EMT-Basic Exam: The Basics of Medical Emergencies - Environmental Emergencies

Environmental emergencies are medical situations that arise from the outdoor environment. These emergencies are often related to weather, water, and bites or stings from various animals. It is important for EMT-Basics to recognize the signs of these emergencies in order to provide adequate prehospital care.
Remember, EMT-Basics responding to environmental emergencies should take the necessary precautions to protect themselves from danger before attempting to assess and treat the patient.

1. Thermoregulatory Emergencies
Thermoregulatory emergencies are situations in which the patient has endured a significant increase or decrease in body temperature. Exposure to excessive cold can lead to hypothermia. Hypothermia is a condition in which the body’s core temperature falls below 98.6°F (37°C).
Generalized hypothermia affects the whole body. The primary sign of generalized hypothermia is impaired mental status and motor function. As a result of the body’s attempt to warm itself, the patient will exhibit elevated heart and breathing rates. As the hypothermia worsens, the patient’s vital signs will diminish. Patients with generalized hypothermia should be warmed with blankets and heat packs. Warmed and humidified oxygen can also be administered.
Local cold injuries are specific to certain parts of the body, most commonly the extremities. Examples of these types of injuries include frostbite and frostnip. Local cold injuries are caused by decreased blood flow to or actual freezing of certain body parts. Body parts with local cold injuries should be protected from further injuries and wet or restrictive clothing and jewelry should be removed immediately.
Hyperthermia occurs when a patient’s body temperature rises above 98.6°F (37°C). Hyperthermia is most common in hot and humid weather. Dehydration is often a contributing factor of this condition. Symptoms of hyperthermia include muscle cramps; weakness; dizziness; rapid, pounding heartbeat; altered mental state; nausea; vomiting; and abdominal cramps.
EMT-Basics can treat patients suffering from hyperthermia by applying cool packs to the neck, groin, and armpits. It is also important for you to remove the patient from the heat immediately and arrange for transport to the hospital.

2. Drowning and Near-Drowning
Drowning is death that results from immersion in water and near-drowning occurs when a patient survives an immersion event. Water rescues can be extremely dangerous. It is important to remember that you should not attempt to rescue a victim from the water unless you have specialized training. In many cases, lifeguards or bystanders may remove the victim from the water before your arrival. At this point, you can begin to assess and treat the patient.
Near-drowning incidents frequently involve spinal injuries caused when the victim strikes an object such as a diving board or the bottom of a body of water. Remember, you should always immobilize the patient’s spine if a spinal injury is suspected. A victim of a near-drowning will most likely require fluid removal from the airway. Artificial ventilation may also be necessary and transport to the nearest hospital should be arranged.

3. Bites and Stings
Environmental emergencies may also involve bites or stings from various animals and insects. Patients who suffer animal or insect bites or stings may exhibit a number of symptoms, including rashes, localized pain, redness, swelling, weakness, dizziness, chills, fever, nausea, and vomiting.
In these situations, your most important task is to ensure that the patient’s airway is clear. Other important tasks in these situations might involve removing stingers, cleaning bite wounds, and observing the patient for signs of an allergic reaction. When a bite or sting is on an extremity, you should position the bite below the patient’s heart.

Tip: If a patient suffers from a bite or sting, remove any jewelry or tight-fitting clothing from the affected area before swelling occurs.

Related Topics You Should Review:
- Body temperature regulation
- Factors that predispose an individual to hypothermia and hyperthermia
- Allergic reactions to animal or insect bites or stings