Untitled Quiz

Environmental Emergencies

• Environmental emergencies include a wide range of situations, affecting temperature regulation, drowning, bites & stings.

Overview

• Thermoregulatory Emergencies: Body temperature regulation, exposure to heat and cold are key categories.
• Drowning and Near Drowning: Emergency medical care for near-drowning patients is crucial.
• Bites and Stings: Signs, symptoms, and emergency medical care for bites and stings are included.

Thermoregulatory Emergencies

• Any emergency that causes a change in body temperature.

Temperature Regulation in the Body

• Maintaining a nearly constant internal body temperature is vital for efficient bodily functions.
• Changes in body temperature lead to profound effects on vital chemical processes, potentially life-threatening.
• The body maintains internal temperature by balancing heat production and heat loss, using systems like peripheral vasoconstriction, shivering (heat production), vasodilation and perspiration (heat loss).

Temperature Regulation in the Body-Types of Heat Loss

• Conduction: Direct transfer of heat from one object to another.
• Convection: Heat transfer to moving air or liquid.
• Evaporation: Heat transfer when liquid changes to gas (like sweating).
• Radiation: Loss of heat as infrared energy to cooler surroundings.
• Respiration: Heat loss from breathing.

Exposure to Cold

• Hypothermia: Condition where body temperature falls below normal. Normal body temperature = 98.6°F (37°C).
• Predisposing Factors: Cold environments, immersion in water, advanced age or youth, alcohol use, shock, head or spinal injury, burns, generalized infection, diabetes, hypoglycemia, medications or poisons.

Exposure to Cold-Signs & Symptoms of Generalized Hypothermia

• Decreasing mental and motor function, correlates with the extent of hypothermia.
• Poor coordination, memory disturbances.
• Reduced/loss of sensation to touch.
• Mood changes, less communicative.
• Dizziness, speech difficulty, poor judgment
• Patient may remove clothing.
• Stiff or rigid posture, muscular rigidity, shivering (may be absent).
• Complaints of joint/muscle stiffness
• Breathing variations: early rapid breathing, late shallow or absent breathing.
• Slowly responding pupils
• Pulse: early rapid, late slow and barely palpable, irregularly or absent
• Low to absent blood pressure
• Skin: early red, then pale, then cyanotic (blue-gray).
• Stiff/hard skin

Exposure to Cold-Focused History

• Source of exposure
• Environmental conditions
• Loss of consciousness
• General or localized effects

Exposure to Cold-Emergency Care for Generalized Hypothermia

• Protect the patient from further heat loss.
• Remove the patient from the cold environment.
• Remove wet clothing & cover with a blanket.
• Handle the patient gently; avoid rough handling.
• Do not let the patient walk or exert themselves.
• Administer warmed and humidified oxygen.
• Monitor for a pulse (30-45 seconds) before starting CPR.
• Actively or passively rewarm if alert; use warm blankets, heat packs or hot water bottles in the groin, axilla, and cervical regions.
• Heat up the ambulance compartment.
• Prohibit the patient from eating or drinking stimulants.
• Do not massage extremities.

Exposure to Cold-Local Cold Injuries

• Can damage extremities and other tissues.
• Result from reduced blood flow or freezing.
• Gradual progression of injury; deeper freezing means more damage.
• Most common in fingers, toes, ears, nose, and face.
• Predisposing Factors: Past cold injury damages the blood vessels, making the area more susceptible. Smoking constricts blood vessels in extremities.

Exposure to Cold-Local Cold Injuries-Signs & Symptoms

• Early/superficial injury: pale skin, delayed capillary refill, loss of feeling/sensation, skin still soft, tingling when rewarmed.
• Late/deep injury: white/waxy skin, firm/frozen feeling on palpation, swelling, blisters, loss of sensation, skin may appear flushed with purple, pale, mottled, or cyanotic areas.

Exposure to Cold-Emergency Care for Local Cold Injuries

• Remove patient from the cold environment.
• Protect the cold extremity from further damage; do not allow unnecessary contact.
• Administer oxygen.
• Remove wet/restrictive clothing & jewelery.
• Splint the extremity; cover with dry, sterile dressings.
• Actions to avoid: re-exposing the area to cold; breaking blisters; rubbing/massaging the area; applying heat/rewarming; allowing patient to walk on affected extremities.
• If prolonged transport, rapidly rewarm: immerse injured area in warm water (102-104°F/38-39°C); continuously add warm water & stir; immerse until skin is soft & sensation is restored. Do not rub dry; pat gently. Dress with dry, sterile dressings, place dressings between fingers/toes. Protect from further freezing.

Exposure to Heat

• Hyperthermia: Internal body temperature rises above normal.

Exposure to Heat-Predisposing Factors

• Hot, humid weather; vigorous activity; elderly; infants and newborns; heart disease; dehydration; obesity; previous history of hyperthermia; fever; fatigue; diabetes, drugs, medications.

Exposure to Heat-Signs & Symptoms of Generalized Hyperthermia

• Muscle cramps, weakness/exhaustion, dizziness/fainting, rapid/pounding heart beat, altered mental status.
• Moist, pale, cool, or normal skin, nausea; vomitting, abdominal cramps, hot skin

Exposure to Heat-Emergency Care

• For patients with moist, pale, cool or normal skin: move patient to cool environment, administer oxygen, remove clothing, or loosen clothing, cool patient by fanning, place patient in head low position, if unconscious and vomiting, position in left lateral position.
• For patients with hot, dry skin: remove patient from heat to a cool environment, apply cool packs to neck, groin, armpits; keep skin wet by using water, a sponge or wet towels; fan aggressively; transport immediately.

Drowning and Near Drowning

• Drowning: death from water immersion (or any other liquid).
• Near Drowning: survival after water immersion.

Emergency Care for Drowning and Near Drowning

• Immobilize the spine if trauma is suspected.
• Ensure an adequate airway
• Provide oxygen and ventilate if necessary.
• Provide external chest compressions if the patient is pulseless.
• Suction as needed.
• If gastric distention interferes with artificial ventilation, place the patient on their left side. With suction available to relieve the distention.
• Do not attempt to relieve gastric distention unless it interferes with artificial ventilation (a significant risk of aspiration).
• Some patients can survive very long submersion periods in cold water.
• All pulseless, apneic patients experiencing cold water submersion should be resuscitated.

Bites and Stings

• Signs and Symptoms: history of bite/sting, pain, redness, swelling, weakness, dizziness, chills, fever, nausea, vomiting, bite marks, stinger
• Emergency Medical Care: remove stinger (scrape with edge of card, not tweezers); wash area gently; remove jewelry if swelling is imminent; place injection site below the heart; do not apply cold; seek medical direction concerning constricting bands; monitor for allergic reactions; treat as needed