Environmental Emergencies

Question 1

thermogenesis

Answer 1

Increased body temperature causes increase heat loss and shut off normal heat production pathways.

Question 2

thermolysis

Answer 2

Decrease body temperature prompts heat production and conservation and turns off normal heat-liberating pathways.

Question 3

conduction

Answer 3

Transfer of heat from body part to a colder object or substance by direct contact.

Question 4

convection

Answer 4

Heat is transferred to circulating air

Question 5

evaporation

Answer 5

Body sweats to cool itself

Question 6

radiation

Answer 6

Loss of body heat directly to colder object in the environment by radiant energy.

Question 7

respiration

Answer 7

Body heat loss as warm air in the lungs is exhaled into the atmosphere and cooler air is inhaled.

Question 8

To protect itself against heat loss, the body :

Answer 8

Constricts blood vessels in skin

Creates heat by shivering

Question 9

s/s mild hypothermia

Answer 9

Core temp 93-95 degrees
Alert, withdrawn, anxious, or restless
Shivering
Tachycardia
Tachypnea
Skin may be red, pale, cyanotic

Question 10

s/s moderate hypothermia

Answer 10

Core temp 89-92
AMS
Poor coordination and memory loss
Loss of sensation to touch, mood changes, and impaired judgement
Difficulty speaking
May appear stiff or rigid

Question 11

s/s severe hypothermia

Answer 11

Core temp below 80
Vital signs low
Unresponsive
Pulse weakens
Respiration decrease or become absent
Cardiac dysrhythmias
Pupillary reaction slow
May appear dead
Cardiac arrest

Question 12

frostnip

Answer 12

Skin may freeze from prolonged exposure, but the deeper tissues are unaffected.

Question 13

signs of frostnip and immersion foot

Answer 13

Skin is pale and cold to touch

Nl color returns after palpitation of skin

Question 14

signs of frostbite

Answer 14

hard, waxy feel

blisters and welling

Question 15

General emergency treatment of cold injuries

Answer 15

Remove pt from further exposure
Handle the injured part gently and protect it
Administer oxygen
Remove any wet or restrictive clothing over injured part

Question 16

Frostnip emergency care

Answer 16

Contact with a warm object - hands, breath, or pt’s own body

Question 17

Immersion foot emergency care

Answer 17

Remove wet shoes, boots, and socks
Rewarm foot gradually and protect from cold
Splint extremity and cover loosely w/ dry, sterile dressing

Question 18

Frostbite emergency care

Answer 18

Remove restrictive items from injured part
Cover injury loosely w/ dry, sterile dressing
Do not apply heat or rewarm
Do not allow pt to stand or walk on frostbitten foot
Splint extremity
Support vital signs
Prompt transport

Question 19

s/s of heat exhaustion

Answer 19

Cold, clammy skin w/ ashen pallor
Dry tongue and thirst
Dizziness, weakness, or faintness
Headache
Nausea
Tachycardia
Hypotension
Nl or slightly elevated temp

Question 20

s/s heatstroke

Answer 20

AMS
Delirium
Seizures
Dry, hot skin. Diaphoresis may persist.
No muscle cramps
Increased RR
Tachycardia - bradycardia, weak

Question 21

Managing heat cramps

Answer 21

Remove pt from environment
Loosen any tight clothing
Administer high-flow oxygen if indicated
Rest cramping muscles
Replace fluids by mouth
Cool pt w/ cool water and add convection method of cooling
–Establish IV and transport to hospital if cramps do not improve

Question 22

Treating heat exhaustion

Answer 22

Remove pt from environment
Remove excess clothing
Administer oxygen if indicated
Check BS if altered
Cool w/ misting and ice packs to trunk.
Ice bath or similar facility if available.
Supine position
Convection cooling method
Slowly drink up to 1 liter of water if alert
IV access - administer saline fluid boluses of 20 mL/kg as needed

Question 23

When should you transport the pt to a hospital for heat exhaustion?

Answer 23

Sxs do not clear up promptly
LOC decreases
Body temperature remains elevated
Person is very young, older, or underlying medical condition

Question 24

Managing heatstroke

Answer 24

Remove pt from environment into ambulance
Set air conditioning to max
Remove clothing
Administer high-flow oxygen if indicated
Cold-water immersion if possible
Cover pt in wet towels or sheets, or spray w/ cool water and fan
Aggressively and repeatedly fan pt
R/o other causes of AMS
Check BS
Rapid transport
Notify hospital ASAP

Question 25

What should you do if cold-water immersion is available, but you are unable to cool en route?

Answer 25

Continue cold-water immersion at the scene until body temp is between 101-102