Environmental Ems (Heat Exhaustion, Frostbite, Hypothermia)

Question 1

An increase in UO due to peripheral vasoconstriction.

Answer 1

Cold Diuresis

Question 2

_____ may be extremely difficult to hear because cold tissue conducts sound waves poorly.

Answer 2

BP reading

Question 3

Start IV with _____; _____ is not recommended

Answer 3

PNSS; PLR

Question 4

There is a history of gradual onset, skin appears red, numbness and/or pain sensation.

Answer 4

Frostnip

Question 5

It is caused by shutdown or failure of the heat regulating mechanism of the body.

Answer 5

Heat Stroke

Question 6

_____ is not recommended for rewarming.

Answer 6

Dry Heat

Question 7

Fruity or acetone odor breathe due to metabolizing ___ as a result of ___ insulin levels.

Answer 7

fats; decreased

Question 8

True or False: If clothing is frozen, they should be left on and removed after rewarming.

Answer 8

True

Question 9

Frostnip may be treated by placing a _____over the chilled area.

Answer 9

warm hand

Question 10

Passive External, Active External, or Active Core

Provide warm fluids to drink.

Answer 10

Passive External Rewarming

Question 11

_____ rewarming is less effective and may increase tissue damage.

Answer 11

Slow

Question 12

Reduce the internal core temperature to _____ as rapidly as possible.

Answer 12

102⁰F (38.9⁰C)

Question 13

A very cold heart is susceptible to _____; conversely, they do not respond to drugs and defibrillation.

Answer 13

ventricular fibrillation

Question 14

Passive External, Active External, or Active Core

Warm mediastinal irrigation through open thoracotomy

Answer 14

Active Core Rewarming

Question 15

Extreme caution should be used in moving, transporting, and intubation of hypothermic patients because the heart is near _____.

Answer 15

fibrillation threshold

Question 16

It is a condition in which the core internal temperature of the body is less than 95⁰F (35⁰C) as a result of exposure to cold.

Answer 16

Hypothermia

Question 17

It is the inadequacy or the collapse of peripheral circulation due to volume and electrolyte depletion.

Answer 17

Heat Exhaustion

Question 18

Hyperthermia may recur spontaneously within _____.

Answer 18

3-4 hours

Question 19

It is a trauma due to exposure to freezing temperatures that cause actual freezing of the tissue fluids in the cell and intracellular spaces, resulting in vascular damage.

Answer 19

Frostbite

Question 20

Passive External, Active External, or Active Core

Warm water immersion

Answer 20

Active External Rewarming

Question 21

For temperature below 28⁰C

Answer 21

Active Core Rewarming

Question 22

Rewarming is complete when the area is:

Answer 22

Warm to touch
Pink or flushed

Question 23

It is a complication of heatstroke.

Answer 23

Acute Tubular Necrosis (ATN)

Question 24

_______: incision through the eschar
_______: incision in the fascia to release pressure on the muscles, nerves, blood vessels.

Answer 24

Escharotomy
Fasciotomy

Question 25

Initial _____ followed by slow shallow respirations.

Answer 25

tachypnea

Question 26

If temperature fails to decrease, initiate core cooling by:

Answer 26

Iced saline lavage Cool fluid peritoneal dialysis Cool fluid bladder irrigation.

Question 27

Advise patient not to use tobacco because of the _____ effects of nicotine, which further reduce the already deficient blood supply to injured tissues.

Answer 27

vasoconstrictive

Question 28

Passive External, Active External, or Active Core Cardiopulmonary bypass

Answer 28

Active Core Rewarming

Question 29

If body temperature fall below ____, the heart sounds may not be audible even if the heart is still beating.

Answer 29

30⁰C

Question 30

_____ is the most efficient. Spray tepid water on the skin while electric fans are used to blow continuously.

Answer 30

Evaporative Cooling

Question 31

Large blisters may develop in _____ after rewarming; these blisters should not be _____.

Answer 31

1 hour to a few days; broken

Question 32

Encourage hourly active motion of the affected digits:

Answer 32

to promote maximum restoration of function to prevent contractures

Question 33

Passive External, Active External, or Active Core Inhalation of warmed, humidified oxygen by mask or ventilator

Answer 33

Active Core Rewarming

Question 34

Provide insulation by wrapping the patient in several blankets.

Answer 34

Passive External Rewarming

Question 35

The body will attempt to produce or conserve more heat by:

Answer 35

a. Shivering b. Peripheral vasoconstriction c. Raising the basal metabolic rate

Question 36

Do not rub or massage a frostbitten extremity. The ice crystals in the tissue will _____ delicate tissues.

Answer 36

lacerate

Question 37

Untreated heat exhaustion may lead to _____.

Answer 37

heat stroke

Question 38

Medications for heat exhaustion:

Answer 38

KCl (Potassium Chloride) for hypokalemia Sodium bicarbonate to correct metabolic acidosis Diazepam for seizures

Question 39

Progressive deterioration marked by:

Answer 39

Apathy Poor judgment Ataxia Dysarthria Drowsiness Coma

Question 40

Warm water immersion

Answer 40

Active External Rewarming

Question 41

_____ may be suppressed if temperature if temperature falls below 32.2⁰C.

Answer 41

Shivering

Question 42

In heat exhaustion and heat stroke, what do we instruct patient to do?

Answer 42

Increase fluid intake Wear loose clothing Avoid immediate reexposure to high temperature

Question 43

Use a _____ to prevent contact with bedding if feet are involved

Answer 43

foot cradle

Question 44

Refreezing of a partially thawed extremity:

Answer 44

reverses ice crystal formation in tissues increases tissue damage and loss

Question 45

On palpation, the skin will feel stiff, but the underlying tissue will be pliable, soft, and have its normal bounce.

Answer 45

Superficial Frostbite

Question 46

Apply ice packs to

Answer 46

Neck Groin Axillae Scalp

Question 47

True or False: Immersion in cold water is contraindicated.

Answer 47

False; indicated

Question 48

The affected part is completely insensitive to touch.

Answer 48

Deep Frostbite

Question 49

Passive External, Active External, or Active Core Provide external heat like warm hot water bottles to armpits, groin, neck.

Answer 49

Active External Rewarming

Question 50

Rewarming procedure may take _____.

Answer 50

20-30 minutes

Question 51

_____ for the affected extremity – to aid circulation, debride dead tissue, and help prevent infection.

Answer 51

Whirlpool bath