Transcript Spring and Summer Emergencies

Silver Cross EMS System
May 2014 EMD CE

When a person is exposed to excess heat,
the body’s mechanisms for regulating temperature can be overwhelmed, resulting in:
◦ Heat cramps
◦ Heat exhaustion
◦ Heatstroke
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Involuntary spasms of the muscles
Often occur after exercise, especially in hot
weather
Most commonly occur in the leg or calf
muscles
When abdominal cramps occur, it may
appear that the patient is having an acute
abdominal problem.
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Treatment
◦ Move the patient to a cool place.
◦ Have the patient lie down in a comfortable
position.
◦ Give the patient water to drink.
◦ If the cramps do not disappear, arrange to have
the patient transported.
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Occurs when a person is exposed to
temperatures greater than 80°F (27°C),
usually in combination with high humidity
Can also occur as the result of vigorous
exercise at lower temperatures
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Signs and symptoms
◦ Profuse sweating
◦ Lightheadedness
◦ Dizziness
◦ Nausea
◦ Weak pulse
◦ Low blood pressure
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Predisposing factors may make some
people more susceptible.
◦ Very young or old age
◦ Preexisting medical conditions
◦ Certain medications
◦ High ambient temperatures
◦ High humidity
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Treatment
◦ Move the patient to a cooler place and treat him or
her for shock.
◦ Unless the patient is unconscious, nauseated, or
vomiting, give fluids by mouth.
◦ Monitor the ABCs.
◦ Arrange transport to a medical facility.
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Occurs when the body is subjected to more heat
than it can handle and the normal mechanisms
for getting rid of the excess heat are
overwhelmed
The patient’s body temperature rises until it
reaches a level at which brain damage occurs.
Signs and symptoms
◦ Flushed, dry skin that feels hot to the touch
◦ Semiconsciousness or unconsciousness
◦ Internal temperatures as high as 106°F (41.1°C)
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Treatment
◦ Maintain the patient’s ABCs.
◦ Remove the patient from the hot environment.
◦ Remove the patient’s clothes, down to the
underwear.
◦ Soak the patient with water.
◦ If the patient is conscious and not nauseated,
administer small amounts of cool water.
◦ Ice packs to the core (torso).
◦ Arrange for rapid transport.
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Normal Body Temp
Cool, clammy skin
Sweating
Dizziness
Nausea
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Heat Exhaustion
High Body Temp
Sweating stops
Flushed, hot skin
Altered Mental Status
or unconscious
TRUE EMERGENCY!
Heat Stroke
1.
2.
3.
4.
5.
How long was the patient
exposed?
Was the onset of symptoms
sudden?
Is the patient exhibiting any
unusual behavior?
Is the patient complaining of
cramps, nausea or vomiting?
Is the patient’s skin hot, dry and
flushed?
Yes? See HEAT STROKE pre-arrival
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1.
2.
3.
4.
5.
6.
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1.
Key Questions
HEAT EXHAUSTION
Move patient to a cool, well ventilated
area
Remove the patient’s outermost clothing
Sponge patient with cool water to lower
body temp. or fan to cool them
Keep them calm and don’t allow them to
move around
If patient is able to swallow and not
nauseated, give them sips of water
Call back if patient’s condition worsens
prior to arrival of medical personnel
HEAT STROKE
Cool rapidly by placing ice packs behind
neck, under armpits and in the groin area.
If patient begins to shiver, remove ice.
Pre-Arrival Instructions
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Definition: Injuries from transmission of
electricity between sky & ground
Strikes injure 500-1000 per year and kill 100
Most common in spring and early summer,
between 3:00PM and 6:00PM
Make yourself small and
stay away from high
profile targets
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Physical findings
◦ Minor injury
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Tympanic membrane rupture
Confusion
Amnesia – may deny event occurred
Brief loss of consciousness
Temporary deafness
Blindness
Numbness or tingling in extremities
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Physical findings
◦ Moderate injury
 Disorientation
 Combativeness
(hypoxia)
 Coma
 Motor paralysis
 Absent pulses due to
arterial spasm
 Sympathetic instability
(cardiac irritability)
 Hypotension
 Vascular trauma
 Spinal shock
 Seizures
 Burns
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Physical findings
◦ Severe injury
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Cardiac arrhythmia
Cardiac arrest
Pulmonary edema
Pulmonary contusion
Ortho injuries
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The electrical injury resulting from a
lightning strike can cause cardiac
irregularities or cardiac arrest.
Treat patients by supporting their ABCs.
◦ CPR may be needed for some patients.
◦ Patients must be transported to a medical facility.
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Lightning injuries can cause electrical burns.
◦ This type of burn is mainly internal.
◦ The extent of burn damage will not be visible
immediately after the injury occurs.
Is patient still in contact with the
electricity?
1.
Yes?
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What’s the source?
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Can you safely disable it? If Yes, do so.
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If No, proceed to next step
Once source is disabled, reassess the patient.
Is the patient now conscious and
breathing?
2.
3.
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1.
2.
3.
Do not touch or approach
patient until it is safe to do so!
Monitor the patient’s breathing
and pulse.
Call back if the patient’s
condition worsens prior to
arrival of medical personnel.
Yes – proceed to next step
No – Go to CPR per age
Are there any obvious injuries?
4.
