Environmental Emergencies Quiz

Environmental Emergencies

• Heat Stroke vs. Heat Exhaustion: Heat stroke is worse; the body cannot sweat, while heat exhaustion allows for some sweating.

• Heat Stroke Treatment: Lower core body temperature with cold water immersion (if possible), ice packs, and cold fluids. Monitor temperature, dysrhythmias, and breathing.

• Hypothermia Treatment: Remove cold clothing, use warm blankets and warm fluids, Active and passive warming. Warm the room to a temperature between 86-90 degrees Fahrenheit. Monitor ABCs, cardiac function, and urine output.

Treating Heat Stroke

• Lower Core Temperature: Use cold water immersion if possible and ice packs.
• Monitor Vital Signs: Monitor temperature, heart rhythm (dysrhythmias), and breathing (ABCs).
• Fluid Administration: Ensure cold fluids are administered.
• Shivering Prevention: Shivering can make the body work harder; thus, minimize it.
• Urine Output Monitoring: Monitor for dark (tea-colored) urine, which indicates dehydration.

Hypothermia

• Cause of Thick Blood: Hypothermia can lead to blood clotting, heart attacks, and pulmonary emboli (PE).
• Cold Clothing Removal: Take cold clothes off immediately
• Active Warming: Utilize warm blankets, fluids, and bear huggers to warm the body
• Passive Warming: Passive warming involves strategies like manipulating the room temperature. Aim for 86-90 degrees Fahrenheit for patient warming.
• Monitor for Death: Check patient temperature to confirm whether death was from cold or heat; warm patient before declaring death.

Cold Water Drowning

• Cooling Effect: Cold water slows down the body's processes, increasing the chances of resuscitation.
• Drowning Injuries: Injuries like pulmonary edema and acute respiratory distress syndrome (ARDS) can occur.
• Treatment Focus: Immediate airway management and warming the body. Use a cervical collar and monitor ABCs.
• Water Type Considerations: The type of water where the incident occurs is relevant to treatment.

Bites

• Cat Bites: Cat bites can cause deep puncture wounds, increasing the risk of infection. Prophylactic antibiotics are often prescribed.
• Dog Bites: Dog bites tend to be more problematic due to larger, more extensive wound areas, and infection risk is higher.
• Dental Issues (Puncture wounds): Wounds located on hands, feet, or over joints should receive antibiotic therapy 6 to 12 hours after the bite.
• Rabies Exposure: The animal's vaccine history is crucial information to determine whether or not rabies prophalaxis (vaccination) is appropriate.

Stings

• Removal Technique: Remove the stinger with a flat object or a blade.
• Allergy Assessment: Determine if the person has any allergies.
• Medication Administration: EPI, antihistamines, and steroids may be required.
• Jewelry Removal: Remove any tight jewelry that can restrict blood flow due to swelling.

Poisoning

• Decontamination: Brush away powder before showering.
• Poison Control: Call for expert counsel.
• Treatment Strategies: Use charcoal to bind to toxins.

Opioid Overdose

• Vital Signs: Monitor pupils (which may be pinpoint), breathing, and responsiveness.
• Treatment: Administer naloxone (Narcan) as required and monitor ABCs.
• Monitor closely: Observe and document for any and all changes.

Spinal Cord Injuries

• Common Cause: Automobile accidents are a common cause
• Primary Injuries: Head lacerations are usually the initial or primary injuries.
• Secondary Injuries: These are more concern for permanent damage: Edema, ischemia, and inflammation of the spinal cord are potential issues.
• Spinal Shock: Immediate loss of reflex below the injury is notable with potential long-term damage if not addressed quickly.
• Neurogenic Shock: Signs include warm, flushed extremities, systolic blood pressure below 90, and potential issues regulating temperature.
• T6 and Higher Injuries: These result in temperature regulation problems, cardiac output issues and respiratory distress.

