EMS World

AUG 2011

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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ASSESSMENT TIPS body heat through direct contact with colder objects in the environment. • Respiration dissipates heat by exhaling warm air from the lungs and inhaling colder ambient air. The amount of heat loss is depen- dent upon both rate and depth of respiration. • Evaporation of perspiration or water on skin results in heat loss. In high-humidity environments, high moisture content of air may severely curtail or prevent evaporative heat loss. Assessment starts with obtaining an accurate measurement of the patient’s core temperature. Methods vary from thermal sensing of the tympanic membrane or temporal artery to temperature-sensing skin strips; the most reliable and accurate means is still the rectal thermometer. Temperature- sensing strips are highly inaccurate. During transport to the trauma center, the paramedic infuses two liters of Ringer’s lactate solution without appreciable improvement in the patient’s level of consciousness or vital signs. Heat Emergencies When the body can no longer shed heat effectively and the tempera- ture rises above the body’s set point, hyperthermia occurs. Fever is an increase in the body’s temperature set point resulting from the body’s infl ammatory response to pathogens. In this lesson, we will limit our discussion to hyper- thermia from environmental causes. Heat emergencies are classifi ed by skin signs, symptoms and core temperature: • Heat exhaustion is character- ized by moist skin that feels cool or normal. At this stage, the body is still able to dissipate heat through radia- tion and perspiration. Loss of electro- lytes through sweat is the main cause of symptoms, and the patient may complain of thirst. He may experi- ence weakness, dizziness, nausea and vomiting, and cramps of the muscles in the abdomen or legs resulting from loss of electrolytes, particularly potas- sium, in perspiration. • Heat stroke is a life-threat- ening condition that occurs when the body cannot dissipate heat and core temperature rises above 105°F (40.5°C). Sustained temperatures above 105°F (40.5°C) can result in seizures, brain damage, organ failure and eventually death. Heat stroke is usually characterized by hot skin, which may or may not be dry, tachy- cardia and neurological changes such as confusion, disorientation and poor coordination. Seizures, coma and death can rapidly follow unless aggressive cooling measures are taken. Basic treatment steps for heat-related emergencies begin with removing the patient from the hot environment, Mobile Printing Solutions for Emergency Services FIRE – AMBULANCE – POLICE Printrex is introducing a lower-profile mobile printer for ambulance and police. The Printrex 812 is widely used in fire trucks, but the smaller confines of ambulance and police vehicles demand a smaller envelope. The wall-mounted Printrex 811 projects a tiny profile that is less than 4 inches high and less than 3 inches deep. An optional quick release system is available. The 811 will be available in the fourth quarter of 2011. &BTU (JTI 3PBE 4BO +PTF $" t 3-1 Printrex has been supplying printers for mobile emergency services since 1996, beginning with installations at the Hereford & Worcester Fire Brigade in the UK. That initial installation was very successful and now installation of 4,000 + units for the UK FireLink program is nearing completion. www.printrex.com Visit us at EMSWORLD EXPO Booth 3328 For More Information Circle 14 on Reader Service Card 30 AUGUST 2011 | EMSWORLD.com See Us at EMS Expo Booth #3328

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