EMT/EMR Environmental Injuries Powerpoint Training PReview

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Information about EMT/EMR Environmental Injuries Powerpoint Training PReview

Published on January 2, 2017

Author: bvbean

Source: slideshare.net

1. EMERGENCY MEDICAL TECHNICIAN ENVIRONMENTAL EMERGENCIES Brave Training Solutions Copyright 2014 www.bravetraining.com EMT-50 V2

2. DESCRIPTION This presentation reviews recognizing the signs and symptoms of heat and cold exposure, as well as the emergency medical care of these conditions. Information on aquatic emergencies and bites and stings will also be included in this lesson. Presentation is over 190 slides in length. Meets or exceeds USDOT NHTSA 2009 EMT training requirements. Recommended classroom time 4 hours. •

3. EMERGENCY MEDICAL TECHNICIAN ENVIRONMENTAL EMERGENCIES Brave Training Solutions Copyright 2014 www.bravetraining.com EMT-50 V2


5. UNIQUE S & S Airway Obstructed with water immediately after rescue Breathing May be coughing if early rescue Agonal breaths if prolonged submersion Respiratory arrest if very prolonged submersion Circulation May be in cardiac arrest Skin is cyanotic Skin may be cold

6. SPECIAL MANAGEMENT CONSIDERATIONS If patient is in water be aware of EMT’s personal safety Risk of vomiting is high & if patient vomits Roll on side Suction mouth

7. CONSIDER POSSIBILITY OF SPINE INJURY If risk of spinal injury exists, manually stabilize the neck & spine If no risk of spinal injury exists & patient is breathing Place in recovery position Administer oxygen If no risk of spinal injury exists & patient is not breathing, follow American Heart Association guidelines for CPR

8. IN WATER SPINAL STABILIZATION Stabilize the spine with manual stabilization Restore airway & begin ventilation Secure patient to backboard Remove patient from water

9. AIRWAY, VENTILATION, & OXYGENATION Suction & maintain open airway Anticipate vomiting Position lateral recumbent if no risk of spinal injury Ventilate with bag-mask if impaired ventilation or respiratory arrest Use CPAP if unconscious & breathing Administer oxygen by non-rebreather mask if breathing is adequate

10. TRANSPORT CONSIDERATIONS Transport to appropriate facility All patients who had submersion injury with any report of signs & symptoms during or after submersion need transport to the hospital

11. WARNING Patients have been resuscitated after up to 2 hours of submersion Resuscitation efforts need to be started immediately upon getting patient to a place where resuscitation efforts can be started



14. LOSS OF BODY HEAT The amount & rate of heat loss or gain can be changed in 3 ways Increased or decreased heat production (Activity or inactivity) Going into a warmer or colder environment Wearing insulated clothing

15. HYPOTHERMIA Body temperature lowered below 95o F (35o F) Infants & elderly are at higher risk Illness & injury increases susceptibility for hypothermia Environment does not have to be freezing for risk of hypothermia

16. SIGNS & SYMPTOMS OF GENERALIZED HYPOTHERMIA Obvious exposure Subtle exposure Underlying illness Overdose/poisoning Ambient temperature decreased (e.g., cool home of elderly patient)

17. SIGNS & SYMPTOMS OF GENERALIZED HYPOTHERMIA Cool/cold skin temperature Place the back of your hand between the clothing & the patient's abdomen to assess the general temperature of the patient The patient experiencing a generalized cold emergency will present with cool or cold abdominal skin temperature iv. shivering

18. SIGNS & SYMPTOMS OF GENERALIZED HYPOTHERMIA Decreasing mental status or motor function Depends on the degree of hypothermia Poor coordination Mood changes Memory disturbances/confusion Reduced or loss of touch sensation Less communicative Dizziness Speech difficulty Stiff or rigid posture Muscular rigidity Slow pulse Poor judgment – patient may actually remove clothing Complaints of joint/muscle stiffness

19. SWISS SYSTEM OF HYPOTHERMIA CLASSIFICATION Stage Symptoms By Degree Temperature 1 Awake & shivering Mild 89.6-95.0o F (32-35o C) 2 Drowsy & not shivering Moderate 82.4-89.6o F (28-32o C) 3 Unconscious, not shivering Severe 68.0-82.4o F (20-28o C) 4 No vital signs Profound <68.0o F (20o C)

20. DO NOT Allow patient to walk, eat, use any stimulants, smoke (including e-cigarettes)or chew tobacco Massage extremities

21. LOCAL COLD EMERGENCIES Freezing or near freezing of a body part Usually occurs in fingers, toes, face, ears, & nose

22. THREE TYPES Frostnip Freezing of the outer skin but not the deeper surface Immersion foot (Trench foot) Prolonged exposure to cold water Frostbite Freezing of a body part, normally an extremity

23. REWARMING BATH Water temperature should be 100-102o F Regularly recheck temperature & Circulate water Keep affected body part in water until rewarmed & sensation returns Dress affected area with dry sterile dressings