Trauma

• Tension Pneumothorax: Tension pneumothorax has the potential to be life-threatening; it can shift the trachea and affect circulation and breathing. Immediate decompression with a needle or chest tube is crucial.
• Flail Chest: Multiple rib fractures can result in flail chest; it causes paradoxical chest wall movement.

Abdominial Injuries

• Caution: Do not pull out impaled objects.

Fractures

• Blood Loss: Long bone fractures can cause significant blood loss.
• Infection Potential: Open fractures increase the chance of infection.
• Compartment Syndrome Risk: Crush injuries can lead to compartment syndrome, an acute limb-threatening complication.
• AKI: Rhabdomyolysis can cause acute kidney injury (AKI).
• Urine Appearance: Red or tea-colored urine is often a sign of rhabdomyolysis.

TBI- Traumatic Brain Injury

• Long-term Effects: TBI can cause chronic issues.
• Routine Needs: Maintain a routine that supports daily health and well-being.
• Support Networks: Utilize support groups for stress management and symptom monitoring.
• Avoid Irritants: Try to avoid substances that might worsen or trigger symptoms (alcohol, drugs, etc.)

Trauma Nursing

• ESI Levels: Trauma care prioritizes the patient based on the ESI level.
• Patient Considerations: Patient care needs may vary based on the ESI level.

TBI- Traumatic Brain Injury

• Lifelong Care: Some TBI injuries may require care for the rest of the patient's life.

Sepsis

• Severity Stages: Includes SIRS, sepsis, severe sepsis, and septic shock; this is noted by lactate levels, if above 4, immediate action is needed.
• Critical Issues: Assess for and address severe metabolic acidosis, inadequate urinary output, and complications like acute kidney injury.
• GI Involvement: Observe for gut symptoms like slowed bowel sounds, which are often caused by stress and/or lack of sufficient hydration; use caution and monitor closely.
• Kidney Failure: Kidney injury or failure needs careful attention, usually requiring medication or assistance.

Oncology Emergencies

• Neutropenia: Low white blood cell count increases susceptibility to infections.
• Infections: Monitor for infections and take appropriate action to prevent or treat them.
• Antibiotic Therapy: Follow antibiotic protocols meticulously to ensure correct application and monitoring.
• Thrombocytopenia: Reduced platelet count requires close monitoring; avoid procedures that may increase bleeding risk.
• Hypercalcemia: High calcium levels may result in many symptoms; carefully evaluate, treat as needed, and monitor for complications.

Tumor Lysis Syndrome

• Chemo Effects: Chemotherapy treatment can cause the death of numerous cells; closely monitor for subsequent side effects.
• Metabolic Acidosis: Monitor for metabolic acidosis.
• Kidney and Fluid Balance: Ensure adequate fluids and monitor kidney function.
• Electrolyte Imbalances: Be sure to check for electrolyte imbalances.

SIADH

• Water Excess: Excessive water intake is common.
• Assessment: Assess for mental status, reflex changes, and elevated sodium levels—critical to detect and address swiftly.

Superior Vena Cava Syndrome

• Symptoms: Symptoms of the obstruction include higher blood pressure in the upper body.
• Causes: Various factors or complications can cause the obstruction.

Spinal Cord Compression

• Pain Changes: Worsening pain, especially in the supine position, often marks the onset of spinal cord compression.

Burns

• Parkland formula: A formula to determine fluid requirements in burn patients.
• Intubation: Intubate patients who are having a burn injury to the mouth or airway, quickly.
• swelling issues in esophageal area: Early intubation is crucial to prevent further issues.

Lab work & monitoring

• Vital monitoring: vital signs including temperature and rhythm.
• Lab Work: lab tests such as blood work and urine.
• Other Tests: NG tubes or OG tubes may be used for patients with facial trauma.
• Medication Management: Provide pain management and other necessary medications.

Test your knowledge on environmental emergencies, focusing on heat-related conditions like heat stroke and heat exhaustion. This quiz covers treatment protocols, including lowering core temperature and monitoring vital signs. Assess your understanding of hypothermia treatment as well.