• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
22)Environmental Emergencies
 

22)Environmental Emergencies

on

  • 1,504 views

 

Statistics

Views

Total Views
1,504
Views on SlideShare
1,504
Embed Views
0

Actions

Likes
1
Downloads
95
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    22)Environmental Emergencies 22)Environmental Emergencies Presentation Transcript

    • Environmental Emergencies
    • Environmental Emergencies
      • Body Temperature
        • 96.4-99.8 degrees F
      • Heat Regulation
        • Based on heat lost v heat gained
        • Variation throughout body core and periphery
        • Cardiovascular System
          • Transports heat through body
        • Skin
          • Allow heat to be lost/gained to/from environment
        • Hypothalamus
          • Temperature control center of the brain
    • Heat Production
      • Metabolism
        • ALL metabolic processes in body produce heat
        • Basal metabolism
          • Metabolic activity to maintain cell function at rest
        • Generally more than enough heat to maintain core temp
    • Heat Loss/Gain
      • Radiation
      • Conduction
      • Convection
      • Evaporation
      • Breathing
    • Radiation
      • Radiation
        • Transfer of heat via infrared rays.
        • Heat rays are radiated by the body and other objects in the environment.
        • If body temp is greater than the surroundings heat is lost.
        • We radiate 550 watts (5 light bulbs)
    • Conduction
      • Conduction
        • Transfer of heat to objects including air that are in direct contact with body.
    • Convection
      • Convection
        • Transfer of heat through movement of currents.
          • i.e. Wind chill factor
    • Evaporation
      • Evaporation
        • Loss of heat when moisture vaporizes on the body surface.
        • Depends on temp/air movement/humidity
          • Wind currents move saturated air away from body
          • Drier air replaces it and takes up moisture
        • Closer to 100% humidity = Less evaporation
    • Breathing
      • Breathing
        • Inhaled air is heated/cooled by body temp
        • Body looses heat when air is cooler than the body
        • Body gains heat when air is warmer that the body
    • Mechanisms of Regulation
      • Brain
        • Hypothalamus
          • Body thermostat
        • Metabolic Rate
          • Heat production
        • Cardio
          • Heat distribution
        • Skin
          • Heat loss
        • Vasodilation
          • Loss by conduction/convection/radiation/sweating
        • Vasoconstricion
          • Inhibits sweating, increased metabolic rate
    • Cardiovascular System
      • Cardiovascular
        • Brings heated blood from core to extremities
        • 5 % of cardiac output is in skin
            • 250-300 ml/min
          • Vasodilation
            • More blood contact with skin
            • Conduction, convection, radiation
            • Can increase to 3000 ml/min!!!!
          • Vasoconstriction
            • Heat conservation
            • Can decrease to 30 ml/min!!!!
    •  
    • Skin
      • Skin
        • Heat regulation
        • Insulation
        • Vasoconstriction
        • Vasodilation
        • Evaporation form sweat
    • Questions to ask
      • Source
      • Environment
      • Loss of consciousness
      • Effects
      • How long exposed
    • Cold Emergencies: Predisposing Factors
      • Cold Environment
        • Immersion
        • Non Immersion
      • Age
        • Very old
        • Very young
          • Small with LARGE surface area
          • Small muscle mass – Poor in children and not existent in infants
          • Less body fat
          • Younger children need help to protect against environment
      • Medical Conditions
        • Shock
        • Head injuries, Injuries to spinal cord
        • Burns
        • Generalized infection
        • Diabetes and hypoglycemia
        • Drugs/poisons
    • Predisposing factor: Idiocy…..
    • Hypothermia
      • Hypothermia
        • Body core temp falls below 95 degrees F
      • Environmental conditions
        • Ethanol ingestion
        • Underlying illness
        • Overdose/poisoning
        • Major trauma
        • Outdoor resuscitation
        • Ambient temperature decrease ( i.e. home of elderly pt)
    • Cold Emergencies S/S
        • Poor coordination
        • Memory disturbances
        • Reduce/loss of sensation
        • Mood changes
        • Less communicative
        • Dizziness
        • Speech difficulty
        • Stiff/rigid posture
        • Muscular rigidity
        • Shivering/absence of shivering
        • Breathing changes
          • Early -Rapid
          • Late – Shallow, slow, or absent
        • Pulse changes
          • Early- Rapid
          • Late – Slow and barely palpable , irregular, absent
        • Skin Changes
          • Red – early
          • Pale
          • Cyanotic
          • Stiff/hard
        • Slowly responding pupils
        • Low to absent BP
        • Joint/muscle stiffness
        • Poor judgment
    • Assessment/Treatment
      • Assessment:
        • Place hand against pt abdomen
        • Cool abdomen = Generalized hypothermia
        • Assess pulse 30-45 seconds before CPR
      • Treatment:
        • Remove pt from environment
        • Remove wet clothing
        • Cover with blankets
