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Flashcards in Enviornmental Emergencies Deck (36)
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Name ways the body loses heat

• Conduction
• Convection
• Radiation
• Evaporation
• Respiration


Characteristics of Hypothermia

• Exposure to cold reduces body heat
• Body is unable to maintain proper core temperature
• May lead to death
• Predisposing factors of hypothermia
– Injury
– Chronic illness
– Geriatric/pediatric


Generalized Hypothermia

• Obvious and subtle exposure
– Alcohol ingestion
– Underlying illness
– Overdose or poisoning
– Major trauma


Assessment: Symptoms of Hypothermia

• Shivering, in early stages
• Numbness
• Stiff or rigid posture
• Drowsiness
• Rapid breathing or pulse
• Loss of motor coordination
• Joint/muscle stiffness
• Unconsciousness
• Cool abdominal skin temperature


Ways to Rewarm the Hypothermic Pt

• Passive
– Cover patient
– Remove wet clothing
• Active
– Apply external heat source
• Central
– Apply heat to lateral chest, neck, armpits, and groin


Extreme Hypothermia

• Patient unconscious, no discernible vital signs
– Heart rate can slow to 10 beats/minute
– Very cold to touch
• If no pulse, start CPR with AED
• If pulse present, care as for any
unresponsive patient
• “You’re not dead until you’re warm and dead”


Localized Cold Injuries

• Most commonly affects ears, nose, face, hands, and feet
– Blood flow limited by constriction of blood vessels
– Tissues freeze, may form ice crystals
• Early/superficial (frostnip)
– Remove from cold and cover
• Late/deep (frostbite)
– Cover and immobilize gently


Effects of Heat on Body

• Heat not needed for temperature maintenance, and not lost, creates hyperthermia
• Left unchecked, leads to death
• Heat cramps and heat exhaustion
– Moist, pale, normal-to-cool skin
• Heat stroke
– Hot, dry, or possibly moist skin


Heat Exhaustion: Signs and Symptoms

• Muscular cramps
• Weakness or exhaustion
• Rapid, shallow breathing
• Weak pulse
• Heavy perspiration
• Loss of consciousness


Heat Exhaustion: Treatment

• Remove from hot environment
• Administer oxygen
• Loosen or remove clothing
• Position supine
• Small sips of water
• Transport


Heat Stroke: Signs and Symptoms

• Rapid, shallow breathing
• Full, rapid pulse
• Generalized weakness
• Little or no perspiration
• Altered mental status
• Dilated pupils
• Seizures


Heat Stroke: Treatment

• Remove from hot environment
• Remove clothing
• Apply cool packs to neck, groin, and armpits
• Administer oxygen
• Transport immediately


Types of Accidents Occurring on or Near Water

• Boating
• Water-skiing
• Wind surfing
• Jet-skiing
• Diving
• Scuba-diving



• Often begins as person struggles to keep afloat
• When they start to submerge, they try to take one more deep breath
• Water may enter airway, followed by coughing and swallowing, and involuntary swallowing of more water



• Reflex spasm of larynx is triggered, sealing airway; unconsciousness results from hypoxia
• Some who die from drowning die just from lack of air
• Most attempt a final breath (or are unconscious) and water enters lungs


Drowning: Treatment

• Begin rescue breathing without delay
• If you reach a non-breathing patient in water, support patient in semi-supine position and provide ventilations
• May encounter airway resistance; will probably have to ventilate more forcefully than other patients
• Do not delay transport


Diving Accidents

• Most involve head and neck, but many also involve spine, hands, feet, and ribs
• Emergency care is the same as for any accident patient out of water


Scuba-Diving Accidents

• Arterial gas embolism (gas bubbles in bloodstream): diver holding breath
– May be due to inadequate training, equipment failure, underwater emergency, or trying to conserve air
• Decompression sickness: diver surfacing too quickly from deep, prolonged dive
– Takes 1–48 hours to appear


Diver Alert Network (DAN)

• Formed to assist rescuers with care of underwater diving accident patients
• Gives EMT or dispatcher information on assessment, care, and how to transfer patient to hyperbaric trauma care center
• Emergency: 919-684-8111
• Non-Emergency: 919-684-2948


Water Rescue

• Reach
– Hold object for patient to grab
• Throw
– Throw object that will float
• Row
– Row boat to patient
• Go
– Swim to patient (last resort)


Ice Rescue

• Throw flotation device to patient
• Toss rope with loop
• Push out flat bottomed aluminum boat
• Lay ladder flat on ice to distribute weight of rescuer
• Treat patient for hypothermia
• Always transport


Spider and Insect Bites and Stings

• All spiders are poisonous
• Insect stings and bites are rarely
• Anaphylactic shock is a major concern
• Remove stinger quickly



• Require special care but are not usually life-threatening
• Death is not sudden unless anaphylactic shock develops
• Stay calm
• Keep patient calm and at rest


Marine Life Poisoning

• Can occur in variety of ways
– Eating improperly prepared seafood or poisonous organisms
– Stings and punctures
• Fresh water activates toxins on skin, increasing pain
• Use salt water to rinse affected area


Chapter Review: Environmental Emergencies

• Patients suffering from exposure to heat or cold must be removed from the harmful environment as quickly and as safely as possible.
• Generalized cold injure involve cooling the entire body (hypothermia). Treatment
is based on whether the patient has normal or altered mental status.


Chapter Review: Environmental Emergencies

• Patients who have hypothermia with altered mental status are considered to have severe hypothermia.
• Local cold injury involves an isolated part or parts of the body (frostbite). Early injury may be rewarmed gently.


Chapter Review: Environmental Emergencies

• Late local cold injury involves freezing of tissue. Transport rather than rewarming unless transport is significantly delayed or if advised by medical direction.


Chapter Review: Environmental Emergencies

• Hyperthermia is a heat emergency. Severity is determined by skin temperature. Skin which is normal to cool
is considered less severe than skin which is hot to the touch. All heat emergency patients should be removed from the heat and cooled.


Chapter Review: Environmental Emergencies

• Altered mental status in the setting of hyperthermia indicates a life-threatening emergency.
• Follow local protocols in reference to rewarming or cooling procedures.


Chapter Review: Environmental Emergencies

• Immediate resuscitation of a water-related emergency patient may require quick, persistent intervention. Always assure
your own safety before attempting any rescue.
• For injection or ingestion of poisons of insects, spiders, snakes, and marine life, call medical direction and follow local