Environmental Emergencies (W2)

Question 1

What is the normal heat production of the body

Answer 1

60-70kcal/h (can increase to 900kcal/h w strenuous exercise/environment)

Question 2

What are the four mechanisms of heat loss

Answer 2

Radiation, convection, conduction, evaporation

Question 3

How does the body regulate heat through radiation

Answer 3

Vasoconstriction in response to the cold, vasodilation in response to heat

Question 4

How does the body regulate heat through convection

Answer 4

Energy transferred by mass motion of obstacles [air or liquid passing through the body]

Question 5

How does the body regulate heat through conduction

Answer 5

Direct physical contact [accounts for 2% of heat loss but in water it can have 32X the impact]

Question 6

How does the body regulate heat through evaporation

Answer 6

Liquid to gas (sweat from skin) skin and lungs are big players here

Question 7

What does respiration combine to facilitate heat loss, and how

Answer 7

convection, radiation, and evaporation [breathing out humidified air]

Question 8

What are the three primary mechanisms of heat related illness

Answer 8

Exogenous heat gain, increased endogenous heat production [physical activity, medications, febrile illness], decreased heat dispersion [dehydration, CV disease, high/low age, obesity, poor clothing, skin disease, drugs]

Question 9

Minor heat related illnesses can include

Answer 9

Heat edema, heat cramps, heat syncope, heat exhaustion, heat stroke

Question 10

What is heat edema

Answer 10

Self-limiting mild tightening of hands/feet, common in old people moving after being stationary

Question 11

What are heat cramps

Answer 11

Na/K/fluid deficiency causing painful/involuntary contractions of skeletal muscle

Question 12

What is heat syncope

Answer 12

A variant of postural HoTN, does not necessarily mean volume depletion

Question 13

What is heat exhaustion

Answer 13

CBT can be normal-40, is usually caused by combination of salt and water depletion, pt will present diaphoretic [tx: wet cloths/cool environment, passive cooling]

Question 14

What is heat stroke

Answer 14

Denaturation of proteins, pt may present with a variety of symptoms including altered LOA and likely no sweating [tx: immediately initiate active cooling]

Question 15

Why does a pt w heat stroke likely have some level of an altered LOA

Answer 15

Bc the cerebellum is very sensitive to temperature —> ataxia is an early finding

Question 16

What are the two most dangerous spiders found in our area

Answer 16

Brown recluse (loxosceles reclusa) & black widow (latrodectus mactans)

Question 17

What are the S/S of a brown reculsa bite

Answer 17

Blue-gray halo 2 hrs after bite, after 5-7 days aseptic necrosis necrotic ucler will have developed

Question 18

What are the S/S of a black widow bite

Answer 18

(Neurotoxic) immediate sharp stinging pain, muscle cramps in 15mins-2hr, symptoms will usually disappear after 24hr

Question 19

What are the general effects of venom

Answer 19

Tissue deconstruction, profuse bleeding, neurological effects, CA, respiratory failure, death!

Question 20

What should you NOT do when dealing with insect/animal bites

Answer 20

-DONT apply a tourniquet or anything too tight
-DONT apply ice
-DONT cut or suck on the bite area
-DONT try to catch or kill the animal/insect
-DONT give pain meds containing aspirin or ibuprofen

Question 21

What should you be considering with diving injuries

Answer 21

Air embolism, decompression illness, barotrauma

Question 22

S/S of wound infection

Answer 22

-new/increasing pain
-delayed healing
-increase in wound size/width/depth
-increase/developing necrotic tissue
-increase/change in exudate
-odour
-increase in temp around wound

Question 23

How do you assess a wound

Answer 23

Looking at the location, age of wound, size of wound, depth/healing stage, evaluation of necrotic, tissue