Environmental Emergencies Flashcards
Body Temp
Tries to maintain at 98.6F
CBT core body temperature
Temperature in body consisting of heart, lungs, brain and abdominal viscera
Hypothermia starting
95F
Heat Stroke 104F
Hypothalmus
Master thermostat in the brain
Thermoregulation
Controlled by hypothalmus
BMR
Basal Metabolic Rate
Energy produced at rest from normal body metabolic reactions
-Normal is 70Kilocalories per hour
Evaporation
Sweat from skin
Convection
Air or liquids
-wind chill
Conduction
Direct physical contact
-falls into cold lake
Radiation
By radiating heat to cold environement via body or ex of ac / heater
-lots lost from the head
Thermolysis
Release of stored heat from the body. 4 types
Thermogenesis
Production of heat and energy from the body is main method of dealing with cold stressors
Heat Illness
Increase in CBT due to inadequate thermolysis
Risk Factors from Medications
Diuretics cause dehydration
Beta blockers limits ability to compensate with heart rate for compensation
Heat Cramps
Acute involuntary muscle spasms
- occur from profuse wearing and sodium loss
- affect those in good physical condition
- increases serum level of potassium with loss of sodium and develops muscle irritabiliy
Heat Cramp Assessment
Hypotension Nausea Rapid pulse Pale and moist skin Normal temperature normally
Management
Move to cool environement
Fluid replenishment
1oz Gateroade to 4oz of water 1:4 ratio
Heat Syncope
Orthostatic syncopal episode from prolonged standing or sitting and suddenly standing and cannot compensate with a sudden sympathetic response
Heat Exhaustion
Mild form of heat illness of volume depletion and heat stress
Two types: water depleted and salt depleted
Exercise associated hyponatremia
Prolonged exertion with excessive fluid intake
Too much water in body in relation to sodium
Assessment
Headache Dizziness Weakness Nausea Vomiting Cramping
Management
Passive Cooling
Fluids
Supine with legs elevated
Oral hydration
Heat Stroke
CBT>104F and AMS
PROTEIN CELLS IN BRAIN start tow twist and break down too fast
Classic Heatstroke
Very old and young people and come in waves of heat
-Dry red hot skin, no longer sweating, vasodialated
Exertion also Heat stroke
Exercising in hot climates
If humidity rises above 75% evaporative cooling is ineffective
-Pale and sweating
Cold Wet Packs
Shunts vasculature and brings chemicals to the core causing dysrhythmia and seizures
Cold Injury
Localized to injuries
Frost Bite
Ischemic injury as superficial or deep depending
Frostnip
Mild form of frost bite, feels like a burn, numbness
Superficial Frostbite
Altered sensation, numbness, tingling, or burning
-white, waxy and swollen
Deep Frostbite
Hands or feet
White, yellow white, black
Causes severe tissue damage and infection
Gangrene
Permnanent cell death set in within few days
Management
Can keep extremity cold and try and not to reward
- get patient out of cold
- remove wet clothing
- do not rub or message area
- cover with dry sterile dressing
- pain management
- consider rewarding if potential to referees does not exist
Trench Foot
Prolonged exposure to wet and cold environments
- wet feet lose heat 25 times faster than dry heat
- keep feet dry and warm
Hypothermia
CBT <95F
- increased thermolysis
- decreased thermogenesis
Mild Hypothermia
>93.2F Passive rewarming -dry -remove wet clothing -blankets
Alcohol most common for hypothermia
Dialate vessels feeling warm when constriction is suppose to keep warm causing heat loss
Moderate Hypothermia
86-93.2 F Start to see Osborn waves and cardiac changes External rewarming -heat blankets -warm air
Severe Hypothermia
<86F Internal Rewarming -warm fluids -humid oxygen -warm enema -esophageal rewarming tubes
Cardiac
Increase in blood viscosity initially speeds up heart
Hypothermia in C
Mild 34-36
Moderate 30-34
Severe <30
Drowning
Process of experiencing respiratory inmpairment from submersion or immersion
in liquid
Drowning continum
Breath Holding
Laryngospasm
Accumulation of CO2
Inability to oxygenate lungs
Daltons Law
Pressure exerted by mixtures of different gases
-same partial pressure
Henry’s lAw
Amount of gas in liquid is same as above liquid
Freshwater
Bacteria and illness from water
Saltwater
Salt causes fluid shift in lungs
Water
Volume decreases farther go down due to increase in pressure
Braotrauma
SQUEEZE
Ascending too quickly to the surface and the lung tissue stretches too much due to decrease of pressure in water compared
-causes pneumo called “pops” which is known as bust lung
Diving Injuries
When gas pressure increases, ability to dissolve in Solution increases as well
- volume decreases pressure increases
- every 30 feet the atmospheric pressure increase by 1
- on land force on body is 1 ATPressure
Decompression Sickness
Bubbles in vascular space happens from submersion and shift of gas from cells to vascular space
Decompression Sickness
Bubbles in vascular space happens from submersion and shift of gas from cells to vascular space
-can cause PE which. Must be treated with hypobaric chamber
Nitrogen Narcosis
Excessive amount of nitrogen buildup and starts to experiencing altered mental status
Hypobaric Chamber
Puts body under certain pressure to disassociate the air back into the cells
Altitude Illness
Less pressure in the air
Usually heights above 8000ft and descends
-gas dissolving diminishes as pressure diminshes
-gas to be transferred in too RBC’s diminishes
Acute Mountain Illness
Headache plus fatigues, weakness, nausea, vomiting
High Altitude Pulmonary Edema
Dyspnea, cough, weakness, chest tightness, wheezing, rales, tachypnea
High Altitude Cerebral Edema
Ams, increased ICP
Treatment of Altitude
Oxygen 100% and bring down altitude
Lightning
Common before and after storm
Lichtenburg Figure
Strands of lightning burned into skin
Crotalids
Pit vipers, with heat seeking pits
Hemotoxin
Elapids
Round pupils
Neurotoxin
Neurotoxic
Ams, weakness, nausea
Meotoxic
Clots everything up until it gets rid of all clotting factors and then causes freebleeding
Manage of Venom
Crofab is antivenom for hemotoxin bites
Brown Recluse
Prefer humid controlled dark places and dry
Brown Recluse
Prefer humid controlled dark places and dry
More over time and causes necrotic tissue with internal effects
Black Widow
Dark Moist and warm environments
Sudden onset, widespread pain
Stingray Treatment
Hot fresh or salt water
Jell Fish
Salt water because if it is hypotonic then the vehicle lodged will be squeezed released more toxin
