Download Environmental Emergencies

Environmental
Emergencies
The body gains and
loses heat two ways:
1. From within the body itself
2. By contact with the external environment
Thermal Gradient
The difference in temperature
between the environment and the
body.
If the ambient temperature is
warmer than the body, then heat
flows from the environment to the
body.
If the ambient temperature is colder
than the body, then heat flows from
the body to the environment.
Other factors that effect
heat gain and loss

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Wind
relative humidity (the
percentage of water vapor in
the air.
Thermolysis
Loss of heat from the body
The transfer of heat from the
body into the environment occurs
through the following 5
mechanisms:
 Respiration
 Evaporation
 Convection
 Conduction
 Radiation
Hyperthermia
State of unusually high
body temperature
As the body attempts to eliminate
excessive heat you will see
general signs of thermolysis (heat
loss)
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Diaphoresis (sweating)
Increased skin temperature
Flushing
Predisposing Factors

Age of patient

Health of patient Diabetics are more prone
Pediatric and geriatric patients
heat regulating mechanisms are not as responsive as
young adults and adults.
to hyperthermia because they develop autonomic
neuropathy. A condition that interferes with the
thermoregulatory input and with vasodilatation and
perspiration.

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Medications
Length of acclimatization
Predisposing Factors
Cont…..
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Length of exposure
Intensity of exposure
Environmental factors such as
humidity and wind
Preventative measures

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Maintain adequate fluid intake
Allow time for gradual
acclimatization
Limit exposure to hot
environment
Specific Heat Disorders
What is sweating?
Sweating occurs as sodium
(salt) is transported to the skin.
Because “water follows
sodium” water is deposited on
the skin surface evaporation
occurs, aiding in the cooling
process.
Sweating Cont…..
Since sweating involves
not only the loss of water,
but also the loss of
electrolytes (sodium),
intermittent cramping of
skeletal muscle may occur.
Heat (muscle) Cramps
Acute painful spasms of the
voluntary muscles
following strenuous activity
in a hot environment
without adequate fluid or
salt intake.
Signs and Symptoms

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Present with cramps in fingers,
arms legs, or abdominal
muscles
Mentally alert with a feeling of
weakness
May feel dizzy or faint
Vital signs stable
Skin moist and warm
Treatment

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
Remove patient from the
environment
Place in a cool environment (shade
or air conditioning)
Administer a sports drink or 4tsp of
salt dissolved in 1 gallon of water.
Massage painful muscles
Apply cool moist cloth over forehead
and over cramped muscles
Heat Exhaustion
A mild heat illness; an
acute reaction to heat
exposure.
Signs and Symptoms

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Increased body temperature ( >100 F)
Skin cool and clammy with heavy
perspiration
Breathing rapid and shallow
Weak pulse
May develop diarrhea and muscle
cramps
Patient may feel weak
Signs and Symptoms
Cont...

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May lose consciousness
Headache
Anxiety
Paresthesia (numbness)
Impaired judgement
Psychosis
Treatment

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Call 911
Remove patient from the
environment.
Place the patient in a supine
position.
Administer oral saline or a
sports drink (administer fluids
only if patient is conscious)
Tx. Cont….

Remove some clothing from the
patient and fan. If the patient
begins to shiver stop fanning

Treat for shock
Symptoms should resolve with
fluids, rest, and supine
posturing with knees elevated.
If they do not, consider that the
symptoms may be due to an
increased core body
temperature which is predictive
of impending heat stroke.
Heatstroke
Acute dangerous reaction to
heat exposure, characterized by
a body temperature usually
above 105° F and central
nervous system disturbances.
Signs and Symptoms

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Cessation of sweating
Skin that is hot and dry
Very high core temperature
Deep respirations that become
shallow, rapid at first but may
later slow
Rapid full pulse, may slow later
Signs and Symptoms

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Hypotension with low or absent
diastolic reading
Confusion, disorientation, or
unconsciousness
Possible seizures
Tx

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Call 911
Remove pt from the
environment
Initiate rapid active cooling,
remove clothing cover the
patient with sheets soaked in
TEPID water. Avoid over cooling
target core temp 102°F
Tx. Cont….

Administer fluid therapy if and
only if pt is able to swallow
Dehydration in Heat
Disorders
Dehydration often goes hand in
hand with heat disorders
because it inhibits vasodilation
therefore thermolysis.
Signs and Symptoms of
Dehydration

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Nausea, vomiting, and
abdominal distress
Vision disturbances
Decreased urine output
Poor skin turgor
Signs of hypovolemic shock
Thirst is a poor indication of the
degree of dehydration present