Environmental emergencies: Nursing

An environmental emergency refers to an event or condition related to exposure to weather, which can include emergencies involving heat and cold.

Alright, so heat-related emergencies happen when the body’s normal thermoregulatory mechanisms like sweating, vasodilation, and increased respirations, are less effective in situations where there’s prolonged exposure to heat, or if there’s brief exposure to intense heat.

Heat exhaustion happens when heat exposure occurs over hours or days, like during a hike on a hot day, leading to a body temperature as high as 105.8° F or 41° C.

Other assessment findings can include anxiety, fatigue, nausea, thirst, and pale skin.

If left untreated, heat exhaustion can progress to heat stroke, which is a medical emergency. With heat stroke, the body’s thermoregulatory mechanisms fail, leading to a temperature above 105.8° F or 41° C. Other assessment findings can include weakness and hot, flushed, dry skin.

Now, in both heat exhaustion and heat stroke, fluid and electrolytes are lost through perspiration, which can manifest as tachycardia, weak pulses, and decreased blood pressure. In heat stroke, an excessive loss of sodium can lead to cerebral edema, brain hemorrhage, and mental status changes ranging from confusion to coma.

Alright, when caring for your patient with a heat-related emergency ensure they are in a cool environment. For heat exhaustion, provide fluid and electrolyte replacement orally, or intravenously, if needed. For heat stroke, provide high-flow oxygen and initiate continuous pulse oximetry; establish IV access to replace fluids and electrolytes; and initiate rapid cooling measures.

These could include placing wet sheets over your patient and placing them in front of a fan to increase airflow over their body; placing ice packs on their groin and axillae; or immersing them in a tepid or cool water bath. Be sure to monitor their temperature closely to control shivering, which can lead to heat production.