Environmental Emergencies

Refer to Handtevy™ for pediatric dosing.

• Heat Cramps:
  • Remove from hot environment, rest, oral fluids.
• Heat Exhaustion (muscle cramps, weakness, dizziness, headache, nausea, vomiting, tachycardia, hypotension):
  • Remove from hot environment, rest, oral fluids if tolerated.
  • If unable to tolerate oral fluids: NS 500 mL bolus IV/IO. May repeat once.
• Heat Stroke (AMS, hot/dry skin, seizures):
  • Remove from hot environment, rapid cooling (remove clothing, cold packs to neck/groin/axilla, cool misting).
  • Administer high-flow O2.
  • If shivering, administer Midazolam 2.5 mg IV/IO/IM/IN. May repeat every 5 minutes (max 10 mg).
  • Contact EMS Operations Captain for OLMC if patient seizes.
• Hypothermia (core temp < 95°F):
  • Remove from cold environment, remove wet clothing.
  • Mild (90-95°F): Passive rewarming (warm blankets).
  • Moderate (82-90°F): Active external rewarming (heating pads, warm bath).
  • Severe (< 82°F): Active internal rewarming (warmed IV fluids, humidified O2).
  • Handle gently, avoid rough movement.
  • Contact EMS Operations Captain for OLMC if patient in cardiac arrest.
• Frostbite:
  • Rewarm affected area in warm water (100-105°F) for 15-30 minutes.
  • Do not rewarm if refreezing is possible.
  • Do not rub or massage affected area.
  • Administer pain medication as needed.

Bites and Stings

Refer to Handtevy™ for pediatric dosing.

• Insect Stings:
  • Remove stinger if present.
  • Clean wound with soap and water.
  • Apply ice pack.
  • Administer pain medication as needed.
  • If signs of anaphylaxis, treat per Allergic Reaction Protocol 4.1.
• Spider Bites:
  • Clean wound with soap and water.
  • Apply ice pack.
  • Administer pain medication as needed.
  • If signs of anaphylaxis, treat per Allergic Reaction Protocol 4.1.
  • If suspected black widow bite, transport to nearest appropriate facility.
• Snake Bites:
  • Calm patient, keep still.
  • Immobilize affected extremity.
  • Remove jewelry and constricting clothing.
  • Clean wound with soap and water.
  • Transport to nearest appropriate facility.
  • Contact EMS Operations Captain for OLMC if suspected coral snake bite.
• Marine Life Stings:
  • Irrigate with vinegar or hot water (110-113°F).
  • Remove tentacles with forceps or gloved hand.
  • Apply ice pack.
  • Administer pain medication as needed.
  • If signs of anaphylaxis, treat per Allergic Reaction Protocol 4.1.
• Animal Bites:
  • Control bleeding.
  • Clean wound with soap and water.
  • Apply ice pack.
  • Administer pain medication as needed.
  • If signs of anaphylaxis, treat per Allergic Reaction Protocol 4.1.
  • Transport to nearest appropriate facility.
  • Contact Animal Control for all animal bites.

Carbon Monoxide/Cyanide

Refer to Handtevy™ for pediatric dosing.

• Suspect CO/Cyanide Exposure:
  • Headache, dizziness, nausea, vomiting, confusion, shortness of breath, loss of consciousness.
  • Multiple patients with similar symptoms in same location.
• Treatment:
  • Remove patient from source of exposure.
  • Administer high-flow O2.
  • If AMS or respiratory distress, use CPAP per Airway Management Protocol 1.4.
  • If cardiac arrest, proceed to appropriate protocol in Section 2.
  • For suspected cyanide exposure, contact EMS Operations Captain for OLMC.

Diving Emergencies

• Suspect Decompression Sickness:
  • Joint pain, fatigue, skin rash, numbness, tingling, weakness, paralysis, dizziness, headache, nausea, vomiting, confusion, seizures, loss of consciousness.
• Treatment:
  • Administer high-flow O2.
  • If AMS or respiratory distress, use CPAP per Airway Management Protocol 1.4.
  • If cardiac arrest, proceed to appropriate protocol in Section 2.
  • Contact EMS Operations Captain for OLMC.
• Transport:
  • Transport to nearest recompression chamber (Tampa General Hospital).

Eye Injuries/Contamination

• Chemical Burns:
  • Irrigate with copious amounts of water or saline for at least 20 minutes.
  • Remove contact lenses.
  • Cover both eyes with sterile dressings.
  • Transport to nearest appropriate facility.
• Foreign Bodies:
  • Do not attempt to remove embedded foreign bodies.
  • Cover both eyes with sterile dressings.
  • Transport to nearest appropriate facility.
• Penetrating Injuries:
  • Do not apply pressure to the globe.
  • Cover both eyes with sterile dressings.
  • Transport to nearest appropriate facility.

HazMat/WMD

• Scene Safety:
  • Ensure scene safety and identify hazardous materials.
  • Establish hot, warm, and cold zones.
  • Don appropriate PPE.
• Patient Care:
  • Decontaminate patients as necessary.
  • Treat according to specific exposure and symptoms.
  • Contact EMS Operations Captain for OLMC.
• Transport:
  • Transport to nearest appropriate facility.