CHAPTER 33 Case Study Environmental Emergencies
Description: CHAPTER 33 Case Study Environmental Emergencies Part 1 At 15:12 hours you and your EMT partner are dispatched to the Green Valley Mobile Home Park for a sick person. When you arrive in front of the mobile home you see an older woman
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slide1. CHAPTER 33 Case Study Environmental Emergencies<br>
slide2. Part 1 At 15:12 hours you and your EMT partner are dispatched to the Green Valley Mobile Home Park for a sick person. When you arrive in front of the mobile home you see an older woman standing on the front porch waving at you. As you approach, the woman states that she just got home and found her husband on the couch not responding appropriately.<br>
slide3. Part 1 As you enter the residence you note that it is very hot, and there appears to be no source of ventilation. You find an older man lying on the couch. He is conscious but disoriented. He has a patent airway and is breathing at a rate of 22 breaths/min. His breathing appears to be very shallow. His skin is red, hot, and dry to the touch.<br>
slide4. Part 1 What does the condition of the residence potentially tell you about your patient’s condition?
What does your index of suspicion tell you about your patient’s skin color and condition?<br>
slide5. Part 2 As your partner applies high-flow oxygen via a nonrebreathing mask, you call for ALS backup. Further assessment shows a rapid and thready pulse, low blood pressure, pupils that are sluggish to react, and a temperature of 104°F. You find no signs of traumatic injury. You remove any constricting clothing and jewelry. With your partner’s assistance, you move your patient out of the hot environment and into your ambulance.<br>
slide6. Part 2 Once you and the patient are in the ambulance, what special treatment does your patient need?
How serious is this emergency?<br>
slide7. Part 3 Once in the ambulance, you set the air conditioner on high. You remove the remaining clothing from your patient. You apply cool packs to the patient’s neck, groin, and armpits. The patient’s wife provides you with additional information about your patient. She states that her husband had been working out in the yard for about 2 hours when he came in complaining that he was hot and felt a bit dizzy.<br>
slide8. Part 3 She had told him to sit down at the kitchen table and eat the sandwich that she had made for him. She went to the neighbor’s house for a few minutes. When she returned, she found her husband lying on the couch mumbling inappropriately.<br>
slide9. Part 3 She immediately called 9-1-1. She then tells you that he has an allergy to milk and cats. He takes furosemide (Lasix) twice a day and a medication for high blood pressure, but she is unsure of the name. He was diagnosed with high blood pressure 4 years ago. He has been relatively healthy for the last few years.<br>
slide10. Part 3 Of what significance is the patient’s medication to his current condition?
What medical condition do you suspect?<br>
slide11. Part 4 Your partner tells you that the ALS unit has been delayed and will not be on scene for 25 minutes. You consider the current condition of your patient and you choose to transport immediately and rendezvous with the ALS unit en route. You prepare your patient for transport.<br>
slide12. Part 4 You spray water on the patient and begin fanning him, constantly reassessing his airway, breathing, circulation, and responsiveness. You notify the hospital personnel of your patient’s condition and continue with a rapid transport.<br>
slide13. Part 4 What are the possible ramifications of lowering the temperature of a patient with hyperthermia too quickly or lowering the temperature too far?<br>
slide14. Summary With a hyperthermic patient, ensure that you rapidly cool your patient but do not cause hypothermia as a result. As with any patient, it is imperative that you survey the scene for clues. Call for backup when needed. Complete an appropriate assessment and treat accordingly. With an environmental emergency such as this, be sure to remove your patient from the hot environment and cool the patient aggressively. Transport immediately and notify the receiving agency of the patient’s condition.<br>
slide2. Part 1 At 15:12 hours you and your EMT partner are dispatched to the Green Valley Mobile Home Park for a sick person. When you arrive in front of the mobile home you see an older woman standing on the front porch waving at you. As you approach, the woman states that she just got home and found her husband on the couch not responding appropriately.<br>
slide3. Part 1 As you enter the residence you note that it is very hot, and there appears to be no source of ventilation. You find an older man lying on the couch. He is conscious but disoriented. He has a patent airway and is breathing at a rate of 22 breaths/min. His breathing appears to be very shallow. His skin is red, hot, and dry to the touch.<br>
slide4. Part 1 What does the condition of the residence potentially tell you about your patient’s condition?
What does your index of suspicion tell you about your patient’s skin color and condition?<br>
slide5. Part 2 As your partner applies high-flow oxygen via a nonrebreathing mask, you call for ALS backup. Further assessment shows a rapid and thready pulse, low blood pressure, pupils that are sluggish to react, and a temperature of 104°F. You find no signs of traumatic injury. You remove any constricting clothing and jewelry. With your partner’s assistance, you move your patient out of the hot environment and into your ambulance.<br>
slide6. Part 2 Once you and the patient are in the ambulance, what special treatment does your patient need?
How serious is this emergency?<br>
slide7. Part 3 Once in the ambulance, you set the air conditioner on high. You remove the remaining clothing from your patient. You apply cool packs to the patient’s neck, groin, and armpits. The patient’s wife provides you with additional information about your patient. She states that her husband had been working out in the yard for about 2 hours when he came in complaining that he was hot and felt a bit dizzy.<br>
slide8. Part 3 She had told him to sit down at the kitchen table and eat the sandwich that she had made for him. She went to the neighbor’s house for a few minutes. When she returned, she found her husband lying on the couch mumbling inappropriately.<br>
slide9. Part 3 She immediately called 9-1-1. She then tells you that he has an allergy to milk and cats. He takes furosemide (Lasix) twice a day and a medication for high blood pressure, but she is unsure of the name. He was diagnosed with high blood pressure 4 years ago. He has been relatively healthy for the last few years.<br>
slide10. Part 3 Of what significance is the patient’s medication to his current condition?
What medical condition do you suspect?<br>
slide11. Part 4 Your partner tells you that the ALS unit has been delayed and will not be on scene for 25 minutes. You consider the current condition of your patient and you choose to transport immediately and rendezvous with the ALS unit en route. You prepare your patient for transport.<br>
slide12. Part 4 You spray water on the patient and begin fanning him, constantly reassessing his airway, breathing, circulation, and responsiveness. You notify the hospital personnel of your patient’s condition and continue with a rapid transport.<br>
slide13. Part 4 What are the possible ramifications of lowering the temperature of a patient with hyperthermia too quickly or lowering the temperature too far?<br>
slide14. Summary With a hyperthermic patient, ensure that you rapidly cool your patient but do not cause hypothermia as a result. As with any patient, it is imperative that you survey the scene for clues. Call for backup when needed. Complete an appropriate assessment and treat accordingly. With an environmental emergency such as this, be sure to remove your patient from the hot environment and cool the patient aggressively. Transport immediately and notify the receiving agency of the patient’s condition.<br>