Enviromental emergencies

Exposure may not only be dangerous.
Preexisting medical problems significantly impact outcomes of exposure.
- Older individuals often have underlying health issues.
- Use of blood thinners can exacerbate problems associated with exposure.

Conduction: Loss of heat through direct contact or water chill.
- Example: Laying on a concrete surface can lead to significant body temperature loss.
Convection: Transfer of heat by the movement of fluids (air or water).
- Example: Wind chill contributing to heat loss.
Radiation: Heat lost to the surrounding air or water.
- Example: Sweating leads to evaporation, cooling the body.
- Breathing also results in heat loss (e.g., visible breath in winter).

Defined as the body's inability to maintain core temperature, potentially leading to death.
Core temperatures can be extremely low
Medical facilities implement methods to rewarm patients:
- Bear Hugger: An air-filled blanket used to provide warmth.
- Cranking the heat in the ambulance can raise body temperature during transport.

Patients in shock (e.g., trauma, bleeding).
Conditions like infection or diabetes, particularly in newborns with hypoglycemia and hypothermia.
Substance abuse, particularly alcohol, as it promotes vasodilation and exacerbates heat loss.
- ETOH: Abbreviation used to denote blood alcohol content.
Geriatric patients may be particularly vulnerable due to fixed income and inability to keep homes adequately heated.
Newborns at risk due to larger skin surface area in relation to body mass.

Avoid rubbing hypothermic patients to prevent tissue damage.
Remove wet clothing and apply external heat sources effectively:
- Hot packs in armpits, groin, and neck areas.
- Warm IV fluids given in a hospital setting.

Cold abdominal skin temperature is alarming; indicates extreme hypothermia.
Early symptoms: Cold extremities, loss of sensation, lack of motor coordination, leading to confusion and altered consciousness.
- Hypothermic patients may exhibit bradycardia, bradypnea, stiff posture, and cold skin upon examination.

Serious tissue damage due to freezing temperatures.
Indicators of frostbite include discoloration and potential necrosis of skin, requiring immediate medical intervention.

Elevated body temperature leading to detrimental effects, including death if unchecked.
Stages of heat-related illnesses:
- Heat Cramps: Initial cramps and pain caused by loss of salts and dehydration.
- Heat Exhaustion: Skin may appear moist and pale, signs of dehydration.
- Heat Stroke: Severe condition with hot, possibly dry skin; signifies the body's thermoregulation failure.

Heat Stroke: Remove from heat, cool body using cold packs, provide oxygen as needed, and transport immediately.
- Seizures and altered mental state signify severe heat stroke.

Drowning: Respiratory impairment due to submersion in liquid, leading to morbidity or mortality.
- Symptoms during drowning include respiratory distress and potential cardiac arrest.
Preventative measures and rapid response are critical in drowning cases:
- If a patient is submerged, start CPR immediately and prepare for potential trauma from hitting water.

Prioritize establishing an airway and beginning ventilation.
Assume head or neck injuries; immobilize the patient appropriately.
Observe for additional signs of distress, including altered consciousness and hypoxia.

Increased difficulty breathing and symptoms such as headaches occur due to altitude changes.
- Severe cases, like High Altitude Cerebral Edema (HACE), present with confusion, loss of coordination, and respiratory distress.
Immediate descent and oxygen supplementation are necessary for severe cases.

Anaphylaxis is a critical concern for certain insect stings (e.g., bee stings).
- Signs include swelling, rapid pulse, and altered mental state.
Venom removal must be done carefully to avoid further injection of venom.
Rattlesnake bites are hazardous; immobilize the limb and seek immediate medical assistance.

Both hypothermia and hyperthermia present critical health risks requiring immediate and effective intervention.
Familiarity with environmental influences and appropriate responses can significantly impact patient outcomes.