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Paramedic 2 > Environmental Emergencies and Trauma > Flashcards

Environmental Emergencies and Trauma Flashcards

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0
Q

Although environmental emergencies can affect anyone, what are some predisposing risk factors for environmental trauma and emergencies?

A

Age - Especially the very young and very old do not tolerate environmental extremes very well

Poor general health

Fatigue

Predisposing medical conditions

Medications - both prescription and over the counter (Beta blockers and diuretics in particular)

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1
Q

What age groups are particularly vulnerable to environmental extremes?

A

Very young and the very old

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2
Q

Define environmental emergency

A

Medical condition caused or exacerbated by environmental factors

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3
Q

Define homeostasis

A

Process of maintaining constant suitable conditions within the body

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4
Q

Define thermogenesis

A

the body creating heat

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5
Q

Define thermolysis

A

The body losing heat

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6
Q

Define conduction

A

transfer of temperature from one source to another through direct contact

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7
Q

Define convection

A

Temperature carried away by currents of air or water

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8
Q

Define radiation

A

In the absence of convection and conduction, the body naturally radiates its temperature outward

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9
Q

Define evaporation

A

Perspiration evaporating from the body which causes a cooling effect

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10
Q

Define respiration and how it relates with environmental emergencies

A

Body breaths air out and replaces it with the ambient temperature air around it

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11
Q

What is the normal range for body temperature?

A

96 to 100 degrees

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12
Q

What is a mild hypothermia temperature for the body?

A

90 to 95 degrees

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13
Q

What is considered severe hypothermia for the body temperature?

A

below 90 degrees

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14
Q

How does the body combat heat loss?

A

Shivering

Sweat reduction

Reduction of circulation to the skin

Increases metabolism

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15
Q

Define hypothermia

A

state of low body temperature, in particular low core temperature

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16
Q

How does alcohol affect the body in relation to environmental emergencies

A

Vasodilates

People tend to feel warm while intoxicated and therefore wear less clothing

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17
Q

What body temp is considered mild heat exhaustion?

A

over 100 degrees

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18
Q

What body temperature is considered heat stroke and high fever?

A

105 degrees and up

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19
Q

What is the temperature at the upper limit of survival for the body?

A

114 degrees

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20
Q

What is considered the lower limit survival temperature for the body?

A

66 degrees

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21
Q

Core body temperature is best assessed where in/on the body?

A

Axially or rectally

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22
Q

Define negative feedback

A

Homeostatic mechanism in which a change in variable will ultimately lead to an inhibition of the process that caused the shift.

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23
Q

What are some signs and symptoms of mild hypothermia?

A

Increased pulse and respires

vasoconstriction

Fatigue

Mental status degradation

Shivering

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24
Q

What cardiac arrhythmia is common in hypothermia?

A

Atrial Fibrillation

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25
Q

What treatments can we give for a hypothermic patient with atrial fibrillation?

A

Cardizem

Possibly cardioversion

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26
Q

What are some signs and symptoms of moderate hypothermia

A

Cardiac arrhythmias

Decreased pulse and respires

hypotension

Shivering will cease

continued altered mental status

27
Q

What are some signs and symptoms that are associated with severe hypothermia

A

unresponsive

cardiac arrest

28
Q

What are Osborne waves?

A

Also known as “J Waves”

Appears similar to ST elevation

Most commonly seen in hypothermic patients

Most commonly seen in leads II and V6

29
Q

All victims of hypothermia should receive what kinds of treatments?

A

Remove wet garments

Protect from further heat loss and wind chill, apply passive rewarming such as blankets, insulating materials, and moisture barriers

Maintaining patient in a horizontal position

Avoid rough handling that may cause an arrhythmia

Monitor core temperature

Monitor cardiac rhythm

30
Q

Active rewarming may be used in what type of hypothermic patient and should be avoided in what kind of hypothermic patient?

A

Mild hypothermia patients may receive active rewarming (warm blankets, heat packs around the axilla, base of the neck, and groin. Remember to insulate heat packs to avoid burning the patient)

Severe hypothermia patients are best actively rewarmed in a hospital environment.

31
Q

What kind of hypothermic patients may receive warm liquids orally?

A

Conscious and alert patients that are able to do it themselves.

32
Q

Unresponsive patients in hypothermic emergencies may appear to be what?

A

Dead

33
Q

When assessing pulse in a patient in a hypothermic emergency how long should you assess pulse and why?

A

30 - 45 seconds because of bradycardia may make pulse harder to assess

34
Q

A patient is not dead until they are ______ and dead.

A

Warm

35
Q

You have a patient that is hypothermic (<86 degrees faherneheit) pulseless and apneic.

