EMS Director speaks about environmental emergencies

Oil & Gas Editor


 

 

Atascosa County EMS Director Jimmy Day spoke about environmental emergencies at the monthly meeting of STEPS (A Safer Texas One STEP Closer) at Cowboy Fellowship Church, on Thursday, June 18.

Day mentioned that often times we associate what we should do regarding medical emergencies with wishful thinking, heresay or what we’ve been told in the past.

“And the medical field changes from time to time,” said Day, “and all the while everybody has their own little way to deal with emergencies – you hear something here and you hear something there – and what you hear is not always right.”

Regarding muscle cramps, Day spoke about the electrolytes in your body. Electrolytes are chemicals that form ions in body fluids. They help make sure specific bodily functions run at optimal levels. Too few electrolytes will cause the body to cramp. As serious athletes know, cramping can make a big difference on race day. So how do we prevent cramping and keep our body running at its peak performance levels? We keep it supplied with the needed amount of electrolytes.

Electrolytes are absolutely necessary to keep everything running smoothly. Proper functioning of the digestive, nervous, cardiac, and muscular systems depends on adequate electrolyte levels.

Muscle cramping, though there are many theories as to why it happens, usually involves improper hydration and/or improper electrolyte replenishment. No one wants to cramp, of course, but remember, cramping is a place far down the road of electrolyte depletion. Cramping is your body’s painful way of saying “Hey! I’m on empty! Resupply me now or I’m going to stop!” It’s like the oil light on the dash; you never want it to get that low.

That’s precisely why, just as you shouldn’t wait too long before you refuel, or you’re dehydrated before you replenish fluids, you shouldn’t wait for cramps to remind you to take electrolytes.

Day mentioned that most sports drinks should have water added to them. It might not taste as good but will do you more good. Day said, “It’s not for refreshment but rather, for replenishment.”

Day suggested “Mix about half and half sports drink and water. That gives you about the right amount to function, properly.”

Many people including those in the oil and gas industry neglect consistent electrolyte replenishment because they’ve never had cramping problems. Even if you’ve been fortunate enough to have never suffered the painful, debilitating effects of cramping, you still need to provide your body with a consistent and adequate supply of electrolytes. Why? Because the goal in replenishing electrolytes is not so much to prevent cramping, but to maintain specific bodily functions at optimal levels. Cramping is your body’s way of letting you know that, in terms of electrolytes, it’s on empty.

Day also spoke to STEPS participants about heat exhaustion.

Heat exhaustion is one part of the spectrum of heat-related illnesses that begin with heat cramps, progresses to heat exhaustion, and finally to heat stroke.

Day said, “Sometimes one can go into heat exhaustion without experiencing cramps.”

The body cools itself by sweating and allowing that sweat to evaporate. This requires enough fluid in the body to make sweat, air circulating across the skin, and low enough air humidity to allow that sweat to evaporate.

Causes of heat exhaustion is activity in a hot environment that can overwhelm the body’s ability to cool itself, causing heatrelated symptoms.

Cooling and rehydration are the cornerstones for treating heat exhaustion. The affected individual should stop his activity and then move from the hot environment to a cooler environment. The person may be placed in the shade or taken to an air conditioned environment (don’t forget that cars have air conditioning). Clothes may be removed to help with air circulation across the body. Misting the skin with cool water also helps by stimulating evaporation and cooling the body.

Rehydration is the next important step in treating heat exhaustion. This may be a challenge if the person begins to suffer from nausea and vomiting. Small sips of water, a mouthful at a time, might be tolerated even if some vomiting persists. Water, sports drink and other electrolyte replacement drinks are reasonable options.

Preventing heat stroke begins with preventing heat exhaustion. This includes acclimating to hot conditions slowly, staying well-hydrated with proper hydration and avoiding exercise during the hottest part of the day. Hydrate well before and during exercise and replace lost electrolytes such as sodium, potassium and magnesium with food or a sports drink.

Wear light, loose clothing. Use sunscreen to prevent sunburn, which can limit the skin’s ability to cool itself.

If you notice any of the symptoms of heat illness, stop activity and seek a cool shaded place. Remember, it is easier to prevent heat illness than to treat it once symptoms develop.

“No fooling around when you see a person who appears to have a heat-related problem. You look at the person. If his skin is hot, if his complexion is red and he’s not sweating, and there’s altered mental status,” said Day, “ask questions to test their alertness and memory function. If they have no clue about what’s going on, there’s a major problem.

