Environmental Ems (Heat Exhaustion, Frostbite, Hypothermia) Flashcards
An increase in UO due to peripheral vasoconstriction.
Cold Diuresis
_____ may be extremely difficult to hear because cold tissue conducts sound waves poorly.
BP reading
Start IV with _____; _____ is not recommended
PNSS; PLR
There is a history of gradual onset, skin appears red, numbness and/or pain sensation.
Frostnip
It is caused by shutdown or failure of the heat regulating mechanism of the body.
Heat Stroke
_____ is not recommended for rewarming.
Dry Heat
Fruity or acetone odor breathe due to metabolizing ___ as a result of ___ insulin levels.
fats; decreased
True or False: If clothing is frozen, they should be left on and removed after rewarming.
True
Frostnip may be treated by placing a _____over the chilled area.
warm hand
Passive External, Active External, or Active Core
Provide warm fluids to drink.
Passive External Rewarming
_____ rewarming is less effective and may increase tissue damage.
Slow
Reduce the internal core temperature to _____ as rapidly as possible.
102⁰F (38.9⁰C)
A very cold heart is susceptible to _____; conversely, they do not respond to drugs and defibrillation.
ventricular fibrillation
Passive External, Active External, or Active Core
Warm mediastinal irrigation through open thoracotomy
Active Core Rewarming
Extreme caution should be used in moving, transporting, and intubation of hypothermic patients because the heart is near _____.
fibrillation threshold
It is a condition in which the core internal temperature of the body is less than 95⁰F (35⁰C) as a result of exposure to cold.
Hypothermia
It is the inadequacy or the collapse of peripheral circulation due to volume and electrolyte depletion.
Heat Exhaustion
Hyperthermia may recur spontaneously within _____.
3-4 hours
It is a trauma due to exposure to freezing temperatures that cause actual freezing of the tissue fluids in the cell and intracellular spaces, resulting in vascular damage.
Frostbite
Passive External, Active External, or Active Core
Warm water immersion
Active External Rewarming
For temperature below 28⁰C
Active Core Rewarming
Rewarming is complete when the area is:
Warm to touch
Pink or flushed
It is a complication of heatstroke.
Acute Tubular Necrosis (ATN)
_______: incision through the eschar
_______: incision in the fascia to release pressure on the muscles, nerves, blood vessels.
Escharotomy
Fasciotomy
Initial _____ followed by slow shallow
respirations.
tachypnea
If temperature fails to decrease, initiate core cooling by:
Iced saline lavage
Cool fluid peritoneal dialysis
Cool fluid bladder irrigation.
Advise patient not to use tobacco because of the _____ effects of nicotine, which further reduce the already deficient blood supply to injured tissues.
vasoconstrictive
Passive External, Active External, or Active Core
Cardiopulmonary bypass
Active Core Rewarming
If body temperature fall below ____, the heart sounds may not be audible even if the heart is still beating.
30⁰C
_____ is the most efficient. Spray tepid water on the skin while electric fans are used to blow continuously.
Evaporative Cooling
Large blisters may develop in _____ after rewarming; these blisters should not be _____.
1 hour to a few days; broken
Encourage hourly active motion of the affected digits:
to promote maximum restoration of function
to prevent contractures
Passive External, Active External, or Active Core
Inhalation of warmed, humidified oxygen by mask or ventilator
Active Core Rewarming
Provide insulation by wrapping the patient in several blankets.
Passive External Rewarming
The body will attempt to produce or conserve more heat by:
a. Shivering
b. Peripheral vasoconstriction
c. Raising the basal metabolic rate
Do not rub or massage a frostbitten extremity. The ice crystals in the tissue will _____ delicate tissues.
lacerate
Untreated heat exhaustion may lead to _____.
heat stroke
Medications for heat exhaustion:
KCl (Potassium Chloride) for hypokalemia
Sodium bicarbonate to correct metabolic acidosis
Diazepam for seizures
Progressive deterioration marked by:
Apathy
Poor judgment
Ataxia
Dysarthria
Drowsiness
Coma
Warm water immersion
Active External Rewarming
_____ may be suppressed if temperature if temperature falls below 32.2⁰C.
Shivering
In heat exhaustion and heat stroke, what do we instruct patient to do?
Increase fluid intake
Wear loose clothing
Avoid immediate reexposure to high temperature
Use a _____ to prevent contact with bedding if feet are involved
foot cradle
Refreezing of a partially thawed extremity:
reverses ice crystal formation in tissues
increases tissue damage and loss
On palpation, the skin will feel stiff, but the underlying tissue will be pliable, soft, and have its normal bounce.
Superficial Frostbite
Apply ice packs to
Neck
Groin
Axillae
Scalp
True or False: Immersion in cold water is contraindicated.
False; indicated
The affected part is completely insensitive to touch.
Deep Frostbite
Passive External, Active External, or Active Core
Provide external heat like warm hot water bottles to armpits, groin, neck.
Active External Rewarming
Rewarming procedure may take _____.
20-30 minutes
_____ for the affected extremity – to aid circulation, debride dead tissue, and help prevent infection.
Whirlpool bath
