Environmental Emergencies
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Transcript Environmental Emergencies
Chapters 25, 26 & 27: Environmental
Emergencies: Cold, Heat, Lightning,
Plants and Animals
Tom Crocker
Fall 2011
Hypothermia
Body temperature
progressively falls
All body functions diminish or
slow
Hypothermia
Primary Hypothermia:
Due to environmental exposure
Falling in a cold lake
Secondary Hypothermia
Associated with other trauma in a
cold environment
Afterdrop
Continued drop in body temp
even after treatment (Typical)
Progression of Hypothermia
Mild (93.2 - 95°F)
Shivering, stumbling, mumbling,
weakness, difficulty speaking, mild
confusion
Moderate (86° - 93.2°F)
Shivering ceases, muscles become
stiff, unable to stand or walk,
impaired responsiveness, slow
breathing and pulse
Severe (< 86°F)
Unresponsive, no pulse, very slow
breathing, cardiac arrest
(ventricular fibrillation) death
Hypothermia Treatment
“No one is dead until they
are warm and dead”
Mild Tx:
Shivering, body-to-body
contact, heating devices, hot
tub, warm liquids (no caffeine)
Moderate/Severe Tx:
Gentle, prevent further
cooling, rewarm slowly with
active heat source, no CPR (VFib), transport
Monitor – Temp
Who to watch for…
Skiers on stalled chairlifts
Ski racers/gate keepers
Event spectators
All patients
Other patrollers
Cold Injuries
Parts of the body become very
cold or frozen
Extremities (feet, ears, ears, nose,
and face) are particularly
susceptible
Frostnip
Very cold – Not frozen
Most common
S/S: Gray or yellowish skin,
tingling, pain, numbness
Tx: Direct body heat
Frostbite
Freezing of a body part
Partial Thickness: only skin
Full Thickness: skin, tissues, muscles,
tendons, and bones freeze
Normally hands or feet
Treatment of Frostbite
Consider hypothermia
Rapidly rewarm
Water 102°-108°F
20 – 30 minutes
Painful
Transport
Do not let it refreeze
Heat Exposure
Heat Syncope
Inadequate perfusion
Temporary fainting
Tx: Remove from heat,
elevate legs, O2, cool water
Heat Cramps
Dehydration Muscular
cramps
Tx: salt water, massage, rest
Heat Exposure
Heat Exhaustion (<104°F)
Dizziness, nausea, headache,
cramping, dehydration due to
hypovolemia (excessive sweating)
Tx: Remove from heat, elevate
legs, rehydrate with salt water,
loosen clothing, O2
Heat Stroke (>104°F)
High HR & RR, Decreased LOR
Tx: Same, remove clothes, water
and fan the skin, icepacks (armpits
& groin), rapid transport
Signs/Symptoms of Heat Emergencies
Weakness/Exhaustion
Hot Skin
Muscle Cramps
Headache
Seizures
Rapid Breathing
Nausea
Sweating
Lightning
Signs/Symptoms
Respirator and cardiac arrest
No breathing but irregular heart
rhythm
Severe tissue damage
Entry and exit wounds
Treatment
Scene safety, safe to touch
the patient, c-spine, CPR/AED,
rescue breathing, O2
Toxin vs. Poison
Toxin: from living creature
Poison: from living creature
or non-living substance
Venom: toxin or poison
specific to a certain animal
Skin
Toxic Plants
Poison Ivy, Sumac, and Oak,
Stinging Nettle
Rashes, burns, blisters
Ingestion
Monkshood, Autumn Crocus,
Foxglove, Rhododendron
(azalea), Jimson weed
Nausea, cardiovascular effects,
shortness of breath, kidney failure,
headache, dehydration, muscle
spasms, diarrhea, delirium
Tx: clean skin, transport for
cases of ingestion
Spiders
Black widows
Found under logs/stones in
woods/fields
Bull’s-eye or target appearance
of bite
Pain, swelling, nausea,
abdominal pain, fever, sweating
Brown Recluse
Violin/fiddle shape on back,
found under stones and
backcountry toilets
Prolonged stinging sensation (8
hours), tissue death
Scorpions, Ticks, & Other Insects
Scorpions
Found in the Southwestern U.S.
Severe pain lasting 24-72 hours
Irregular cardiac rhythms, blurred
vision, nausea, muscle spasms
Ticks
Live in wood piles, grass, on
animals
Painless bite, red rash around bite
Lyme disease: flu-like symptoms and
joint pain
Tx: Scrape stinger with firm flat
object, ice, epi-pen, transport
Snake Bites
Signs/Symptoms
Burning pain, swelling, puncture
wound, blood, tissue death,
inability of blood clotting,
paralysis, respiratory failure
Treatment
Rapid transport, wrap extremity
proximal to distal to the fang
mark with an elastic band, splint
extremity, elevate to heart
DON’T suck the poison out, no ice,
limit physical exertion
Marine Animals
Sharks: eyes and gills!!
Moray Eel: lives in coral reefs
Stingray: think Crocodile Hunter
Jellyfish: stinging chemicals
Skin reactions, paralysis,
respiratory, cardiac, and
neurological distress
Tx: wash skin with vinegar (30secs),
immerse affected site in hot water,
check with local healthcare
personnel to standard procedures
Mammals
Bites, kicks, scratches, licks, hugs
Treatment
Clean wound, rapid transport,
typical trauma treatment