NREMT EMT 4: Patient Treatment and Transport - Environmental Emergencies, Hypothermia, Heat Stroke, Drowning, Lightning Injuries

What This Is: Environmental Emergencies

Environmental emergencies occur when the body is exposed to extreme temperatures, water, or electrical forces. A real-world example is a hiker who gets caught in a sudden snowstorm and starts to shiver uncontrollably. Think of environmental emergencies like a car's engine – if it overheats or freezes, it won't run properly.

Key Steps / Core Facts:

• Hypothermia: A body temperature below 95°F (35°C). It matters because hypothermia can cause confusion, slurred speech, and even death. Example: A 3-year-old child playing outside in 40°F (4°C) weather for 30 minutes can develop hypothermia. (OPQRSTI)
  • Assess for hypothermia: Look for shivering, confusion, or slurred speech. If you suspect hypothermia, call 911.
  • Hypothermia treatment: Move the person to a warm location, remove wet clothing, and use a blanket or emergency blanket.
• Heat Stroke: A body temperature above 104°F (40°C). It matters because heat stroke can cause seizures, coma, and death. Example: A 50-year-old construction worker working in direct sunlight for 2 hours without water can develop heat stroke. (OPQRSTI)
  • Assess for heat stroke: Look for a body temperature above 104°F (40°C), confusion, or altered mental status. If you suspect heat stroke, call 911.
  • Heat stroke treatment: Move the person to a cool location, remove excess clothing, and use cool water to lower their body temperature.
• Drowning: When the body is submerged in water for an extended period. It matters because drowning can cause brain damage, cardiac arrest, and death. Example: A 2-year-old child playing near a pool for 5 minutes can drown. (AVPU)
  • Assess for drowning: Look for a lack of coughing, blue lips or skin, or a lack of response to verbal commands. If you suspect drowning, call 911.
  • Drowning treatment: Start CPR if the person is unresponsive, and use a backboard to immobilize the spine.
• Lightning Injuries: Electrical shock caused by lightning. It matters because lightning injuries can cause cardiac arrest, burns, and death. Example: A 30-year-old hiker struck by lightning during a thunderstorm can develop a lightning injury. (SAMPLE)
  • Assess for lightning injuries: Look for burns, cardiac arrest, or altered mental status. If you suspect a lightning injury, call 911.
  • Lightning injury treatment: Start CPR if the person is unresponsive, and use a defibrillator if available.

What Laypeople Can Do:

• If someone is experiencing hypothermia, move them to a warm location and remove wet clothing.
• If someone is experiencing heat stroke, move them to a cool location and remove excess clothing.
• If someone is drowning, call 911 and start CPR if they are unresponsive.
• If someone is injured by lightning, call 911 and start CPR if they are unresponsive.

Common Mistakes:

• Mistake: Not recognizing the signs of hypothermia or heat stroke.
• Fix: Pay attention to body temperature, confusion, and altered mental status.
• Mistake: Not calling 911 in a drowning or lightning injury.
• Fix: Call 911 immediately if you suspect a drowning or lightning injury.
• Mistake: Not starting CPR in a cardiac arrest.
• Fix: Start CPR if the person is unresponsive and not breathing.

Quick Practice Scenarios:

• A 5-year-old child is playing outside in 40°F (4°C) weather for 30 minutes and starts to shiver uncontrollably. What should you do first?
  • Answer: Move the child to a warm location and remove wet clothing.
  • Reason: Hypothermia can cause confusion and death if not treated promptly.
• A 30-year-old hiker is struck by lightning during a thunderstorm and collapses to the ground. What should you do first?
  • Answer: Call 911 and start CPR if the person is unresponsive.
  • Reason: Lightning injuries can cause cardiac arrest and death if not treated promptly.
• A 2-year-old child is playing near a pool for 5 minutes and suddenly stops moving. What should you do first?
  • Answer: Check the child's airway, breathing, and circulation (ABCs) and call 911 if they are unresponsive.
  • Reason: Drowning can cause brain damage and death if not treated promptly.

Last-Minute Exam Cram:

• Normal body temperature is between 97.7°F (36.5°C) and 99.5°F (37.7°C).
• CPR compression depth is at least 2 inches (5 cm).
• Hypothermia treatment involves moving the person to a warm location and removing wet clothing.
• Heat stroke treatment involves moving the person to a cool location and removing excess clothing.
• Drowning treatment involves starting CPR if the person is unresponsive.
• Lightning injury treatment involves starting CPR if the person is unresponsive.
• Agonal breathing is NOT normal breathing – start CPR.
• The OPQRSTI mnemonic is used to assess for hypothermia and heat stroke.
• The AVPU mnemonic is used to assess for drowning.
• The SAMPLE mnemonic is used to assess for lightning injuries.