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Yes – go to proper protocol
Key Questions
Pre-Arrival Instructions
Mosquitoes
West Nile virus (WNV) is most commonly transmitted to humans by
mosquitoes. You can reduce your risk of being infected with WNV by
using insect repellent and wearing protective clothing to prevent
mosquito bites. There are no medications to treat or vaccines to
prevent WNV infection. Fortunately, most people infected with WNV
will have no symptoms. About 1 in 5 people who are infected will
develop a fever with other symptoms. Less than 1% of infected
people develop a serious, sometimes fatal, neurologic illness.
 Black widow spider signs/symptoms
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Severe pain at bite site
Swelling at bite site
Sweating
Tachycardia
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High Blood Pressure
Fever, hyperthermia
Muscle spasms
Abdominal pain
 Brown recluse spider signs/symptoms
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Local: itchiness at site bite
redness, edema
Papule formation
Necrotic lesion
Bull’s-eye rash
Systemic: fever, chills
Malaise, weakness
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Nausea, vomiting
Rash
Seizures
Hypotension
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Tick diseases
• Rocky Mountain spotted
fever
• Fever, headache, abdominal
pain, vomiting, muscle pain,
rash.
• Lyme disease
• Fever, headache, fatigue,
characteristic skin rash.
• Can spread to joints, heart,
nervous system.
•
Treatment
• Remove tick with tweezers (get close to skin and be
patient)
• Clean wound with soap & water, dress
• Treat symptoms
• Watch for rash
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Signs and symptoms
◦ Obvious injury site (bite or sting marks)
◦ Tenderness
◦ Swelling
◦ Red streaks radiating from the injection site
◦ Weakness
◦ Dizziness
◦ Localized pain
◦ Itching
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Keep the patient quiet and still.
Apply ice packs to reduce swelling and pain.
Some people may experience an extreme
allergic reaction and go into anaphylactic shock.
Signs and symptoms of anaphylactic shock
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Itching
Hives
Swelling
Wheezing and severe respiratory distress
Generalized weakness
Loss of consciousness
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Signs and symptoms of anaphylactic shock
(cont’d)
◦ Rapid, weak pulse
◦ Rapid, shallow breathing
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Treatment for anaphylactic shock
◦ Maintain the patient’s ABCs.
◦ Administer oxygen if available.
◦ Elevating the patient’s legs may help.
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Treatment for anaphylactic shock (cont’d)
◦ Remove the allergen if possible.
◦ Stingers should be scraped off skin and area
cleaned with soap and water.
◦ Monitor the patient’s vital signs.
◦ If the patient’s condition progresses to the point of
respiratory or cardiac arrest, begin mouth-tomask breathing or CPR.
◦ Immediately arrange for rapid transport.
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Treatment for anaphylactic
shock (cont’d)
◦ If the patient has a
prescribed auto-injector, tell
them to follow their doctor’s
orders for use.
 Place the tip of the autoinjector against the outer
thigh.
 Push the auto-injector
firmly against the thigh and
hold it for at least 10
seconds.
Is the patient responding normally?
Is the patient having DIB or problems
swallowing?
Does the patient have a history of
allergic reactions?
Does the patient have or take allergy
meds?
1.
2.
3.
4.
Yes – Oral, when was it last taken?
Does the patient have an Epi-pen?
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2.
3.
Do not give anything by mouth
Call back if patient’s condition
worsens prior to the arrival of
medical personnel
On insect stings, if stinger is still
present, gently scrape off of skin
and clean area with soap and
water. Do not use tweezers.
Has patient had any allergic reactions
in the past?
5.
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6.
Yes – follow their doctor’s instructions for use and
notify responders if used
1.
Recently eaten?
Any bites or stings?
Recent medications?
Any swelling noted to face, throat or
airway?
Key Questions
Pre-Arrival Instructions
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Four kinds of poisonous snakes in the United
States:
◦ Rattlesnake
◦ Cottonmouth (water moccasin)
◦ Copperhead
◦ Coral snake (Red on yellow bands)
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A snake injects its poison into a person’s
skin and muscles with its fangs. Coral
snakes chew with a row of teeth.
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Signs and symptoms
◦ Immediate pain at the bite site
◦ Swelling and tenderness around the bite site
◦ Fainting (from the emotional shock)
◦ Sweating
◦ Nausea and vomiting
◦ Shock
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The bite of the coral snake delivers a slightly
different poison that may cause these
additional problems:
◦ Respiratory difficulties
◦ Slurred speech
◦ Paralysis
◦ Coma
◦ Seizures
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Keep the patient calm and quiet.
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Have the patient lie down and try to relax.
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Wash the bite area with soap and water.
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If the bite occurred on the arm or leg, splint
the affected extremity.
Treat the patient carefully.
Arrange for prompt transport to a hospital
for possible antivenin.
1.
2.
3.
4.
Where is the animal now?
Any serious bleeding?
 Yes, go to bleeding protocol
What body part was bitten?
What type of animal was
involved?
Key Questions
1.
2.
3.
Isolate patient from the animal,
if safe to do so
Call back if the condition
worsens prior to the arrival of
medical personnel
Advise responders if risk from
animals still exist
Pre-Arrival Instructions
Silver Cross EMS March 2012 CME
AAOS Emergency Medical Responder,
Your First Response in Emergency
Care, 5th Edition
Google Images
CDC.GOV
Mosby Wilderness Medicine, 5th Edition
Will County 9-1-1 EMD Protocols