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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 • • • • handle gently remove from environment high flow oxygen warming measures • Ambulance should be heated (86+ degrees) • GOAL IS TO PREVENT FURTHER HEAT LOSS Frostbite • • • • white, cold, hard, waxy skin painful or painless may have blisters or swelling common locations: feet - hands - nose - ears Frostbite Tx • • • • • 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 • • • • • • 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 • • • • • • 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 • • • • • • 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 • • • • ABC’s high flow oxygen left lateral trendelenberg rapid transport* • consider treatment for hypothermia • Transport to hyperbaric chamber questions???