Environmental Emergencies CHAPTER 22. Thermoregulatory Emergencies

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Transcript of Environmental Emergencies CHAPTER 22. Thermoregulatory Emergencies

  • Slide 1
  • Environmental Emergencies CHAPTER 22
  • Slide 2
  • Thermoregulatory Emergencies
  • Slide 3
  • Thermoregulatory emergency: An increase or decrease in the temperature of the body or body part that results in an injury.
  • Slide 4
  • Temperature Regulation in the Body
  • Slide 5
  • The body performs a delicate balancing act between the heat generated in the body and the heat lost from it.
  • Slide 6
  • Types of Heat Loss Convection Evaporation Respiration Conduction Radiation
  • Slide 7
  • Heat loss occurs during respiration - when the body warms and humidifies the air.
  • Slide 8
  • Maintenance of Body Temp Falling body temperature Peripheral blood vessels constrict Muscles produce heat through shivering Rising body temperature Blood vessels dilate Sweat glands produce moisture
  • Slide 9
  • The body also produces heat by shivering.
  • Slide 10
  • Ambient temperature affects how the body maintains its temperature. This results from the combined effects of wind and humidity.
  • Slide 11
  • Exposure to the Cold
  • Slide 12
  • Extreme weather conditions can produce a variety of cold emergencies.
  • Slide 13
  • Hypothermia: A condition in which the core body temperature falls below 35 o C (95 o F) and the bodys normal functions are impaired. Caused by prolonged exposure to cold.
  • Slide 14
  • The most common cause of generalized hypothermia is exposure to a cold environment.
  • Slide 15
  • Factors that Contribute to Hypothermia Cold environments Immersion or submersion in water Age (the very young and the elderly) Alcohol Shock (hypoperfusion) Some medications and poisons
  • Slide 16
  • Factors that Contribute to Hypothermia continued Medical conditions Diabetes and hypoglycemia Metabolic and infectious processes Trauma Hypovolemia or shock Head injuries Spinal cord injuries Burns
  • Slide 17
  • Alcohol use is a complicating factor in many hypothermic patients.
  • Slide 18
  • Mental & Motor Function Changes caused by Hypothermia Dizziness and poor coordination Altered mental status Memory disturbances Poor judgement Mood changes Communication and speech difficulties
  • Slide 19
  • Mental & Motor Function Changes caused by Hypothermia continued Stiffness/rigid posture Reduced or absent sense of touch Changes in vital signs Joint or muscle pain
  • Slide 20
  • Vital Signs in Hypothermia
  • Slide 21
  • Focused Assessment What was the source of the cold? If water, what was the temperature? What were the general environmental conditions like? Did the patient experience a loss of consciousness? Are the effects general or local?
  • Slide 22
  • Hypothermia Treatment Remove the patient from the cold environment and protect from heat loss Remove any cold or wet clothing, and cover the patient with blankets Handle the patient with care, and avoid rough handling Warm the patient compartment of the ambulance as much as possible
  • Slide 23
  • Apply high-flow oxygen; warmed and humidified if possible Use no stimulants such as caffeine or alcohol Do not massage the extremities Check for a pulse for 30 - 45 seconds before starting CPR Hypothermia Treatment continued
  • Slide 24
  • Do not attempt to actively warm hypothermic patients who have a decreased level of consciousness......simply prevent further heat loss.
  • Slide 25
  • Care for Hypothermia with No Signs of Life Ensure a patent airway Ventilate the patient with 100% oxygen Begin CPR if no pulse for 30 - 45 seconds Use the AED according to local established protocols, or call medical direction
  • Slide 26
  • Local cold injuries result from decreased blood flow to, or freezing of, a body part. These injuries are often called frostbite or frostnip.
