Thermo-Regulated Emergencies Flashcards
What are types of environmental illnesses?
- heat related illness
- cold injury
- altitude
- UV light
- lightning
Constant core temp is
37deg Celcius
What is hypothermia
body loses heat faster than it can produce heat
What is hyperthermia
heat gain is faster than body can shed heat
What happens in humid environments?
Sweat can’t evaporate as easity
Factors that affect exposure to thermoregulatory injuries
- Physical condition (tolerating extreme temps)
- Age (children, elderly, chronic illnessess)
- Nutrition and hydration (calories for metabolism, water catalyst)
- Environmental conditions (temp, humidity, wind)
Head stroke cases at what temp?
26.7deg C
Hypothermia at what temp?
-1 to 10deg C
What are the 4 ways the body loses heat?
1- radiation
2- convection
3- conduction
4- evaporation
Describe convection
loss of heat when air close to skin moves away taking body heat w/ it
- 40% loss thru head and neck
What is radiation
- body heat emitted into environment
What is conduction
- loss of body heat thru direct contact w/ another surface
In what environments do you lose heat faster due to conduction?
- water
- on ice (2x)
What is evaporation
- loss of body heat thru evaporation of moisture in form of sweat on skin
- during exercise: 75% heat loss in hot-humid environment
What are some preventions?
- education
- acclimatization (7-10 days)
- monitor weight daily for dehydration (if >3%, rehydrate)
- proper uniforms (light clothing)
- monitor temp and environmental conditions
- adjust practice times/intensity
What are heat related illnesses?
- burns
- heat edema
- heat rash
- heat syncope
- heat cramps
- heat exhaustion
- heat stroke
What are burns a result from?
- heat
- electricity
- chemicals
- radiation
What are the burn degrees?
1st degree: superficial
2nd degree: partial thickness (blisters)
3rd degree: full thickness, all layers of skin (black/white charred tissue)
Burns tx
- remove from source
- flush w/ cool water up to 15mins
- cover w/ loose, dry, sterile dressing
- NO OINTMENT
How do you get heat edema?
sit/stand for a long time in a hot environment: swelling of feet/hands
S/S and Tx of heat edema
- transient venodilation to facilitate core heat loss
- normal body temp
- dependent edema
Tx: hydration, elevate LE, cooling
Edema test
Pitting: press finger into swollen area
Grade: identify how much fluid is in tissues
What are other names for a heat rash?
Prickly heat, miliaria rubra
S/S and Tx of heat rash
- profuse sweating saturates kin and clogs sweat ducts
- pruritic rash (itchy)
- normal body temp
Tx: cooling, reduce clothing, antihistamines/lotions
What are common types of exertional heat illnesses?
- heat syncope
- heat cramps
- heat exhaustion
- heat stroke
Describe heat syncope
- Orthostatic dizziness (often in un-acclimatized ppl, and standing for a long time)
- usually first 5 days of unaccustomed heat exposure (before blood volume expands)
- Contributing factors: dehydration, venous pooling of blood, reduced cardiac filling, low BP
Heat syncope S/S
- brief episode of fainting
- dizziness
- Tunnel vision
- pale/sweaty skin
- dec. pulse rate
Tx of Heat syncope
- remove from heat to shaded area
- monitor vitals
- elevate legs
- cool skin
- rehydrate
What happens in heat exhaustion, heat cramps, and heat stroke?
- electrolyte imbalance
- inability to cool oneself
- build up of heat, life-threatening
Heat/muscle cramps during/after exercise: potential contributing factors
- dehydration
- electrolyte imbalances
- fatigue
- altered neuromuscular control
Heat cramps S/S
short <5mins (overload and fatigue
- visible cramping
- localized pain
- dehydration
- thirst
- sweating
- fatigue
- normal or slightly elevated core temp (37C)
Heat cramps tx
- rest/relaxation
- shade/cooler environment
- slowly sip a COOL electrolyte-replacement beverage/water
- passive stretching
- icing, massage
RTP for heat cramps
- when cramps stop
Review: - diet, hydration
- electrolyte consumption
- fitness lvl
- acclimatization lvl
- dietary supplements
Describe heat exhaustion
- normal or slightly raised core temp (37-39)
- high rate/volume of skin blood flow, heaving sweating, dehydration
- hot/humid environments
- can progress to heat stroke
Heat exhaustion S/S
- excessive fatigue/exhaustion
- profuse sweating
- fainting
- weakness
- vomiting
- nausea
- light headedness
- dehydration or intense thirst
- low BP, pulse is weak, breathing is rapid and shallow
- impaired muscle coordination
Heat exhaustion Tx
- rest
- remove clothing
- cool/shady place (fans, ice towels, cold pack to armpits and chest)
- monitor vital signs
- fluid replacement (electrolyte drink)
- supine + elevate legs
- cool until rectal temp 38.3
- if no improvement after 30mins: 911 (or if vomiting, altered LOC, unable to drink)
Can heat exhaustion occur over a number of days?
