AAOS Emergency Care and Transportation of the Sick and Injured Tenth Edition : Chapter 30 – Environmental Emergencies

Air Embolism
Air bubbles in the blood vessels.

Ambient temperature
The temperature of the surrounding environment.

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

Common name for decompression sickness.

Breath-holding syncope
Loss of consciousness caused by decreased breathing stimulus

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

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

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

Decompression sickness
A painful condition seen in divers who ascend to quickly, in which gas, especially nitrogen, forms bubbles in blood vessels and other tissues; also called “the bends.”

Diving reflex
Slowing of the heart rate caused by submersion in cold water.

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

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.

Conversion of water or another fluid from a liquid to a gas.

Damage to tissues as the result of exposure to cold; frozen body parts.

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

Cold illness
Can be a local or a systemic problem.

Local cold injuries
May include frostbite, frostnip, and immersion foot.

Heat illness
Heat cramps, heat exhaustion, and heatstroke.

Signs and symptoms of 93 to 95 degrees to the body
Shivering, foot stamping

Signs and symptoms of 89 to 92 degrees to the body
Loss of coordination, muscle stiffness

Signs and symptoms of 80 to 88 degrees to the body

Signs and symptoms of less than 80 degrees to the body
Apparent death

Cardiorespiratory response of 93 to 95 degrees to the body
Constricted blood vessels, rapid breathing

Cardiorespiratory response of 89 to 92 degrees to the body
Slowing respirations, slow pulse

Cardiorespiratory response of 80 to 88 degrees to the body
Weak pulse, arrhythmias, very slow respirations

Cardiorespiratory response of less than 80 degrees to the body
Cardiac arrest

Level of consciousness of 93 to 95 degrees to the body

Level of consciousness of 89 to 92 degrees to the body
Confused, lethargic, sleepy

Level of consciousness of less than 80 to 88 degrees to the body

Emergency care of local cold injuries treatment:
1. Remove the patient from further expose to the cold.
2. Handle the injured part gently, and protect it from further injury.
3. Administer O2, if this was not already done as part of the primary assessment.
4. Remove any wet or restricting clothing of the uninjured part.

Illness from heat exposure can take the following three forms:
Heat cramps, heat exhaustion, and heat stroke

What does moist, pale, and cool skin indicate?
Excessive fluid and salt loss.

What does hot and dry or moist skin indicate?
Body is unable to regulate core temperature.

Self contained underwater breathing apparatus, gear is a system that delivers air to the mouth and lungs at atmospheric pressures that increase with the depth of the dive.

What is very important to consider to ask the patient for drowning and or diving emergencies?
To determine the dive parameters in your history, including depth, time, and previous diving activities.

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.

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

A condition in which the body core temperature rises to 101 degrees or more.

A condition in which the body core temperature falls below 95 degrees after exposure to a cold environment.

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

The loss of body heat as warm air in the lungs is exhaled into the atmosphere and cooler air is inhaled.

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

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

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