Environmental Emergencies & Toxicology Flashcards
(78 cards)
Shivering stops at what temperature?
32*C
Body’s response to cold
Increased CBG
Respiratory acidosis
Enzyme function drops dramatically
Mild hypothermia temperature
32C - 34C
Moderate hypothermia temperature
29C - 32C
Severe hypothermia temperature
<28*C
S/S of Mild hypothermia
Increased basil metabolic rate
Increased cardiac output
Decreased heart rate at 32*C
S/S of Moderate hypothermia
LOC and SVR decrease
Acidosis
Decreased cardiac output
Hyperglycemia
S/S of Severe hypothermia
PT and APTT increase by 50%
Platelets decrease by 40%
Prolonged PR, QRS, QT
Osborne waves
V Fib risk is highest at ____.
22*C
Defer medications until core temp is ____.
> 30*C
Enzymatic retardation occurs at _____.
<33*C
Examples of passive external rewarming
Patient is allowed to rewarm self
Blankets
Heater in truck
Examples of active external rewarming
Heat placed on body surfaces mainly neck, groin, and axilla
Examples of active internal rewarming
Heat directly to core using warm IV fluids (warmed to 39*C), hemodialysis, gastric lavage, rectal lavage, ECMO
Sweat evaporation can lead to fluid loss of _____.
1-3 L/HR
High output failure may lead to ____.
AMI
Body’s response to heat
NA+ loss causing cerebral edema and seizures Increased clotting times ARDS/DIC Hypokalemia ATN Rhabdomyolysis
Define heat cramps
Cramps of muscles in high heat caused by hyponatremia
Define heat exhaustion
Increase in core temperature without neurological impairment. Patient retains ability to sweat.
Define Heat stroke
Failure of body to dissipate heat effectively
Altered LOC
Core temp >42*C
Heat cramp treatment
Remove from heat, rehydrate with salt containing solution
Heat exhaustion treatment
remove from heat, cool patient, fluid replacement with electrolytes
Heat stroke treatment
Aggressive cooling and airway management
Iv fluids
Prevent shivering
Labs to monitor for heat emergencies
ABG for acidosis
Watch clotting factors for DIC
Monitor liver enzymes
Watch Sodium for hyponatremia
