Environmental Emergencies

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Environmental Emergencies

• Heat Cold emergencies

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Ways the body loses heat (1 of 2)

• Radiation - heat lost from host to air
• Convection - heat lost through the
  movement of air
• Conduction - heat lost from host to solid
  objects

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Ways the body loses heat (2 of 2)

• Evaporation - Heat loss through sweating
• Respiration - Loss of heat through
  breathing
• (warm air out - cool air in)

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Hypothermia

• Lowering of the body temperature below 95F
  (35ºC)
• Can develop rapidly or gradually
• Weather does not have to be below freezing
• Elderly persons, infants and ill or injured are
  at higher risk.

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Signs and Symptoms of Mild Hypothermia

• Shivering
• Rapid pulse and respirations
• Red, pale, cyanotic skin

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Signs and Symptoms of More Severe Hypothermia

• Shivering stops
• Muscular activity decreases
• Lethargy/apathy
• ALOC
• Bradycardia hypotension
• Dilated pupils
• Eventually, all muscle activity stops

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Core Temperature Less Than 80ºF

• Patient may appear dead (or in a coma).
• Never assume that a cold, pulseless patient is
  dead.

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medical wisdom

• NOT DEAD UNTIL WARM DEAD!

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Treatment for Hypothermia

• handle gently
• remove from environment
• high flow oxygen
• warming measures
• Ambulance should be heated (86 degrees)
• GOAL IS TO PREVENT FURTHER HEAT LOSS

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Frostbite

• white, cold, hard, waxy skin
• painful or painless
• may have blisters or swelling
• common locations
• feet - hands - nose - ears

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Frostbite Tx

• remove from cold
• high flow O2
• passive rewarming
• do not massage
• do not break blisters

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Heat emergencies

• Heat cramps
• Heat exhaustion
• Heat stroke

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Heat cramps

• definition depletion of body salts
• symptoms
• muscle spasms of legs abdomen
• history of exertion with no salt intake

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Treatment for heat cramps

• remove from environment
• PO - isotonic solution (if available)

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Heat Exhaustion

• definition dehydration with loss of salt
• symptoms
• cold, moist, ashen skin
• thirsty
• headache nausea
• weakness, dizziness, syncope

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Treatment for Heat Exhaustion

• remove patient from environment
• loosen clothing
• High flow O2
• oral fluids (isotonics or water)
• position of comfort
• transport

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Heat Stroke

• definition failure of bodys cooling mechanism
• Symptoms
• hot, dry, flushed skin
• ALOC
• hypotensive - tachycardia
• seizure

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Treatment for Heat Stroke

• remove from environment
• no oral fluids
• high flow oxygen
• cooling measures
• shock position prn
• rapid transport

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Water accidents

• drowning/near drownings
• diving injuries
• air embolism
• bends or decompression sickness

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Near drowning

• history of underwater episode
• dyspnea
• tachypnea
• laryngospasms
• ALOC
• apnea cyanosis

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Treatment for Near Drowning

• ABCs, aggressive suctioning, ventilating with
  100 oxygen
• C-spine precautions
• Rapid transport
• Caution there are delayed complications in near
  drownings. Always insist on transport even when
  the patient looks fine.

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Air Embolism

• caused by holding breath while ascending - air
  bubbles are forced into blood stream.
• symptoms
• mottled skin
• froth at nose/mouth
• dizziness, headache
• confusion or ALOC

• chest pain, dyspnea
• pain
• neuro deficits
• cardiac arrest

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Decompression sickness

• formation of nitrogen bubbles in blood stream
• Symptoms
• joint pain
• abdominal pain
• itching
• vertigo, nausea ,vomiting

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Treatment of Air Embolism and Decompression
Sickness

• ABCs
• high flow oxygen
• left lateral trendelenberg
• rapid transport
• consider treatment for hypothermia
• Transport to hyperbaric chamber

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stop

• questions???