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Chapter 4: Environmental Injuries and Illnesses

Video 4a: Bites and Stings
Script: Welcome to the lesson on Bites and Stings. In this video, we will discuss the signs and symptoms of bites and how to care for specific cases of bites and stings.

Insect bites and stings are a common and annoying occurrence. Most bites are minor but the potential for a serious allergic reaction does exist.

Signs and symptoms of a serious reaction consist of nausea or vomiting, severe pain at the site, abdominal pain, difficulty breathing, muscle rigidity, headache, and decreased responsiveness. If any of these signs or symptoms occur, immediately call 911.

The black widow spider bite is known to cause severe abdominal pain that can mimic appendicitis in children.

Signs of the tick-borne disease include fever, headache, joint pain, and skin rash. To remove an attached tick, grasp it by the head with tweezers and pull straight out. Clean the area with soap and water or an alcohol swab. If the tick bite occurred in a geographic area where the tick-borne disease occurs, seek medical treatment for possible prophylactic antibiotic therapy.

Seek medical treatment for “bull’s eye” rash produced by Lyme disease.

For bee stingers, remove it by scraping it away. Wash the area with cold water and apply ice. Stay with the individual for at least 30 minutes as some allergic reactions can be delayed in onset.

A bite from an animal, such as a raccoon, bat, skunk fox, or coyote, carries the highest risk of rabies. Always make sure that the scene is safe when providing first aid to someone with an animal bite. Contact the emergency response system as an animal control officer may be able to capture the animal and determine the risk of rabies. To care for the animal bite, clean the wound with soap and water, and control bleeding by applying direct pressure. Animal bites are prone to infection and can cause further injury due to the puncture nature of the wound. Seek medical care by a qualified health care professional for any bite that breaks the skin, or if there is concern about rabies or other infection.

Snakebites also require medical attention. As the pain gets worse, swelling occurs, bruising develops, or systemic signs (nausea and vomiting) develop in case of a snakebite, call 911 immediately, and do not delay medical attention. Make sure the scene is safe, and the snake is no longer a threat. Keep the individual calm and try to avoid moving the extremity that was bitten. Remove any constricting clothing and jewellery from the affected area. Gently wash the affected area with soap and water if available. Do not apply a tourniquet. Additional care should be sought in a hospital setting.

This concludes our lesson on Bites and Stings. Next, we will review Temperature Related Illnesses.

Video 4b: Heat-Related Illnesses
Script: Welcome to the lesson on Heat-Related Illnesses. In this video, we will discuss symptoms of heat-related illnesses, such as heat cramps, heat exhaustion, heat strokes, and sunburns.

Heat-related illnesses can occur due to extremes of temperature, particularly in the elderly and during vigorous exercise.

Heat cramps result in painful muscle spasms of the extremities, the back, and the stomach. Sweating and headache may accompany the cramps. Symptoms of heat cramps usually resolve with resting, cooling-off, and drinking water or a sports drink. Light stretching and massage can also be helpful.

Heat exhaustion is more serious than heat cramps. Signs of heat exhaustion consists of dizziness, vomiting, muscle cramps, fatigue, increased sweating, and lightheadedness. To care for someone dealing with heat exhaustion, immediately move them to a cooler environment. Have them lie down and loosen or remove as much clothing as possible. Use cool water to spray them and fan them if possible. Encourage them to drink water or a sports drink. Remain with them until advanced help arrives.

Heat strokes, on the other hand, are life-threatening and require immediate action. Signs and symptoms of heat stroke consist of confusion, loss of consciousness, dizziness, muscle cramps, vomiting, and seizures. If you think someone is having a heat stroke, immediately call 911.

To care for someone with heat stroke, first assess scene safety, wear personal protective equipment, and get the first aid kit and AED.

Then, use a spray bottle filled with cold water and a fan to cool them.

If the individual is able to do so, have them drink water or a sports drink.

