Environmental Problems Flashcards
How to prevent, recognize, and treat problems created by the environment.
What is a non-freezing cold injury and when does it occur?
Injury due to prolonged exposure to wet and cold that causes vasoconstriction and loss of local perfusion.
Describe some of the important considerations in preventing lightning strikes.
- Sitting on an insulator to reduce contact with ground current.
- Spread the group out.
- Inside a full-frame vehicle or building is best location – faraday principle.
- If moving toward safety, keep moving (i.e. coming down a ridge to lower elevation or paddling on water).
- Lower is safer.
- Don’t hold metal or wet rope.
- Get off the water.
- Avoid being near the tallest trees or rock outcrops.
- Avoid hollows and shallow caves.
What additional information is important in assessing toxin exposure?
Mechanism, type of toxin, amount of exposure, the effect on the person so far, the patient’s weight, the patient’s allergies to similar substances, previous exposure.
What is High Altitude Pulmonary Edema (HAPE)?
Blood vessels leak fluid into the lower airway (alveoli).
List the signs / symptoms of scorpion envenomation and the treatment.
S/Sx – local pain / numbness, and systemic neurotoxic effects.
Tx – pain medication, high-risk wound care, and centauroids antivenom.
Moderate HACE = _________________________. List the signs/symptoms and treatment guidelines.
Moderate HACE = early s/sx of ↑ICP.
S/Sx – mental status changes, persistent vomiting, and severe headache.
Treatment – descend, PROP, rest, fluids, food, maintain body temperature, and altitude medications.
Describe precautions one can take to prevent cold injuries (both self and group).
Coach proper lacing up of boots (not too tight, one sock) and avoid constricting clothing.
Coach and monitor calorie/water intake.
Mandatory 8 hours warm/dry time – designated camp socks and sleep socks in sleeping bag that never come out/always dry.
Daily foot checks.
Review med forms/check in with clients/students pre-trip about history of cold injuries and/or Raynaud’s Syndrome.
What contributing factors make an individual more prone to a cold injury?
Tight splints, gloves, and boots, direct contact between skin and ice or metal, drugs that cause blood vessels to narrow (vasoconstrictors), evaporative cooling, shell/core effect, and wind chill.
Give specific examples of how altitude illness can be prevented.
Check med forms and have a conversation with client about recent changes. Look for risk factors: past hx of altitude illness, respiratory depressants, lives below 1000m (3,300ft), and recent respiratory illness.
Ascend slowly. Take acclimatization rest days/day hike days.
Maintain calories/water intake and body temperature.
Consider the use of altitude medications prophylactically.
At what ambient temperature is frostbite an issue?
-5°C/23°F
Severe HACE = ___________________________. List the signs/symptoms and treatment guidelines.
Severe HACE = late s/sx ↑ICP.
S/Sx - ↓AVPU, seizures, and deteriorating vital sign changes.
Treatment – descend, PROP, rest, fluids/food if possible, maintain body temperature, and altitude medications.
List some of the general contributing factors to drowning.
Loss of muscular coordination due to cold water and sudden immersion in cold water.
Raynaud’s Syndrome
A disorder that causes the blood vessels to constrict in cold environments resulting in temporary ischemia.
How is the treatment for frostnip and superficial frostbite different for full thickness frostbite?
Don’t rewarm in the field unless it is absolutely necessary. If rewarming, then you must prevent the limb from refreezing. Apply dry, sterile dressings. Separate digits when dressing.
List four ways toxins can enter the body.
Ingested, inhaled, injected, and absorbed.
When does exposure to a toxin become a high-risk problem requiring emergent evacuation?
When the patient presents with: S/Sx of infection, or S/Sx of neurological problems. Then the patient is getting worse, when there is a Critical System problem, and in the presence of animal envenomation requiring anti-venom.
Describe the signs/symptoms and treatment guidelines for moderate HAPE.
S/Sx - persistent cough, crackles when breathing in, shortness of breath at rest, low grade fever.
Tx – descend, rest, fluids, food, maintain body temp, PROP, altitude medications
What are the complications associated with severe hypothermia?
Heart is irritable. Patients can have undetectable vital signs. CPR can cause the heart to go into an irregular rhythm.
Describe how to remove a tick.
Using tweezers grasp tick at neck at skin surface and slowly pull up and away from the skin. Tick spoons and other specialized removers are also very effective.
Describe the effects of a tissue toxin.
Damages and destroys tissue cells, swelling, discoloration, pain, volume shock, multi-organ failure – more serious envenomation.
What is High Altitude Cerebral Edema (HACE)?
When blood vessels leak fluid in the brain which can result in ↑ICP. HACE typically develops within 24 hours.
Besides temperature, what other factors contribute to heat related illness?
Patient not being acclimated to hot conditions (i.e., lives in a cool climate and taking a vacation in a hot environment). Fluid intake.
What precautions can one take to prevent drowning and snow immersion incidents (both self and group)?
Swimming: coach good backcountry swimming practices. Stay in shallow water (no deeper than chest deep). Designate an “observer” on shore.
Paddle Sports: wear a properly fitting PFD.
Snow: skiing/riding/traveling with a buddy is cool! “No friends on a powder day” is lame! Carry safety equipment (i.e., probe, shovel, beacon) and know how to use it. Learn how to read snow conditions.
Educate yourself. Have a plan.
What are the primary problems with drowning and their anticipated problems? How are each managed?
Respiratory Arrest which leads to Cardiac Arrest: treat with PPV, Hypothermia wrap, and Urgent Evacuation.
Water Inhalation Injury which leads to Pulmonary Edema: monitor for s/sx of respiratory distress, PROP, maintain calorie/fluid intake, and keep warm.
Hypoxic Brain Injury which leads to ↑ICP: PROP, maintain calorie/fluid intake, and keep warm.
When is the scene considered low-risk when it comes to lightning?
When the potential for lighting strike is no longer present. The patient is safe to touch.
Describe the effects of a neurotoxin.
Inhibits nerve cells. Idea = doesn’t want prey to get away so it paralyzes it, numbness, cramping, paralysis, spasm, respiratory failure.
Describe treatment for a severely hypothermic patient.
Hypothermia wrap w/heat sources; consider PPV (if will not delay evac); urgent, gentle evac; keep patient horizontal.
Describe the signs/symptoms and treatment guidelines for severe HAPE.
S/Sx - respiratory failure, lots of phlegm, crackles.
Tx - descend, rest, fluids, food, maintain body temp, PROP, and altitude medications.
