Emergency Care and Transportation of the Sick and Injured 12th Edition - Chapter 33: Environmental Emergencies

The rate and amount of heat loss or gain by the body can be modified in three ways:

1. Increase or decrease in heat production. 2. Move to an area where heat loss can be decreased or increased. 3. Wear the appropriate clothing for the environment.

A person's ability to shiver is lost when his or her body temperature falls below:

90 degrees Fahrenheit (32 degrees Celsius).

homeostasis

A balance of all systems of the body.

bends

A common name for decompression sickness.

hypothermia

A condition in which the body core temperature falls below 95 degrees Fahrenheit (35 degrees Celsius).

hyperthermia

A condition in which the body core temperature rises to 101 degrees Fahrenheit (38.3 degrees Celsius) or more.

hymenoptera

A family of insects that includes bees, wasps, ants, and yellowjackets.

heat exhaustion

A heat emergency in which a significant amount of fluid and electrolyte loss occurs because of heavy sweating; also called heat prostration or heat collapse.

heatstroke

A life-threatening condition of severe hyperthermia caused by exposure to excessive natural or artificial heat, marked by warm, dry skin; severely altered mental status; and often irreversible coma.

decompression sickness

A painful condition seen in divers who ascend too quickly, in which gas, especially nitrogen, forms bubbles in blood vessels and other tissues; (see bends). The effects of this usually takes several hours.

antivenin

A serum that counteracts the effect of venom from an animal or insect.

scuba gear

A system that delivers air to the mouth and lungs at various atmospheric pressures, increasing with the depth of the diver; stands for self-contained underwater breathing apparatus.

reverse triage

A triage process used in treating multiple victims of a lightning strike, in which efforts are focused on those who are in respiratory and cardiac arrest. Reverse triage is different from conventional triage, where such patients would be classified as deceased.

Mild Hypothermia

Ambient: 93.2 F Core: 95 F - 93 F Signs and Symptoms: Shivering, foot stamping Cardiorespiratory Response: Constricted blood vessels, Rapid Breathing L.O.C: Withdrawn

Moderate Hypothermia

Ambient: 93.2 F - 86 F Core: 92 F - 89 F Signs and Symptoms: Loss of coordination, muscle stiffness Cardiorespiratory Response: Slowing respirations, slow pulse L.O.C: Confused, lethargic, sleepy

Severe Hypothermia

Ambient: Less than 86 F Core: 88 F to 80 F Signs and Symptoms: Coma Cardiorespiratory Response: Weak pulse, dysrhythmias, very slow respirations L.O.C: Unresponsive

dysbarism injuries

Any signs and symptoms caused by the difference between the surrounding atmospheric pressure and the total gas pressure in various tissues, fluids, and cavities of the body.

Fatal Hypothermia

Core: Less than 80 F Signs and Symptoms: Apparent death Cardiorespiratory Response: Cardiac arrest L.O.C: Unresponsive

frostbite

Damage to tissues as the result of exposure to cold; frozen body parts; frozen or partially frozen body parts are frostbitten.

What is an example of an early sign of pit viper envenomation?

Local swelling and ecchymosis

breath-holding syncope

Loss of consciousness caused by a decreased breathing stimulus.

heat cramps

Painful muscle spasms usually associated with vigorous activity in a hot environment.

turgor

The ability of the skin to resist deformation; tested by gently pinching skin on the forehead or back of the hand.

evaporation

The conversion of water or another fluid from a liquid to a gas.

respiration

The inhaling and exhaling of air; the physiologic process that exchanges carbon dioxide from fresh air.

convection

The loss of body heat caused by air movement (eg, a breeze blowing across the body).

conduction

The loss of heat by direct contact (eg, when a body part comes into contact with a colder object).

air embolism

The presence of air in the veins, which can lead to cardiac arrest if it enters the heart. The effects of this usually takes place immediately after surfacing from the water.

drowning

The process of experiencing respiratory impairment from submersion or immersion in liquid.

diving reflex

The slowing of the heart rate caused by submersion in cold water.

core temperature

The temperature of the central part of the body (eg, the heart, lungs, and vital organs).

ambient temperature

The temperature of the surrounding environment.

radiation

The transfer of heat to colder objects in the environment by radiant energy; for example, heat gain from a fire.

Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when:

a swimmer hyperventilates prior to entering the water.

The most prominent symptom of decompression sickness is:

abdominal or joint pain.

After being stung on the leg by a jellyfish, a man complains of severe pain to his leg, dizziness, and difficulty breathing. He has a red rash covering his trunk, and his blood pressure is 90/50 mm Hg. The EMT should:

administer oxygen and epinephrine and prepare for rapid transport.

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30 degrees Fahrenheit (-1 degrees Celsius). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should:

assess for a carotid pulse for up to 60 seconds.

A dysbarism injury refers to the signs and symptoms related to changes in:

barometric pressure.

The diving reflex might allow a person to survive extended periods of submersion in cold water secondary to:

bradycardia and a slowing of the metabolic rate.

When a warm hand is immersed in water that is 70 degrees Fahrenheit (21 degrees Celsius), heat is transferred from the hand to the water through a process called:

conduction.

The transfer of heat to circulating air, such as when cool air moves across the body's surface, is called:

convection.

In heat exhaustion, the skin temperature may be normal or ____________ and ____________.

cool, clammy

Drowning is most accurately defined as:

death from suffocation after submersion in water.

Common signs and symptoms of heat exhaustion include:

dry tongue and thirst, tachycardia, and nausea.

High humidity reduces the body's ability to lose heat through:

evaporation.

Moist, pale, cool skin is a sign of:

excessive fluid and salt loss.

Geriatric patients, newborns, and infants are especially prone to hyperthermia because they:

exhibit poor thermoregulation.

Covering a patient's ____________ will significantly minimize radiation heat loss.

head

In heatstroke, the skin is:

hot.

To obtain the most accurate reading of a patient's core body temperature, you should place a special hypothermia thermometer:

into the patient's rectum.

For sweating to be an effective cooling mechanism:

it must evaporate from the body.

A frostbitten foot can be identified by the presence of:

mottling and blisters.

The venom of a black widow spider is toxic to the:

nervous system.

The cottonmouth, copperhead, and rattlesnake are all examples of:

pit vipers.

A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:

provide rescue breathing, remove his wet clothing, immobilize his entire spine, keep him warm, and transport carefully.

Patients with a submersion injury might deteriorate rapidly because of:

pulmonary injury and cerebral hypoxia.

High air temperature reduces the body's ability to lose heat by:

radiation.

A patient with a core body temperature of 95 degrees Fahrenheit (35 degrees Celsius) will most likely experience:

rapid breathing.

Falling blood pressure indicates that the patient is going into:

shock.

Lightning strikes might cause cardiac dysrhythmias that:

spontaneously resolve.

Burns associated with lightning strikes are typically:

superficial.

A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:

supine positioning, splinting the leg, and transporting.

The two most efficient ways for the body to eliminate excess heat are:

sweating and vasodilation.

Patients who are hyperthermic will be:

tachycardic and tachypneic.

Hot, dry skin and hot, moist skin is a sign that:

the body is unable to regulate core temperature.

An air embolism associated with diving occurs when:

the diver holds his or her breath during a rapid ascent.

Patients with symptoms of heatstroke should be:

transported immediately.

Heat loss from the body through respiration occurs when:

warm air is exhaled into the atmosphere.