Environmental Problems Flashcards
How to prevent, recognize, and treat problems created by the environment.
Describe some of the important considerations in preventing lightning strikes.
- Sitting on an insulator to reduce contact with ground current.
- Spread the group out.
- Inside a full-frame vehicle or building is best location – faraday principle.
- If moving toward safety, keep moving (i.e. coming down a ridge to lower elevation or paddling on water).
- Lower is safer.
- Don’t hold metal or wet rope.
- Get off the water.
- Avoid being near the tallest trees or rock outcrops.
- Avoid hollows and shallow caves.
List some of the general contributing factors to drowning.
Loss of muscular coordination due to cold water and sudden immersion in cold water.
What are the complications associated with severe hypothermia?
Heart is irritable. Patients can have undetectable vital signs. CPR can cause the heart to go into an irregular rhythm.
Besides temperature, what other factors contribute to heat related illness?
Patient not being acclimated to hot conditions (i.e., lives in a cool climate and taking a vacation in a hot environment). Fluid intake.
What are the primary problems with drowning and their anticipated problems? How are each managed?
Respiratory Arrest which leads to Cardiac Arrest: treat with PPV, Hypothermia wrap, and Urgent Evacuation.
Water Inhalation Injury which leads to Pulmonary Edema: monitor for s/sx of respiratory distress, PROP, maintain calorie/fluid intake, and keep warm.
Hypoxic Brain Injury which leads to ↑ICP: PROP, maintain calorie/fluid intake, and keep warm.
When is the scene considered safe with respect to lightning injuries?
When the potential for lighting strike is no longer present. The patient is safe to touch.
Describe treatment for a severely hypothermic patient.
Hypothermia wrap w/heat sources; consider PPV (if will not delay evac); urgent, gentle evac; keep patient horizontal.
Describe the principles of a hypothermia wrap. How do you build one?
- Remove patient’s wet clothing (if applicable). Put on dry clothes.
- Place an ensolite pad under patient.
- Consider putting a diaper on patient. If have the materials available wrap patient in interior vapor barrier (full body is better) to keep insulation from getting wet due to wastes and sweating.
- Sandwich patient between layers of insulation.
- Place hot water bottles near the patient’s core (think big arteries).
- Wrap patient and entire package in waterproof layer (i.e., tarp).
How is the treatment for cold response different for mild hypothermia? Explain why.
No exercise – exercise will make problem worse as there is often very little fuel in the tank. Insulate using hypothermia wrap. In addition, exercise induces rapid rewarming resulting in a bigger after drop effect. The shell/core effect is reverse and cold blood rapidly returns to core causing body temperature to lower. If rewarmed slowly via food/fluids/hypothermia wrap there is less of an after drop due the fact that the reversal of the shell/core effect is slower.
Hypothermia
Abnormally low body core temperature.
What types of injuries/problems can lightning cause?
An array of injuries/problems can occur depending on the impact of the strike. Examples include TBI, blown out ear drums, cardiac arrest, fractured bones, damage to internal organs, wounds, burns, etc.
What is heat stroke?
Condition where the body core temperature is so high that the brain is cooking. Heat production greatly exceeds ability to cool down.
How does the body retain, produce, and dissipate heat?
The body has temperature sensors in the skin that provide information to brain. The brain adjusts heat retention and production based on this information. Muscles generate heat through shivering. Blood vessels in skin constrict to retain heat and dilate to dissipate heat. Sweat glands release fluid to cool the body by evaporation.
Describe the treatment principle for lightning injuries.
Treat what you see!
How is risk different in situations where a downed power line is involved?
A downed powerline may still be attached to the source. Those coming into contact with a patient who is touching the power line or touching a powerline directly can result in electrocution.
