respiratory distress (usually pulmonary edema) that occurs from minutes to days after initial recovery

During initial drowning lots of fluid entered the system
now looking to get rid of excess via path of least resistance

42
Q

Secondary drowning signs and symptoms (7)

A

Progressive dyspnea

Wheezing

Tachycardia

Cyanosis

Chest pain

ALOC - coma - death.

A good history will reveal and help with treatment

43
Q

Secondary drowning treatment (7)

A

C spine?

Oxygen

ECG

IV tkvo

Be prepared for vomiting

Transport / ALS intercept

Treat hypothermia

44
Q

Scuba diving emergencies barotraumas (3)

A

Pressure is increased one atmosphere for every 33 feet of depth

When is descending, compressed air is inhaled from tanks, keeping lungs expanded

When ascending, air expands, requiring the diver to exhale to avoid over inflation of lungs

45
Q

Scuba diving emergencies four main questions

A

Time underwater

Number of dives

Depth of each dive

Gas mixture in scuba tanks

46
Q

Scuba diving emergencies air embolism (2)

A

The presence of air bubbles in the central circulation

Caused by diver holding his breath, resulting in alveolar rupture

47
Q

Scuba diving emergencies air embolism signs and symptoms (9)

A

Chest pain (commonly sharp and pinpoint)

Sob

Pink and frothy sputum

Vertigo

Paresthesias

Paralysis

Seizures

Aloc

Tension pneumothorax

48
Q

Scuba diving emergencies air embolism treatment (4)

A

Oxygen

Position Trendelenburg or left lateral, transport to decompression chamber

ECG

IV therapy

49
Q

Scuba diving emergencies nitrogen narcosis (3)

A

The development of apathy and euphoria due to increased levels of dissolved nitrogen in the bloodstream

Signs and symptoms become more severe with depth

Treatment requires a gradual ascent

50
Q

Scuba diving emergencies decompression sickness (4)

A

Commonly called the bends

Illness occurring during or after rapid ascent secondary to the release of nitrogen bubbles

Nitrogen gas is released from solution when pressure is decreased (open a bottle of Coke)

Commonly occurs with repetitive dives as it takes up to 12 hours for gas levels to normalize

51
Q

Scuba diving emergencies decompression sickness signs and symptoms (7)

A

Torso rash

Pruritus

Pain in joints

Dizziness

Paralysis

SOB

Cardiovascular collapse

52
Q

Scuba diving emergencies decompression sickness treatment (6)

A

Immediate decompression

Transport Trendelenburg or left lateral

Oxygen

IV therapy

ECG

Medevac do not fly above 1000 feet if not pressurized

Non sense (22 decks)

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