Environmental Emergencies

1. Environmental Emergencies Union Hospital Emergency Department

2. Heat Cramps • Result from depletion of fluid and electrolytes in exerted muscles • Symptoms: pain in exerted muscles and thirst • Care: rest in cool place, replacement of fluids with balanced solution

3. Heat Exhaustion • Major exertion in hot weather • Peripheral vasodilation occurs to dissipate heat and fluids and electrolytes are lost through profuse sweating • Symptoms: Pale, ashen, sweating profusely, weakness, altered MS, hypotension, tachycardia, severe thirst • Care: cool environment, monitor for dysrhythmias

4. Heat Stroke • Medical Emergency • Patient is not able to dissipate heat because of failure of thermoregulation mechanisms • Core temp is greater than 106 • Symptoms: confusion to coma, skin hot and dry, hypotensive, tachycardia • Care: stabilization of ABC’s with rapid cooling, IVF and electrolyte replacement

5. Frost Bite • Formation of ice crystals in the tissue • Initial response is vasoconstriction with stasis • Decreased blood flow leading to sludging and thrombosis • Symptoms: pale to blue to mottle skin, edema, blisters, or anesthesia if severe • Care: Maintain ABC’s, obtain core temperature, begin rewarming, analgesics, antibiotics, tetanus

6. Hypothermia • Defined as core body temperature of less than 95 degrees • Symptoms: temp less than 95, hypoventilation, hypotension, altered mental status, pale cyanotic skin, absence of reflexes • Care: Maintain ABC’s, rewarm patient, administer warm IVF, heated, humidified oxygen, monitor

7. Submersion Injuries • Person becomes hypoxic from submersion in a substance • Initial breath holding, hyperventilation, aspiration, hypoxia, pulmonary injury then brain death • Symptoms: cool, clammy or cyanotic skin, gastric distention, LOC • Care: Maintain ABC’s, oxygen, IVF, rewarming, NG