IDTANDY
03-11-2012, 08:50 PM
This is good reference.Medical types or not .
There is a DIFFERENTIAL DIAGNOSIS MATRIX in attachment 2.
http://www.e-publishing.af.mil/shared/media/epubs/AFMAN44-158.pdf
Page example.
AFMAN 44-158 1DECEMBER 1999 73
Chapter 14
ENVIRONMENTAL INJURY PROTOCOLS
14.1. Heat Stress Injuries
14.1.1. Heat Cramps
14.1.1.1. Etiology - loss of Sodium Chloride (NaCl): Signs and symptoms: Abrupt onset, muscle cramps
/ muscle spasms profuse sweating, hyperventilation, normal body temperature.
14.1.1.2. IMMEDIATE ACTION:
14.1.1.2.1. Move patient to a cool environment
14.1.1.2.2. Have patient drink liquids, especially with high sodium or saline content.
14.1.1.2.3. Work muscles using passive stretching techniques.
14.1.1.2.4. CONSULT PRECEPTOR:
14.1.1.2.5. I.V. normal saline for victims unable to tolerate oral fluids.
14.1.2. Heat Exhaustion
14.1.2.1. Etiology - loss of fluids and salts. Signs and symptoms: weakness, fatigue, headache,
nausea/vomiting, anxiety, impaired judgment, ashen/gray pale/cool/clammy skin, diaphoresis, slight
elevation to temperature/pulse rate.
14.1.2.2. IMMEDIATE ACTION:
14.1.2.2.1. Treat impending shock
14.1.2.2.2. Remove to cooler area
14.1.2.2.3. Initiate more aggressive fluid replacement; oral fluids if tolerable … monitor patient for
sudden changes.
14.1.2.2.4. CONSULT PRECEPTOR:
14.1.2.2.5. I.V. normal saline or Ringer’s lactate if unable to tolerate oral fluids.
14.1.2.2.6. Possible evacuation. Initiate evacuation process. Consult with physician preceptor to
determine evacuation priority.
14.1.3. Heat Stroke [a true medical emergency]
14.1.3.1. IMMEDIATE ACTION:
14.1.3.1.1. Airway -secure and monitor.
14.1.3.1.2. Breathing - may need positive pressure ventilation with high flow O2 .
14.1.3.1.3. Cooling - immediately:
14.1.3.1.3.1. Remove clothing.
14.1.3.1.3.2. Wet and fan for evaporation.
14.1.3.1.3.3. Ice packs to groin and arm pits.
14.1.3.1.3.4. Icy towels.
14.1.3.1.3.5. CONSULT PRECEPTOR:
14.1.3.1.3.6. Establish immediate I.V. access with normal saline or Ringer’s lactate.
14.1.3.1.3.7. Two liters the first hour, then 1 liter per hour for 3 consecutive hours.
14.1.3.1.3.8. Administer diazepam IM or I.V. for seizures.
14.1.3.1.3.9. Unconscious patients - consider for:
14.1.3.1.3.9.1. Endotracheal intubation.
14.1.3.1.3.9.2. Nasogastric tube.
14.1.3.1.3.9.3. Foley catheter
14.1.3.1.3.9.4. Monitor I & O
14.1.3.1.3.9.5. Initiate evacuation process. Consult with physician preceptor to determine evacuation
priority and modality.
There is a DIFFERENTIAL DIAGNOSIS MATRIX in attachment 2.
http://www.e-publishing.af.mil/shared/media/epubs/AFMAN44-158.pdf
Page example.
AFMAN 44-158 1DECEMBER 1999 73
Chapter 14
ENVIRONMENTAL INJURY PROTOCOLS
14.1. Heat Stress Injuries
14.1.1. Heat Cramps
14.1.1.1. Etiology - loss of Sodium Chloride (NaCl): Signs and symptoms: Abrupt onset, muscle cramps
/ muscle spasms profuse sweating, hyperventilation, normal body temperature.
14.1.1.2. IMMEDIATE ACTION:
14.1.1.2.1. Move patient to a cool environment
14.1.1.2.2. Have patient drink liquids, especially with high sodium or saline content.
14.1.1.2.3. Work muscles using passive stretching techniques.
14.1.1.2.4. CONSULT PRECEPTOR:
14.1.1.2.5. I.V. normal saline for victims unable to tolerate oral fluids.
14.1.2. Heat Exhaustion
14.1.2.1. Etiology - loss of fluids and salts. Signs and symptoms: weakness, fatigue, headache,
nausea/vomiting, anxiety, impaired judgment, ashen/gray pale/cool/clammy skin, diaphoresis, slight
elevation to temperature/pulse rate.
14.1.2.2. IMMEDIATE ACTION:
14.1.2.2.1. Treat impending shock
14.1.2.2.2. Remove to cooler area
14.1.2.2.3. Initiate more aggressive fluid replacement; oral fluids if tolerable … monitor patient for
sudden changes.
14.1.2.2.4. CONSULT PRECEPTOR:
14.1.2.2.5. I.V. normal saline or Ringer’s lactate if unable to tolerate oral fluids.
14.1.2.2.6. Possible evacuation. Initiate evacuation process. Consult with physician preceptor to
determine evacuation priority.
14.1.3. Heat Stroke [a true medical emergency]
14.1.3.1. IMMEDIATE ACTION:
14.1.3.1.1. Airway -secure and monitor.
14.1.3.1.2. Breathing - may need positive pressure ventilation with high flow O2 .
14.1.3.1.3. Cooling - immediately:
14.1.3.1.3.1. Remove clothing.
14.1.3.1.3.2. Wet and fan for evaporation.
14.1.3.1.3.3. Ice packs to groin and arm pits.
14.1.3.1.3.4. Icy towels.
14.1.3.1.3.5. CONSULT PRECEPTOR:
14.1.3.1.3.6. Establish immediate I.V. access with normal saline or Ringer’s lactate.
14.1.3.1.3.7. Two liters the first hour, then 1 liter per hour for 3 consecutive hours.
14.1.3.1.3.8. Administer diazepam IM or I.V. for seizures.
14.1.3.1.3.9. Unconscious patients - consider for:
14.1.3.1.3.9.1. Endotracheal intubation.
14.1.3.1.3.9.2. Nasogastric tube.
14.1.3.1.3.9.3. Foley catheter
14.1.3.1.3.9.4. Monitor I & O
14.1.3.1.3.9.5. Initiate evacuation process. Consult with physician preceptor to determine evacuation
priority and modality.