Transcript Environmental Emergencies - Emergency Medical Technology

Environmental Emergencies
Heat & Cold emergencies
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
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)
Hypothermia
• Lowering of the body temperature below 95°F
(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.
Signs and Symptoms of Mild
Hypothermia
• Shivering
• Rapid pulse and respirations
• Red, pale, cyanotic skin
Signs and Symptoms of More
Severe Hypothermia
• Shivering stops
• Muscular activity decreases
• Lethargy/apathy
• ALOC
• Bradycardia & hypotension
• Dilated pupils
• Eventually, all muscle activity stops
Core Temperature Less Than
80ºF
• Patient may appear dead (or
in a coma).
• Never assume that a cold,
pulseless patient is dead.
medical wisdom
• NOT DEAD UNTIL WARM &
DEAD!
Treatment for Hypothermia
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handle gently
remove from environment
high flow oxygen
warming measures
• Ambulance should be heated (86+ degrees)
• GOAL IS TO PREVENT FURTHER
HEAT LOSS
Frostbite
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white, cold, hard, waxy skin
painful or painless
may have blisters or swelling
common locations:
feet - hands - nose - ears
Frostbite Tx
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remove from cold
high flow O2
passive rewarming
do not massage
do not break blisters
Heat emergencies
• Heat cramps
• Heat exhaustion
• Heat stroke
Heat cramps
• definition = depletion of body salts
symptoms
• muscle spasms of legs & abdomen
• history of exertion with no salt intake
Treatment for heat cramps
• remove from environment
• PO - isotonic solution (if available)
Heat Exhaustion
• definition = dehydration with loss of
salt
symptoms
• cold, moist, ashen skin
• thirsty
• headache & nausea
• weakness, dizziness, syncope
Treatment for Heat Exhaustion
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remove patient from environment
loosen clothing
High flow O2
oral fluids (isotonics or water)
position of comfort
transport
Heat Stroke
• definition = failure of body’s cooling
mechanism
Symptoms
• hot, dry, flushed skin
• ALOC
• hypotensive - tachycardia
• seizure
Treatment for Heat Stroke
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remove from environment
no oral fluids
high flow oxygen
cooling measures
shock position prn
rapid transport
Water accidents
• drowning/near drownings
• diving injuries
– air embolism
– bends or decompression sickness
Near drowning
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history of underwater episode
dyspnea
tachypnea
laryngospasms
ALOC
apnea & cyanosis
Treatment for Near Drowning
• ABC’s, 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.
Air Embolism
• caused by holding breath while ascending air bubbles are forced into blood stream.
symptoms
• chest pain,
• mottled skin
dyspnea
• froth at nose/mouth
• pain
• dizziness, headache
• neuro deficits
• confusion or ALOC
• cardiac arrest
Decompression sickness
• formation of nitrogen bubbles in blood
stream
Symptoms
• joint pain
• abdominal pain
• itching
• vertigo, nausea ,vomiting
Treatment of Air Embolism and
Decompression Sickness
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ABC’s
high flow oxygen
left lateral trendelenberg
rapid transport*
• consider treatment for hypothermia
• Transport to hyperbaric chamber
questions???