Enviromental Emergencies Flashcards
(43 cards)
Who is at risk of heat illnesses and why
Older people - do not adjust well, acclimatise slowly, likely to have chronic conditions and be on medications which can disrupt mechanisms
Children - have high heat production, do not dissipate heat well, thermoregulatory centres not fully developed
What are heat cramps
Acute involuntary muscle pains
Occurs because of sweating and sodium loss
Treatment of heat cramps
1) move to cool are
2) drinks fluid or give saline
Do not massage muscle
What is heat syncope
It can be called orthostatic syncopal episode - can occur with prolonged standing or from sitting/ lying to standing
Occurs because of peripheral vasodilation
Treatment for heat syncope
Place in supine position and replace fluids
What is heat exhaustion?
Volume depletion and heat stress
There is two forms
Water depleted
Sodium depleted
Sodium depleted in heat exhaustion what is it
Exertional hyponatremia
- loss of sodium through sweating
Can cause nausea, vomiting, mental status change and convulsions
Heat exhaustion symptoms
Headache Nausea Fatigue Vomiting Dizziness Abdo cramps Pale/clammy Respiratory rate fast and shallow Tachypneoa
What can heat exhaustion progress to
Heat stroke
Treatment for heat exhaustion
Move patient out of hot environment
Cool patient - sponge, spray, fan
Rehydration - water, IV fluids, replace electrolytes
If it is exertional hypontraemia do not give fluids by mouth do IV
Monitor observation
What is heat stroke
Severe disturbance in body’s regulation have core body temperature greater than 40
Altered mental status
Can be classic or exertional
Clinical features of heat stroke
Not be able to give coherent history Changes in behaviour Older patient may look as though stroke CNS disturbance e.g tremors posturing Elevated temperature Degree of dehydration
Treatment for heat stroke
Rapid cooling
Spray water on patient
Ice pack on neck, groin, axillae
IV fluids, glucose, may seize
May need to intubate
What is hypothermia
Decrease in core body temperature below 35c
Caused by inadequate thermogenesis or cold environment
Risk factors for hypothermia
Body factors Trauma Issue with development Alcohol Older people
Clinical features of hypothermia
Umbles
Stumbles
Mumbles
Fumbles
Grumbles
As it is affecting cerebral and cognitive function
Tempeture ranges for hypothermia
Mild 35-32
Moderate 32-28
Severe - below 28
Happens to cvs in hypothermia
Blood shunted to core, increased viscosity of blood, impairs circulation, hypovolaemia.
Initially speeds up then slows rate = disrupted electrical conduction
Arrhythmias
Happens to resp in hypothermia
Speed up then decreases
Minute volume decreases
Secretions increase, increased bronchospasm
Happens to msk in hypothermia
Slow in response to cold
Start to shiver
Shivering stops when to low below 32
Cold muscles = weaker and stiffer
Happens to metabolism in hypothermia
Shivering decreases glucose
Insulin levels falls body changes to metabolism of fat
Liver metabolism of drugs is slowed
Stages of hypothermia
1- conscious and shivering
2- reduced conscious level may or may not be shivering
3- unconscious vital signs present
4 - apparent death, vital signs absent
Treatment for hypothermia
Prevent further heat loss and rewarm Take off wet clothes Passive rewarming Promote heat generation People only dead if warm and dead
Sequence of Drowning
Breath holding
Small amount enter mouth nose = coughing, gasping, sets off spasms
Laryngospasms - leads to asphyxia and may lose conscious dry drowning
Water enters lungs = wet drowning
Decompensation = gasps for air allowing more water in
