Course Library

Environmental Emergencies

Information Covered:

1. Submersion Incidents
   1. Drowning
      1. Definition
      2. Incidence
      3. Predictors of morbidity and mortality
   2. Types
      1. Fresh water
      2. Salt water
   3. Pathophysiology
   4. Unique Signs and Symptoms
      1. Airway – obstructed with water immediately after rescue
      2. Breathing
      3. Circulation
   5. Assessment Considerations
   6. Management Considerations
2. Temperature-Related Illness
   1. Incidents
      1. Temperature-related illness
         1. Cold-related illness
         2. Heat-related illness
      2. How the body loses heat
         1. Conduction
         2. Convection
         3. Radiation
         4. Evaporation
         5. Respiration
      3. Type of temperature-related illness
         1. Generalized cold injury (hypothermia)
         2. Localized cold injury
         3. Generalized heat injury – may affect full body or muscle groups
   2. Pathophysiology
      1. Cold-related injuries
         1. Low environmental temperatures generalized exposure
            1. factors that contribute to risk of cold injury
               1. clothing of the patient
               2. age and time of exposure
               3. alcohol or other medication ingestion
               4. suicide
               5. activity level of the victim
               6. pre-existing injury or illness
            2. environment factors that contribute to risk of cold injury
               1. ambient temperature
               2. wind speed
               3. moisture
         2. Local cold exposure
            1. local exposure of body appendage to cold – ears, fingers, and toes very susceptible
            2. ice crystals form
            3. impairs local blood flow
            4. temporary or permanent tissue damage – may lead to amputation
      2. Heat-related illness
         1. Environmental factors that contribute to risk of heat-related illness
            1. ambient temperature
            2. humidity
         2. Patient factors that contribute to risk of heat injury
            1. no acclimation to heat
            2. medical illness or injury
            3. age
            4. exertion
            5. alcohol or other medication use
         3. Patient with moist, pale, cool skin – excessive  fluid and salt loss
         4. Patient with hot, dry skin
         5. Patient with hot, moist skin
   3. Signs and Symptoms
      1. Cold-related illness – (generalized) hypothermia
         1. Decreased level of consciousness
         2. Impaired motor function
            1. rigidity
            2. altered balance
         3. Shivering
            1. muscle contractions help to increase body temperature
            2. temperature will drop quickly when shivering stops
         4. Slow pulse and breathing in later stages
         5. Cool abdominal skin below clothing
         6. Extreme hypothermia
            1. may have no palpable pulse
            2. cardiac arrest
      2. Cold-related illness (localized)
         1. Frozen extremity
         2. Loss of color
         3. Loss of movement
         4. Pain
      3. Heat-related illness (moist, pale skin)
         1. Muscle cramps
         2. Change in level of consciousness, dizziness
         3. Weakness
         4. Weak, rapid pulse
         5. Nausea and vomiting
         6. Apply pulse oximetry
      4. Heat-related illness (hot skin)
         1. Little or no perspiration – in exertional heat stroke the skin may be sweaty and hot
         2. Loss of consciousness
         3. Rapid breathing
         4. Rapid pulse
         5. Seizures
   4. Management Considerations
      1. Cold-related illness – (generalized) hypothermia
      2. Cold-related illness (localized)
      3. Heat-related illness, with moist, pale, cool skin
         1. Remove from hot environment
         2. Remove clothing
         3. Splash the patient with cool water
      4. Heat-related illness with hot skin
         1. Remove patient from hot environment
         2. Administer high concentration oxygen
         3. Assist ventilation if inadequate
         4. Cool packs to armpits, groin, neck
         5. Transport immediately
         6. This is true emergency
3. Bites and Envenomations
   1. Injuries of Concern
      1. Spider bites
      2. Snake bites
      3. Hymenoptera (bees, wasps, ants, yellow jackets)
   2. Pathophysiology of Bites and Envenomations
      1. Spider bites (black widow) -- inject neurotoxins
      2. Snake bites -- rattlesnake is most common in United States
      3. Hymenoptera
   3. Signs and Symptoms
      1. Spider bite (black widow)
      2. Rattlesnake bite
      3. Bee, wasp, and other stings
   4. Unique Management Considers of Bites and Stings
      1. Spider bite (black widow)
         1. Clean wound with soap and water
         2. Transport immediately with supportive care
      2. Rattlesnake bite
         1. Note time of bite to transport
         2. Slow venous return
         3. Keep patient calm
         4. Immobilize extremity
         5. Position extremity
         6. Clean bite site with soap and water
         7. Identify snake if possible
      3. Bees, wasps, and other stings
         1. Remove stinger or venom sac
         2. If anaphylaxis develops follow protocol
4. Diving Emergencies (Dysbarism)
   1. Mechanism of Injury
   2. Pathophysiology
   3. Signs and Symptoms
   4. Unique Management Considerations
5. Electrical
   1. Electrical

Content Creator: James Stone
CAPCE Course Number: 20-EMTP-F3-2102
NJ Course Number: 141114
Total CE Hours: 1.0
Level: Basic
EMT-CE uses the NEMSES guidelines as the foundation for every course outline.