What is your treatment?

A

Begin CPR

Preform quick look, if VF or pulseless V-Tach present defibrillate

INtuabte

Initiate IV with warm fluid

Assess core temperature

If core temperature continues to be below 86 degrees fahrenheit then continue CPR but DO NOT ADMINISTER MEDICATIONS OR DEFIBRILLATION

If core temperature is above 86 degrees fahrenheit then continue with normal ACLS algorithm

36
Q

Define frostbite

A

Environmental freezing of skin that causes cell death

37
Q

What are the two types of frostbite?

A

Superficial Frostbite (Frost nip)

And Deep Frostbite

38
Q

What is the treatment of superficial frostbite?

A

Remove from the area

Warm affected body part

DO NOT MASSAGE THE BODY PART

Splint if possible

39
Q

What is the treatment of deep frostbite?

A

Rapid transport

Gentle handling, splinting. Treat as if it were a fracture

Rewarm according to protocol

Contact medical direction

Treat associated symptoms

40
Q

Define trench foot

A

Similar to frostbite but occurs at temperatures above freezing

May result in tissue sloughing and gangrene

Also known as immersion foot

41
Q

Define heat stroke

A

Patient loses ability to thermoregulate combined with fluid and electrolyte loss

42
Q

What are signs and symptoms of heat stroke

A

Increased respires

rapid pulse

low blood pressure

lack of perspiration

hot dry skin

seizure

43
Q

What are febrile seizures

A

Seizure caused by drastic change in temperature, usually seen in pediatrics

44
Q

How should patients with hypothermia and hyperthermia be transferred to your cot?

A

Carried

DO NOT WALK THESE PATIENTS to the cot

45
Q

Define drowning

A

Process of experiencing respiratory impairment from submersion/immersion in liquid which may result in mortality, morbidity or no morbidity

46
Q

Drowning can happen _________ in only a ____ inches of liquid

A

Anywhere, few

47
Q

True or false

Drownings are loud events

A

False

Drownings are silent

48
Q

Define Atelectasis

A

Complete or partial collapse of a lung or lobe of the lung resulting from alveoli

49
Q

_____% of drowning victims have water in their lungs

Why?

A

10%

When water contacts the vocal cords a coughing reflex is triggered.

50
Q

Which type of drowning is preferable and why

Cold water or warm water drownings?

A

Cold water drownings are preferable because water below 70 degrees fahrenheit can slow the onset of death due to the bodies response to hypothermia

51
Q

What is the treatment of drownings?

A

Remove patient from water without compromising your own safety

C-spine precautions on all victims

Rescue breaths should be initiated ASAP and the airway controlled

CPR if pulseless

Main concern is hypoxia to the brain

52
Q

How will salt water and fresh water drownings be different?

A

Patient drowning in fresh water is more likely to develop sepsis due to the increased presence of microbes and germs in fresh water.

53
Q

How can water be removed from the lungs?

A

Positive pressure ventilations

Osmosis

54
Q

Define Air Embolus

A

Air bubble in the blood stream

55
Q

What are signs and symptoms associated with air embolus?

A

Localized chest pain

Numbness/tingling in extremities

Blood in the airway

Sudden LOC

Cardio/Respiratory arrest

56
Q

Define Boyles Law

A

Volume of gas is inversely proportional to its pressure if temperature is kept constant

57
Q

Define Daltons Law

A

The total pressure of a mixture of gases is equal to the sum of all the partial pressure of the individual gases

58
Q

Define Henrys Law

A

The amount of gas dissolved into a given volume of fluid is proportional to the pressure of the gas above it

59
Q

Define the bends (decompression sickness)

A

Nitrogen concentration in tissues and joints as a result of resurfacing too quickly

60
Q

What are signs and symptoms associated with the bends?

A

Altered LOC

Muscle/joint pain

Blotchiness on skin

Difficulty breathing

LOC

61
Q

What are the 4 steps of water rescue?

A

Reach

Throw

Row

Go

62
Q

Define altitude illness

A

Caused by rapid ascension to high altitudes

May include Acute Mountain Sickness, High Altitude Cerebral Edema, High Altitude Pulmonary Edema

63
Q

What is the criteria for Acute Mountain Sickness?

A

Rapid increase in altitude with headache and AT LEAST ONE of the following:

Fatigue and or weakness

Dizziness or light headedness

GI Problems

Difficulty sleeping

64
Q

What is the treatment of high altitude sickness?

A

Remove to lower altitude if possible

High flow oxygen

Hyperbaric bags

If pulmonary edema is present provide CPAP and Furosemide

Treat associated signs and symptoms

Paramedic 2 (17 decks)

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