Chapter 33: Environmental Emergencies

Introduction

• Homeostasis: The body's systems work best in balance.
• Environmental factors (temperature, pressure) can disrupt this balance, leading to emergencies.
• Affects vulnerable groups like children, elderly, chronically ill, and overexerted young adults.
• Emergencies can lead to mental and functional changes or death.
• EMTs play a vital role in recognizing and treating environmental emergencies.

Body Temperature Regulation

• Body aims to maintain a core temperature of 98°F (36.7°C).
• Heat loss mechanisms:
  • Conduction: Direct heat transfer.
  • Convection: Heat transfer through air.
  • Evaporation: Sweating and liquid to gas conversion.
  • Radiation: Heat transfer through radiant energy.
  • Respiration: Heat loss through exhalation.

Factors Affecting Exposure

• Physical Condition: Illness or poor fitness can impair temperature tolerance.
• Age: Infants and elderly are more susceptible to temperature changes.
• Nutrition and Hydration: Critical for metabolism and coping with heat/cold stress.
• Environmental Conditions: Air temperature, humidity, wind can affect body heat management.

Cold Exposure

• Heat always travels from warmer to cooler areas, risking body heat loss in the cold.
• Hypothermia: Core temperature below 95°F (35°C).
  • Symptoms progress from shivering to lethargy, poor coordination, and eventually cardiac arrest if untreated.
  • Requires immediate medical attention and rewarming.
• Local Cold Injuries:
  • Frostnip: Skin cold but not frozen.
  • Frostbite: Tissues frozen, requiring specialized care.

Heat Exposure

• Hyperthermia: Core temperature above 101°F (38.3°C).
• Heat Emergencies:
  • Heat Cramps: Muscle spasms due to electrolyte loss.
  • Heat Exhaustion: More severe dehydration and electrolyte depletion.
  • Heat Stroke: Dangerous overheating; requires rapid cooling and medical intervention.

Drowning and Diving Emergencies

• Drowning leads to hypoxia and potential cardiac arrest.
• Spinal Injuries: Common in diving accidents; require careful handling.
• Decompression Sickness: From rapid ascent, causing nitrogen bubbles in blood.
• Air Embolism: Air bubbles in blood vessels from rapid ascent while holding breath.

Lightning and Bites

• Lightning Injuries affect cardiovascular and nervous systems, causing direct and indirect injuries.
• Spider Bites: Black widow and brown recluse are significant threats.
• Snake Bites: Pit vipers and coral snakes cause systemic and local effects.
• Hymenoptera Stings: Can lead to anaphylaxis.
• Marine Animal Injuries: Include jellyfish stings and spiny fish injuries.

Management and Treatment

• Cold Emergencies:
  • Remove from cold, warm gradually, avoid moving affected parts too much.
  • Handle gently to avoid cardiac complications.
• Heat Emergencies:
  • Move to a cooler environment, hydrate, and cool effectively.
  • Rapid transport for heat stroke.
• Drowning:
  • Prioritize airway management and prevent hypothermia.
• Bites and Stings:
  • Remove stingers, administer epinephrine for anaphylaxis, wash snake bites.
  • Use hot water for marine stings.

Preventive Measures

• Education: Awareness campaigns about temperature-related risks and first aid can save lives.
• Proper Gear: Wear appropriate clothing and gear for climate and conditions.
• Emergency Preparedness: EMTs should be trained for environmental risks in their areas.