        • Handle pt EXTREMELY carefully
        • Do not allow pt to walk/exert self
        • Admin O2 (warmed/humidified if able)
        • Do not let pt ingest stimulants
        • Do not massage extremity
      • If pt responsive : Active rewarming
      • If pt unresponsive : Passive rewarming
        • AFTERDROP…
    • Active Vs. Passive Rewarming
      • Active rewarming
        • Warm blankets
        • Heat packs /warm water bottles
          • Groin
          • Neck
          • Under arms
        • Turn heat on in pt compartment
      • Passive rewarming
        • Warm blankets Turn heat on in pt compartment
    • Localized Injuries
      • Localized to one area of the body
      • Tend to happen in extremities and exposed ears/nose/face
      • Early/Superficial Injury
        • Blanching of the skin
        • Loss of feeling/sensation in area
        • Skin remains soft
        • If rewarmed – tingling sensation
      • Late/Deep Injury
        • White, waxy skin
        • Firm to frozen feeling on palpation
        • Swelling
        • Blisters
        • If thawed – Flushed with area of purple and blanching or mottled and cyanotic
    •  
    •  
    • Localized Injuries: Care
      • Remove pt from the environment
      • Protect injured extremity from further injury
      • Administer O2
      • Remove wet/constrictive clothing
      • If early/superficial
        • Splint extremity
        • Cover extremity
        • Do not massage
        • Do not re expose to cold
      • If late/deep
        • Remove jewelry
        • Cover with dry clothing/dressings
        • DO NOT:
          • Break blisters – Rub/massage area – Apply heat – Rewarm – Allow pt to walk on affected extremity
    • Prolonged/Delayed Transport
      • Active Rapid Rewarming
        • Immerse affected part in warm water bath
        • Monitor water so that it doesnt cool from frozen part
        • Continuously stir water
        • Continue until the part is soft and sensation returns
        • Dress the area with dry sterile dressings
        • Protect against refreezing
        • Expect pt to c/o SEVERE pain
    • Changing Directions…
    • Heat Emergencies: Predisposing Factors
      • Climate
        • High ambient temp = Less evaporation
        • High relative humidity = Less evaporation
      • Exercise and activity
        • Can lose 1+ Liter of sweat per hour
        • Loss of electrolytes (Na, Cl, H2O)
      • Age
        • Elderly
          • Poor thermoregulation
          • Medications
          • Lack mobility- cannot escape environment
        • Newborns
          • Poor thermoregulation
          • Cannot remove own clothing
      • Pre existing illness
        • Heart disease
        • Dehydrations
        • Obesity
        • Fever
        • Fatigue
        • Diabetes
        • Drugs/medications
    • Heat Emergencies S/S
      • Muscular Cramps
      • Weakness
      • Exhaustion
      • Dizziness/faintness
      • Skin
        • Moist, pale, normal to cool temp
          • Heat Exhaustion
        • Hot, dry or moist – Dire emergency
          • Heat Stoke
      • Rapid Heart Rate
      • AMS
      • Unresponsive
    • Treatment: Heat Exhaustion
      • Moist, pale, normal to cool skin
        • Remove pt from hot environment and place in cool one
        • Administer O2
        • Loosen or remove clothing
        • Cool pt by fanning
        • Put in shock position
        • If pt responsive and not nauseated have them drink water
        • If pt is unresponsive or vomiting transport pt left lateral recumbent
    • Treatment: Heat Stoke
      • Hot, dry or moist skin
        • Remove pt from hot environment and place in cool one
        • Administer O2
        • Remove clothing
        • Apply cold packs to neck, groin, armpits
        • Keep skin wet by applying water by sponge/wet towels
        • Fan aggressively
        • Transport IMMEDIATELY
    •  
    • Water Related Emergencies
      • Near drowning/drowning
        • Ensure safety of crew
        • Suspect spinal injury if diving injury
        • Consider length of time in cold water
          • Any pulseless non breathing pt submerged in cold water should be resuscitated
        • C-Spine control and removal via LBB if pt responsive and spinal injury suspected
        • If injury not suspected, place pt on L lateral recumbent
        • Suction as needed
        • Administer O2
        • If gastric distention interferes with ventilation:
          • Roll pt to L side
          • Have suction ready
          • Apply firm pressure on abdomen (epigastric are) and decompress
          • SUCTION
    •  
    •  
    • Bites and Stings
    • Bites and Stings: S/S
      • Hx of bite (spider, snake) or sting (insect, scorpion, marine animal)
      • Pain
      • Redness
      • Swelling
      • Weakness
      • Dizziness
      • Chills
      • Fever
      • Nausea
      • Vomiting
      • Bite marks
      • Stinger
    • Bites and Stings Treatment
      • If stinger present remove it
        • Scraping motion
      • Wash area gently
      • Remove jewelry from area before swelling occurs
      • Place injection site slightly below pt heart
      • Do not apply cold to snakebites
      • Consult medical direction for constricting band for snake bite
      • Observe and treat for S/S of allergic reaction
    • Remember… Scene Safe! Its already injured the patient. So…
    •