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Referencing the content of EMT-Basic training and emergency patient care

EMT Basic · Chapter 33

Environmental Emergencies

Learning objectives (28)

  1. Demonstrate how to care for a patient who has been bitten by a coral snake and is showing signs of envenomation — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  2. Demonstrate how to care for a patient who has been bitten by a pit viper and is showing signs of envenomation — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  3. Demonstrate how to care for a patient who has sustained a coelenterate envenomation — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  4. Demonstrate how to treat a patient with heat cramps — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  5. Demonstrate how to treat a patient with heat exhaustion. (pp 1215–1217, Skill Drill 33-1) 5. Demonstrate how to treat a patient with heatstroke — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  6. Demonstrate how to use a warm-water bath to rewarm the limb of a patient who has sustained a local cold injury — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  7. Demonstrate the emergency medical treatment of local cold injuries in the field — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  8. Describe drowning, including its incidence, risk factors, and prevention — Knowledge/skills objective (printed page 1199); confirm wording in your course copy.
  9. Describe local cold injuries and their underlying causes — Knowledge/skills objective (printed page 1199); confirm wording in your course copy.
  10. Describe the five ways heat loss occurs in the body, and how the rate and amount of heat loss or gain can be modified in an emergency situation — Knowledge/skills objective (printed page 1199); confirm wording in your course copy.
  11. Describe the four general stages of hypothermia — Knowledge/skills objective (printed page 1199); confirm wording in your course copy.
  12. Describe the process of providing emergency care to a patient who has been bitten by each of the following types of snake and is showing signs of envenomation: — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  13. Describe the process of providing emergency care to a patient who has been involved in a drowning or diving emergency, including assessment of the patient, review of signs and symp — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  14. Describe the process of providing emergency care to a patient who has been stung by a coelenterate or other marine animal — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  15. Describe the process of providing emergency care to a patient who has sustained a bite or sting from each of the following insects and arachnids, including steps the EMT should fol — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  16. Describe the process of providing emergency care to a patient who has sustained a cold injury, including assessment of the patient, review of signs and symptoms, and management of — Knowledge/skills objective (printed page 1199); confirm wording in your course copy.
  17. Describe the process of providing emergency care to a patient who is experiencing a heat emergency, including assessment of the patient, review of signs and symptoms, and managemen — Knowledge/skills objective (printed page 1199); confirm wording in your course copy.
  18. Describe the process of providing emergency care to patients who have been bitten by each of the following venomous spiders: — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  19. Describe the three emergencies that are caused by heat exposure, including their risk factors, signs, and symptoms — Knowledge/skills objective (printed page 1199); confirm wording in your course copy.
  20. Describe the three types of diving emergencies, how they may occur, and their signs and symptoms — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  21. Discuss lightning injuries, including their incidence, risk factors, signs and symptoms, and emergency medical treatment — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  22. Discuss recovery techniques and resuscitation efforts EMTs may need to follow when managing a patient who has been involved in a submersion incident — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  23. Discuss the types of dysbarism injuries, including their incidence, risk factors, signs and symptoms, and emergency medical treatment — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  24. Explain the importance of following local protocols when rewarming a patient who is experiencing moderate or severe hypothermia — Knowledge/skills objective (printed page 1199); confirm wording in your course copy.
  25. Explain why EMTs should have a prearranged rescue plan based on the environment in which they work — Knowledge/skills objective (printed page 1199); confirm wording in your course copy.
  26. Identify the four factors that affect how a person deals with exposure to a cold or hot environment — Knowledge/skills objective (printed page 1199); confirm wording in your course copy.
  27. List five conditions that may result in a spinal injury following a submersion incident and the steps for stabilizing a patient with a suspected spinal injury in the water — Knowledge/skills objective (printed page 1200); confirm wording in your course copy.
  28. List the basic rules of performing a water and ice rescue — Knowledge/skills objective (printed page 1199); confirm wording in your course copy.