YES
Main diff btwn heat exhaustion and heat stroke
Heat exhaustion: inability to cool oneself
- moist/clammy skin
- dilated pupils
- normal or subnormal temp
Heat stroke: build up of heat, life threatening
- dry hot skin
- pupils constricted
- very high body temp
Describe heat stroke
- least common, most severe
- neuropsychiatric impairment and high core body temp (>40.5)
- from environment and metabolic heat production of inhibited heat loss
- First sign; CNS dysfunction
- can progress to systemic inflammatory response and multi-organ system failure
heat stroke S/S
- hot+dry skin
- red or pale skin
- rapid, weak pulse (irregular)
- hypotension
- rapid, shallow breathing
- thirst
- altered LOC
- loss of balance
- seizure/coma
- apathy
- aggressive/delirious/hysterical
-etc
heat stroke tx
- remove excess clothing
- lower core temp to less than 38.9C
- immerse into tub of cold water (2-14C): up to neck and stir
- alternative: cold compresses (armpits, neck, groin), fan, lie down
When to call 911?
Heat stroke: always
Heat exhaustion: nausea, vomiting, fainting, anxiety, dizziness
How much water should you drink
- 24oz 2 hrs before
- 8oz 30min before
- 6-8oz every 20-30mins during
avoid too much water: dilutes electrolytes
monitor colour of urine
Acclimatization benefits:
Reduce:
- heart rate
- body temp responses
- skin temp responses
- perceived exertion
Increases:
- sweat rate
- sweat onset (earlier)
- heart function/blood distribution
- ability to perform in heat
How to acclimatize?
- max 1 practice per day for first 5 days
- max 3hrs per day
- no full gear until day 6
- no full-contact until day 6
- increase intensity GRADUALLY
- inc. sodium in diet for first few days
- no practice when sick
- breaks and sleep
What are the 3 categories of cold exposure injuries?
- Hypothermia: dec. core temp
- Frostbite: freezing injuries of the extremities
- Chilblains: non freezing injuries of extremities
What are the stages of frostbite?
1st degree (frostnip): irritates the skin
2nd degree (superficial frostbite): blisters, no major damage
3rd degree (deep frostbite): all layers of skin + permanent damage, numbness, jnts/muscles don’t work (large blisters 24-48hrs after rewarming, area turns black and hard)
Frostbite S/S
- waxy, pale skin to mottle skin
- edema
- redness
- transient numbness/tingling
- tissue is hard and does not rebound
Frostbite: what happens when the tissues are actually frozen?
(-2C tissue temp)
- damage to cells
- warm blood shunted
- water crystallization
Frostbite Tx
- shelter, care, transport
- drink smth warm (if alert)
- no alcohol
- remove jewelry
- separate digits w/ dry sterile gauze
- do not burst blisters
- rewarm in control setting (rapid immersion with water 38-42C): painful
- do not allow to refreeze: gangrene
- elevate
Explain hypothermia (S/S)
- body temp under 35C
- vessels constrict and body shivers at first
- HR: rapid then slow
- rapid to slow breathing
- inc. BP
- muscle stiffness
- decreased LOC
How to assess S/S of hypothermia
- pull back glove, place hand on patient’s skin at abdomen
- rectal temp
- Never assume that a cold pulseless person is dead: maintain CPR until at hospital and rewarmed
When to call 911
- Impaired mvmt + not alert + not shivering
- unconscious
Hypothermia Tx
- gentle handling (avoid ventricular fibrilation (V-fib))
- remove from cold + remove wet clothes
- dry blankets or sleeping bags
- warm water bottles, heating pads, or electric blankets to upper torso
What should a person with hypothermia ingest?
No: food, stimulants, smoke, tabacco, alcohol
Yes: warm, sweet fluids-water non-alcoholic liquids
How to prevent hypothermia?
- Nutrition + hydration
- check temp and wind chill factor
- proper layering: multiple layers (under/over), wicking close to skin, synthetic/wool clothing, scarfs/gloves/hat/socks
What is C.O.L.D.
Cover: socks/gloves/hat/scarf
Overexertion: loosefitting, layered, lightweight clothing
Layers: outer (tightly woven, water-repellent) + inner (wool/silk/polypropylene)
Dry