24. MANAGEMENT CONSIDERATIONS FOR COLD RELATED LOCALIZED ILLINESS Move patient out of cold environment Administer oxygen Consider active rewarming if no chance of re- injury Immerse part in tepid (100 – 105 degrees Fahrenheit) water After rewarming, apply sterile dressings Keep patient warm Transport as soon as possible


26. HEAT EXPOSURE Normal body temperature is 98.6o F Body cools by dilation of blood vessels & sweating Body will attempt to maintain it’s temperature despite ambient temperature Humidity & temperatures may defeat body’s temperature control mechanisms

27. PATHPHYSIOLOGY OF HEAT RELATED ILLINESS Patient with moist, pale, cool skin – excessive fluid & salt loss Patient with hot, dry skin True emergency Seen on hot, humid days in patients with fluid & salt loss Body unable to regulate temperature

28. SIGNS & SYMPTOMS OF HEAT RELATED ILLINESS Moist, Pale Skin Muscle cramps Change in level of consciousness, dizziness Weakness Weak, rapid pulse Nausea & vomiting Apply pulse oximetry


30. PATHYPHYSIOLOGY OF BITES & ENVENMATIONS Spider bites (black widow) -- inject neurotoxins

31. PATHYPHYSIOLOGY OF BITES & ENVENMATIONS Snake bites -- rattlesnake is most common in United States Toxins affect blood & nervous system both at the bite site & systemically Patient age & size cause different effects Amount of toxin injected is related to toxicity (often none at all) Initial 6-8 hours of care is essential

32. BLACK WIDOW SPIDER Found in all states except Alaska Has a distinctive red-orange hour glass marking on abdomen Damages nerve tissue No recent reported deaths in the US Anti-venom primarily used for pain relief

33. 4 TYPES OF VENOMOUS SNAKES IN THE USRattle Snake Cottonmouth Copperhead Coral Snake

34. CORAL SNAKE Small snake with red, yellow, & black bands “Red on black, friend of Jack. Red on yellow kills a fellow” or “yellow, red, stop” for North America Primarily found in southern states Injects venom with teeth, using a chewing motion which leaves puncture wounds

35. SCORPION STINGS Venom gland & stinger in tail Primarily found in SE States Most species stings are only painful except the “Centruroides sculpturatus”

36. TICK BITES Ticks bite the skin & attach to skin Bite is not painful, but potential for infection Tick bites can carry Rocky Mountain Spotted Fever, Lyme Disease, Typhus, Tularemia, Colorado Tick Fever, & others

37. TICK BITES EMS care Wash & disinfect area Remove tick with tick tweezers Transport if indicated


39. DIVING INJURIES (DYSBARISM) Mechanism of Injury SCUBA diving at greater depths for long periods of time Repeated dives at depth on the same day

40. DECOMPRESSION SICKNESS AKA Caisson disease, bends A condition arising from the dissolved gases coming out of solution forming bubbles as the diver ascends from depth With current technology divers can stay under pressure for months at a time with long decompression times

41. S & S OF DECOMPRESSION SICKNESS Joint pain Primarily large joints 60-70% of time Skin Itching, sensation of insect bites, mottled or marbled, swelling of the skin S & S may not show up for hours after surfacing

42. FLYING Most aircraft fly with lower cabin pressures than at sea level This could cause a diver to have the gases in the blood stream to surface causing the bends Divers who may have needed decompression are told to refrain from flying for 48 hours after their dive

43. AIR EMBOLISM Signs & symptoms Blotching of skin Froth at mouth & nose Severe muscle, joint, & abdominal pain Dyspnea &/or chest pain Dysphasia Dizziness Nausea Vomiting Vision difficulties Paralysis &/or coma Irregular pulse or cardiac arrest

44. EAR SQUEEZE Caused by blockage of Eustachian tubes or failure to clear ears during descent S & S Pain in ear on assent Ringing in ears Bleeding from the ear


46. MARINE ANIMAL INJURIES Numerous aquatic animals have toxic bites or stings They include Sea urchin Jelly fish Portuguese man of war Fire coral Cone Snail Stingray Torpedo Ray

47. SEA URCHIN INJURY Hard spines are brittle & can easily break off upon entering the skin

48. JELLYFISH Has nematocysts that can be triggered by touch & inject venom into the skin Beached or dead jellyfish may sting Some species may be deadly

49. PORTUGUESE MAN O WAR Float on surface with tentacles that may reach 30 feet which have stinging nematocysts

50. FIRE CORAL Not a true coral but related to the jellyfish Stings in similar manor as jellyfish with similar S & S, & EMS care Divers often mistake fire coral for regular coral

51. CONE SNAIL They have a harpoon which can penetrate a wetsuit The harpoon injects a an analgesic which with some species can kill a human in 5 minutes by paralyzing the victim

52. STINGRAY Most injuries are caused by stepping on their venomous stinger Estimated 2,000 injuries annually in US Stinger in cm


54. ELECTRICAL INJURIES Skin wounds may not indicate seriousness of burn Entrance & exit wounds May cause cardiac arrest or other cardiac arrhythmias Lighting strikes may cause cardiac arrest

55. To purchase this EMT/EMT Powerpoint training presentation go to www.bravetraining.com Or tap the above link

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