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 O 2 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 O 2 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 mottled skin froth at nose/mouth dizziness, headache confusion or ALOC chest pain, dyspnea pain neuro deficits 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???