Chapter 11; care of patients with environmental emergencies and I am going to skip through these first few slides because we discussed these in class this week. So I believe we left off we were talking about heat stroke complications because I do remember getting in there and talking about coagulopathy, that was related to directly pulmonary edema and also cerebral edema are some common complications that are going to be associated with heat stroke. Heat stroke in the prehospital setting, of course rapid cooling is priority, you can imagine most people that are prone to heat stroke are probably going to be outside in the hot humid weather like we kind of discussed already. So in the acute care setting, oxygen therapy as indicated of course, that is going to be definitely relative to what their needs are at the time. If they’re having difficulty breathing, if their O2 stats are low. We always to fluid resuscitate with 0.9 NS if we’re not sure exactly what type of electrolytes have been lost or how badly those electrolytes have been effected. Cool them down quickly, I shouldn’t say quickly, I should say aggressively as it does on this slide, quick cooling down can also cause further complications that we may not want to occur such as shivering. Thorazine is a medication you may give for shivering, Thorazine is an excellent antiemetic, valium is given for seizures associated with cerebral edema, that is related to the heat stroke. Your book has some pages associated with snake bites, I just want to lend a little bit of time here. I am not a master of even being able to recognize these snakes, however I know that some of them are definitely very common around here. I transitioned to the south as part of my travels and I can honestly say I have never taken care of patients that have been bitten until I got down in the south. It was a pretty common complication or diagnoses, or admitting diagnoses particularly in the summer of course. Something I got familiar with pretty quickly and actual names of snakes. I actually walked out of my house and there was a cotton mouth on my front door steps, so I have become at least familiar with the names now since I have been welcomed to Georgia/Carolina area. Venomization, the grades of venomization or the ability for venom to penetrate the system are going to be really dependent on the sake of our assessment if there are fang marks left, the degree or grade of swelling, what type of pain they have, and if that client is having any systemic reactions. I have had patient lose an arm because of the swelling and compartment syndrome that developed as a result of a snake bite. Some effects of venomization are going to be of course local tissue necrosis, massive tissue swelling, again a big part of that problem is going to be compartmentalization where clients may have to end up having a fasciotomy done because the swelling can happen so very quickly. Intravascular fluid shifts and
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- Winter '16
- Brown recluse spider, pulmonary edema, Spider bite, triage