Continue to cool them until their behaviour returns to normal or until advanced help arrives.

This concludes our lesson on Heat-Related Illnesses. Next, we will review Sunburns.

Video 4c: Sunburns
Script: Welcome to the lesson on Sunburns. In this video, we will discuss the causes and symptoms of sunburns and how to care for sunburns.

Sunburns are caused by exposure to UV radiation from sunlight. Sunburns can be minor or result in blistering and sloughing of skin. In case of sunburn, have the individual avoid additional sun exposure. Have them hydrate and drink extra fluids. Topical aloe vera can provide symptomatic relief. If they are not allergic, ibuprofen can also help alleviate some discomfort.

This concludes our lesson on Sunburns. Next, we will review Frostbites.

Video 4d: Frostbites
Script: Welcome to our lesson on Frostbites. In this video, we will review causes, symptoms, and care for frostbites.

Frostbites are a result of exposure to cold and are most common in ears, nose, fingers, and toes. Wind chill increases the risk of frostbite. In severe cases, ice crystals form in the tissues and destroy cells causing permanent damage. In the case of frostbites, the skin appears waxy and white and yellow-grey. The frostbite area is cold and numb and may feel like a block of wood. The frostbite tissue is firm and does not move or compress easily when squeezed. However, do not try to rub, squeeze, or slap the affected extremity as this may increase tissue damage.

To care for frostbites, first, get the individual to a warm place, and then call 911.

Remove any constricting clothing and all jewellery from the affected body part. Remove all wet clothing as well. Redress them in dry, warm clothing and cover them with a heavy blanket.

The frostbitten extremity should be quickly rewarmed in hot water (104 degrees F). However, do not rewarm a frozen extremity if there’s a risk of refreezing.

Seek further care from a health care professional.

This concludes our lesson on Frostbites. Next, we will review Hypothermia.

Video 4e: Hypothermia
Script: Welcome to our lesson on Hypothermia. In this video, we will review signs and symptoms of hypothermia and hot to take of hypothermia cases.

Hypothermia is a potentially life-threatening condition when the body temperature falls dangerously low. Hypothermia can even develop in non-freezing temperatures. Signs and symptoms consist of behaviour change (confusion or lethargy), paradoxical undressing, shivering (stops as hypothermia worsens), muscle stiffness, cold skin, decreased respiratory effort, and progression to unresponsiveness and death.

To care for someone with hypothermia, rapid action is required. Start by removing the individual from the cold and get them to a warm environment.

Remove any wet clothing and dry the individual. Redress them in dry, warm clothing and cover them with a blanket. Cover the head as it is a source of significant heat loss.

Be prepared to perform CPR. Stay with the person until advanced help arrives.

This concludes our lesson on Hypothermia. Next, we will review Toxin and Poison Exposure.

Video 4f: Toxin and Poison Exposure
Script: Welcome to the lesson on Toxin and Poison Exposure. In this lesson, we will discuss how to provide care for situations of toxin and poison exposure.

The list of toxins and potential poison exposures is extensive and beyond the scope of this video and the CPR handbook. A material safety data sheet (or MSDS) is required where chemicals are in use in businesses and institutions. The data sheets provide information about the composition of various chemicals and are useful when contacting poison control.

To provide first aid care for toxin and poison exposure, first call 911. Tell the dispatcher about the chemicals involved.

Ensure scene safety and wear personal protective equipment.

Get the first aid kit and the AED.
Remove the individual from the toxin or poison and seek a well-ventilated area if possible.

Remove saturated clothing if present.

Follow any recommendations from the 911 dispatcher or the MSDS sheet.

Stay with them until advanced help arrives.

If CPR is required, ensure the mask is used if possible.

When treating any toxin and poison exposures, the eyes should be flushed with copious amounts of water. Acids and alkaline solutions are particularly caustic and can lead to permanent vision impairments or loss.

This concludes our lesson on Toxin and Poison Exposure. Next, we will review Adult CPR.