  • Slide 27
  • Local cold injury after thawing. Frostbite
  • Slide 28
  • Early or Superficial Cold Injury Pale skin with delayed capillary refill Loss of feeling/sensation in injured area Skin still soft Tingling sensation when rewarmed
  • Slide 29
  • Late or Deep Cold Injury White or waxy skin appearance Firm or frozen skin presentation Swelling and blister formation Loss of sensation in injured area If thawed, skin may be purple and pale
  • Slide 30
  • Care for Local Cold Injuries Remove patient from cold environment Protect the cold extremity from injury Administer oxygen Remove wet or restrictive clothing and all jewelry Splint if extremity involved, and cover with dry, sterile dressing
  • Slide 31
  • Place dressings between those fingers affected by local cold injury.
  • Slide 32
  • Never re-expose the area to cold, break blisters, rub or massage the area, apply heat, or allow the patient to use the affected area.
  • Slide 33
  • In a cold emergency, if transport time will be long: Immerse the affected part in warm water (102 o - 104 o F) Continuosly stir and add warm water to maintain temperature Continue immersion until the area is soft and color and sensation return Pat gently and dress with dry, sterile dressings Protect the injured area from refreezing Refer to local protocols for other treatment
  • Slide 34
  • Exposure to Heat
  • Slide 35
  • Hyperthermia: A condition in which the core body temperature exceeds normal limits and starts to malfunction. Caused by exposure to heat.
  • Slide 36
  • Predisposing Factors for Heat Emergencies Hot, humid weather Vigorous physical activity Age (the very young and the elderly) Medical conditions Diabetes Heart disease Fever
  • Slide 37
  • Predisposing Factors for Heat Emergencies continued Dehydration Obesity Fatigue Drugs and medications Previous history of hyperthermia
  • Slide 38
  • Working in a hot environment can result in a heat emergency.
  • Slide 39
  • Signs and Symptoms of Hyperthermia Muscle cramps Weakness or exhaustion Dizziness or fainting Rapid, bounding pulse Altered mental status Moist, pale, cool, hot or normal skin Nause, vomiting and abdominal cramps
  • Slide 40
  • Care for Hyperthermia with Moist, Pale, Cool or Normal Skin (Heat Exhaustion) Remove patient from hot environment Administer oxygen Loosen or remove clothing Cool the patient by fanning Place responsive patient supine with legs elevated; if vomiting, place on side If no nausea, provide cool water to drink
  • Slide 41
  • Remove patients from the hot environment and allow them to cool off.
  • Slide 42
  • Care for Hyperthermia with Hot, Dry Skin (Heat Stroke) Remove patient from hot environment Remove clothing and administer oxygen Apply cold to neck, groin and armpits Moisten patients skin with wet towels Fan the patient aggressively Transport patient immediately
  • Slide 43
  • Severe hyperthermia can lead to cardiac arrest.
  • Slide 44
  • Drowning and Near Drowning
  • Slide 45
  • Water-related Emergencies: Drowning is death following submersion in water. Near-Drowning is survival (either short or long term) following submersion in water.
  • Slide 46
  • Water rescue requires specialized training - NEVER ENDANGER yourself or others by attempting something you are not trained to do.
  • Slide 47
  • Water Rescue with Spinal Immobilization
  • Slide 48
  • Care of the Near Drowning Patient Immobilize spine if trauma is suspected Ensure adequate airway, provide oxygen and ventilate if necessary Provide CPR if pulseless (use AED if allowed by local protocols) Suction as needed If no trauma, place patient on left side Transport immediately
  • Slide 49
  • DO NOT attempt to relieve gastric distention unless it interferes with ventilation. There is significant risk of aspiration.
  • Slide 50
  • Bites and Stings
  • Slide 51
  • Creatures that Bite and Sting
  • Slide 52
  • Signs & Symptoms of Bites and Stings Local pain, swelling Headache, dizziness Rash,redness Nausea,vomiting Bitemarks Fever and chills may also follow the bite or sting.
  • Slide 53
  • Care of Bites and Stings Ensure adequate ABCs Inspect the site for stinger or bite marks Wash the area gently Remove jewelry from injured area If extremity, position just below level of heart If snakebite, consult medical direction Watch for development of allergic reaction
  • Slide 54
  • SUMMARY Thermoregulatory Emergencies Thermoregulatory Emergencies Drowning and Near-Drowning Drowning and Near-Drowning Bites and Stings Bites and Stings