Vocabulary (11)

Heat cramps
Painful muscle cramps that occur during heavy exertion in heat, related to sodium and fluid loss in sweat.
Heat exhaustion
Heat illness with profuse sweating, weakness, nausea, and normal-to-mildly-elevated core temperature; mental status remains intact.
Heat stroke
Life-threatening heat illness with altered mental status and very high core temperature; requires rapid cooling.
Hypothermia
Core body temperature below 95°F (35°C); may progress from shivering to confusion, loss of consciousness, and cardiac arrest.
Frostbite
Local tissue injury from freezing — typically of fingers, toes, ears, nose; severity ranges from frostnip to deep tissue loss.
Trench foot
Non-freezing cold injury from prolonged exposure of feet to cold, wet conditions; reversible if treated early.
Drowning
The process of respiratory impairment from submersion or immersion in a liquid; outcome can be survival, morbidity, or death.
Lightning strike injury
Multi-system trauma from very high-voltage direct or indirect lightning discharge, often with cardiac arrest and central nervous system injury.
Decompression sickness ('bends')
A diving injury caused by nitrogen bubbles forming in tissue when ascending too rapidly; presents with joint pain, rashes, or neurologic symptoms.
Air embolism
Entry of air into the bloodstream — for example, from rapid uncontrolled diving ascent — that can cause stroke-like symptoms or cardiac arrest.
Wind chill
The perceived effect of cold on exposed skin caused by the combination of air temperature and wind speed.

Sequence practice (2 puzzles on Quiz Me)

Field management of hypothermia

Order EMT steps for a hypothermic patient.

  1. Remove the patient gently from the cold environment
  2. Remove wet clothing; cover with dry blankets and shield from wind
  3. Handle the patient gently — the cold heart is prone to ventricular fibrillation
  4. Initiate passive rewarming with blankets and a warm cabin
  5. Provide oxygen as needed; check for a pulse for up to 45 seconds if severe
  6. Transport to definitive care; avoid rapid external rewarming in the field
Field management of heat stroke

Order EMT steps for a heat-stroke patient.

  1. Recognize: high body temperature with altered mental status after heat exposure
  2. Move to a cool, shaded environment
  3. Remove excess clothing
  4. Apply active cooling — wet sheets with fanning, ice packs to neck, groin, and axilla
  5. Provide oxygen; do not give oral fluids if obtunded
  6. Rapid transport — heat stroke is a true emergency

Quick fire sample (11 of 11 on Quiz Me)

Painful muscle cramps that occur during heavy exertion in heat, related to sodium and fluid loss in sweat.
  1. Frostbite
  2. Trench foot
  3. Heat cramps
  4. Heat exhaustion
Heat illness with profuse sweating, weakness, nausea, and normal-to-mildly-elevated core temperature; mental status remains intact.
  1. Frostbite
  2. Heat stroke
  3. Heat exhaustion
  4. Drowning
Life-threatening heat illness with altered mental status and very high core temperature; requires rapid cooling.
  1. Heat stroke
  2. Air embolism
  3. Hypothermia
  4. Frostbite
Core body temperature below 95°F (35°C); may progress from shivering to confusion, loss of consciousness, and cardiac arrest.
  1. Hypothermia
  2. Lightning strike injury
  3. Wind chill
  4. Trench foot
Local tissue injury from freezing — typically of fingers, toes, ears, nose; severity ranges from frostnip to deep tissue loss.
  1. Air embolism
  2. Frostbite
  3. Heat exhaustion
  4. Drowning
Non-freezing cold injury from prolonged exposure of feet to cold, wet conditions; reversible if treated early.
  1. Drowning
  2. Trench foot
  3. Decompression sickness ('bends')
  4. Hypothermia
The process of respiratory impairment from submersion or immersion in a liquid; outcome can be survival, morbidity, or death.
  1. Heat stroke
  2. Drowning
  3. Trench foot
  4. Decompression sickness ('bends')
Multi-system trauma from very high-voltage direct or indirect lightning discharge, often with cardiac arrest and central nervous system injury.
  1. Trench foot
  2. Heat exhaustion
  3. Air embolism
  4. Lightning strike injury
A diving injury caused by nitrogen bubbles forming in tissue when ascending too rapidly; presents with joint pain, rashes, or neurologic symptoms.
  1. Wind chill
  2. Frostbite
  3. Heat exhaustion
  4. Decompression sickness ('bends')
Entry of air into the bloodstream — for example, from rapid uncontrolled diving ascent — that can cause stroke-like symptoms or cardiac arrest.
  1. Air embolism
  2. Drowning
  3. Heat stroke
  4. Trench foot
The perceived effect of cold on exposed skin caused by the combination of air temperature and wind speed.
  1. Hypothermia
  2. Wind chill
  3. Lightning strike injury
  4. Drowning

Some topics in this course differ across field references. See when sources disagree on Quiz Me before you teach from this sheet alone.

Full scored drills are on Quiz Me at /courses/nm-emt-b/chapters/33/print/. Answers are not marked on this sheet.