Environmental Emergencies

Question 1

What is the hypothalamus responsible for?

Answer 1

It controls and monitors the body’s temperature.

Question 2

Define:

thermoregulation

Answer 2

The body’s ability to maintain a set temperature.

Question 3

What is a typical BMR?

Basal Metabolic Rate

Answer 3

70 kilocalories/hr

Question 4

Define:

evaporation

Answer 4

Conversion from liquid to gas.

E.g. sweating

Question 5

Define:

convection

Answer 5

Transfer of energy by moving air over a liquid.

E.g. wind chill across the body

Question 6

Define:

conduction

Answer 6

Direct physical contact transfers energy from one to the other.

E.g. jumping into a cold lake

Question 7

Define:

radiation

Answer 7

Heat transfer through electromagnetic waves.

Heat loss through the head.

Question 8

Define:

thermolysis

Answer 8

Refers to the body’s process of releasing stored heat.

Question 9

Define:

thermogenesis

Answer 9

The body’s ability to produce heat and energy.

Question 10

How do certain medications alter the body’s ability to maintain proper thermoregulation?

Answer 10

• Diuretics causes dehydration.
• Beta blockers limit compensation of cardiovascular systems.

Question 11

Define:

heat cramps

Answer 11

acute muscle spasms

It occurs from profuse sweating and sodium loss.

Question 12

Assessment:

heat cramps

Answer 12

• Hypotension
• Nausea
• Rapid pulse
• Pale and moist skin
• Normal temperature

Question 13

Treatment:

heat cramps

Answer 13

• Move to a cool environment.
• Fluid replenishment
• IV normal saline

Question 14

Define:

heat exhaustion

Answer 14

Heat stress and volume depletion.

Question 15

Assessment:

heat exhaustion

Answer 15

• Temperature of < 104 °F
• Headache
• Dizziness
• Weakness
• Nausea
• Vomiting
• Cramping

Question 16

Treatment:

heat exhaustion

Answer 16

• Passive Cooling
• Fluids
• Supine with legs elevated
• Oral hydration

Question 17

Define:

heat stroke

Answer 17

• core body temp of > 104°F
• altered mental status

Question 18

Assessment:

heat stroke

Answer 18

• CBT of > 104°F
• Altered mental status
• Dry and flushed skin
• Tachycardia
• Hypotension or normotensive

Question 19

Treatment:

heat stroke

Answer 19

• Remove the patient from the offending environment.
• Strip the patient’s clothing.
• Cover the patient in ice water.
• Fan the patient.
• Administer fluid resuscitation.

Question 20

Define:

frostbite

Answer 20

Ischemic injury to tissues due to exposures to extremely cold temperatures.

Question 21

What are the signs/symptoms of superficial frostbite?

Answer 21

• Altered sensation
• Numbness
• Tingling
• Burning
• White/waxy

Question 22

What are the signs/symptoms of deep frostbite?

Answer 22

• hard skin and tissues
• skin color: yellow, mottled blue, white
• loss of sensation

Question 23

What are the signs/symptoms of Gangrene?

Answer 23

skin color: black or mottled black

It causes permanent damage.

Question 24

Treatment:

frostbite

Answer 24

• Get the patient out of the cold.
• Remove wet clothing.
• Do not rub or massage the affected area.
• Cover with a dry, sterile dressing.
• Administer pain management.
• Consider rewarming the area if there’s no risk of refreezing.

Question 25

# Define: Trench Foot

Answer 25

Extended exposure to **wet** and **cold** environments.

Question 26

# Define: hypothermia

Answer 26

core body temperature of **< 35°C**

Question 27

# Define: mild hypothermia

Answer 27

core body temperature of **34-36°C**

Question 28

# Treatment: mild hypothermia

Answer 28

passive rewarming

Question 29

# Define: moderate hypothermia

Answer 29

core body temperature of **30-34 °C**

Question 30

# Define: severe hypothermia

Answer 30

core body temperature of **< 30°C**

Question 31

# Treatment: severe hypothermia

Answer 31

* Administer warm IV fluids. * Provide warm, humidified oxygen. * Perform warm cavity lavage. * Implement passive or active rewarming techniques.

Question 32

How is **hypothermia** classified based on **body temperature in degrees Celsius**?

Answer 32

* Mild: **34-36 °C** * Moderate: **30-34 °C** * Severe: **< 30 °C**

Question 33

# Fill in the blank. Every **33 feet below sea level** is \_\_\_ atmosphere(s).

Answer 33

1

Question 34

What are the **associated considerations** in a **freshwater** drowning?

Answer 34

**Bacteria** and **infection** from the water.

Question 35

What are the **associated considerations** in a **saltwater** drowning?

Answer 35

Salt causes **fluid shift in the lungs**.

Question 36

What is **barotrauma**, and how does it occur?

Answer 36

An injury caused by **ascending too quickly** to the surface which causes the **lung tissue to expand** too quickly. ## Footnote It can cause pneumothorax.

Question 37

# Define: decompression sickness

Answer 37

**Nitrogen** within the blood is **forced into the tissues** of the body.

Question 38

# Treatment: decompression sickness

Answer 38

hyperbaric chamber

Question 39

# Define: altitude illness

Answer 39

**The effects of altitude** on the body due to a **decrease in atmospheric pressure**.

Question 40

What are the **signs/symptoms** of **acute mountain illness**?

Answer 40

Headache associated with fatigue, weakness, GI symptoms, dizziness, and difficulty sleeping.

Question 41

What are the **signs/symptoms** of **high-altitude pulmonary edema**?

Answer 41

At least **two** of the following: * Dyspnea * Cough * Weakness * Chest tightness * Wheezing * Rales * Tachypnea

Question 42

What are the **signs/symptoms** of **High Altitude Cerebral Edema**? | HACE

Answer 42

altered mental status or mental changes

Question 43

# Define: The Lichtenburg Figure

Answer 43

Lightning strands burned into the skin.

Question 44

What type of snakes are **crotalids**?

Answer 44

pit vipers ## Footnote E.g. Rattlesnakes, Cottonmouths (venomous snakes)

Question 45

What type of snakes are **elapids**?

Answer 45

coral snakes

Question 46

What are the **characteristics** of a **venomous** and **non-venomous** snake?

Answer 46

**_Venomous_**: * Vertical pupils * Two fangs * Pit between the eye **_Non-venomous_**: * Round pupils * Double row of teeth

Question 47

# Treatment: venom

Answer 47

* Clean the wound with antimicrobials. * Draw blood from the affected area. * Immobilize the extremity. * Remove jewelry. * Administer CroFab (antivenom).

Question 48

# Assessment: **Brown Recluse** vs. **Black Widow** bite

Answer 48

**_Brown Recluse_:** * Bites are painless * Sloughing of skin * Necrotic lesion * Nausea/vomiting * Fever **_Black Widow_**: * Instant pain * Local muscle spasm * Abdominal spasms * Nausea/vomiting * Respiratory difficulty

Question 49

# Treatment: stingray injury

Answer 49

Soak the affected area in hot (not scalding) **fresh/salt water**.

Question 50

# Treatment: jellyfish sting

Answer 50

Rinse the affected area with **saltwater**. ## Footnote If the fluid is hypotonic, the vesicle can swell and potentially burst, releasing more toxin.

Question 51

What **insect** can cause **Lyme Disease** from its bite?

Answer 51

tick

Question 52

How do you properly remove a **tick**?

Answer 52

* Use curved forceps. * Grasp the tick by its head, as close to the skin as possible. * Pull straight up with steady pressure. * Dispose of the tick in a container of alcohol.