“If he’s alert and conscious and he can swallow and control his own airways, give him something to drink. If he can’t control his airways, don’t give him anything by mouth. Keep him where it’s cool and make sure to call 911.”

“Now, let’s talk about snakes. In Texas there’s all kinds of snakes crawling around, some are poisonous and some are not. If bitten, rather than stand around and try to identify what kind of snake it is, you’re better off treating it likes it’s a venomous snake,” said Day.

Day said, “Just about every item in a typical snake bite kit is useless. You don’t need the scalpel. There’s some kind of suction devise and there’s this chemical cold pack. This is where the medical field and the proprietors disagree. If you have a snakebite kit, what I want you to do is open it and throw everything in the trash. Keep the box and the suction device. The rest of that is of no use.”

He pointed out that the method of making an incision over each fang mark and sucking it out gets the snake venom in your mouth and spitting it out is too late, you already have the venom in your mouth.

Day said, “If you suck poison out of the patient, you have now become a snake bite victim. When you use the scalpel, the patient has two big incisions along with his snake bite. You could also cut into a vessel and there’s more damage to the patient and possibly a problem stopping the bleeding.

“Use of the cold pack feels good to the patient but it crystallizes the venom inside the bite site and makes it ten times more of a probem than if you just left the cold pack alone.

“When using the suction cup, look at what’s coming out. If you see blood and something in it that looks like oil, continue pulling all of the venom you can get access to. Don’t take a pint of blood out of the patient, though. Then he’ll be needing a blood transfusion.”

“If you’re able to look around, find the snake and identify it, a small venomous snake is almost ten times more potent than a grown, adult snake,” said Day.

A small poisonous snake doesn’t have any control over venom. An adult snake will use as little as possible to save venom for use later.

It’s important to keep the victim calm so as to limit the spread of the venom.

“If it’s cold outside, keep him warm. If it’s warm outside, keep him cool,” said Day, continuing, “If he’s bit on the ankle, set him up. If the snake bite is on the upper body, lower patient down. The bite site should be kept lower than the heart to slow blood movement upward to the heart. In cleaning the bite wound, soap water and antiseptic can help.”

“You can cover the bite marks up using a sterile dressing and take him to the hospital or arrange for an ambulance to pick him up.

If the emergency site is remote in the oil field, look for a site where a helicopter such as AirLIFE can land and transport the victim.

Day also spoke about insect bites.

“Anything that can sting you can create what is called anaphylactic shock.” said Day.

Symptoms of anaphylactic shock can be difficulty breathing; hives appearing as red, itchy rash; swelling of the face, throat or mouth tissue; wheezing or difficulty swallowing; restlessness and anxiety; rapid pulse; dizziness or a sharp drop in blood pressure.

“If the patient’s eyes are getting to look puffy, his lips are getting to look puffy…call 911.”

Day mentioned that most stinging insects such as wasps and hornets can sting you over and over again and go on to sting another day. But, in the case of a honey bee, if it stings you, it attaches a barb from which the venom sack provides the sting. After losing that barb, the honey bee will fly away and die.

Day also talked about spiders such as the black widow and recluse varieties. He mentioned that spiders aren’t interested in attacking you. That’s not in their nature. They only bite when we initiate the contact by pressing against them in some manner or another.

“It depends on the person. I’ve seen people bitten by a brown recluse and get a little irritation, complain about it a couple days and go on about their business,” said Day.

Then there are the cases where a brown recluse bite creates severe reactions.

He also mentioned that black widows don’t always have the same markings. They vary a lot in coloring. “People say they can always tell if it’s a black widow if it has a red dot on its belly. It, really, can be red, it can be orange, it can be white, it can be yellow, it can be brown. It can be a diamond, it can be an hour glass, it can be a square or it can be nothing at all. Females tend to have no color. They’re small and ten times more deadly,” said Day, “In about a 24 hour period you’re going to start experiencing nausea, vomiting, diarrhea and abdominal cramps.”

“It’s rare that anybody dies from a brown recluse or black widow bite. If you see something and feel it might be a spider bite, have it checked out.”

The next meeting of STEPS will be held at the Wood Training Group Center in Kenedy, Texas, located at 3830 FM 2102, on Thursday, July 23, from 8:30 until 11:00. a.m.

LEON ZABAVA is the Oil and Gas Editor for the Pleasanton Express. He can be reached at 830.281.2341 or lzabava@pleasantonexpress.com.


Jimmy Day, Atascosa County EMS Director, speaking at the STEPS meeting.

Jimmy Day, Atascosa County EMS Director, speaking at the STEPS meeting.

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