RT Book, Section A1 Haque, Zaffar K. A1 Stefanec, Tihomir A2 Oropello, John M. A2 Pastores, Stephen M. A2 Kvetan, Vladimir SR Print(0) ID 1136417658 T1 Environmental Injuries and Toxic Exposures T2 Critical Care YR 1 FD 1 PB McGraw-Hill Education PP New York, NY SN 9780071820813 LK accessmedicine.mhmedical.com/content.aspx?aid=1136417658 RD 2024/03/28 AB KEY POINTSEarly recognition and implementation of appropriate therapy is essential in the care of the patient who has suffered environmental injury.The 2 main forms of heat stroke are exertional and nonexertional. Rapid initiation of cooling is essential to management.The mildly hypothermic patient should be rewarmed at a rate of 0.5 to 2°C/h. Indications for a more rapid rate include cardiovascular instability and temperature below 32°C.In the pre-hospital management of frostbite, protect the affected area from thawing; if thawing is inevitable, then prevent refreezing. In the hospital, immerse the affected body part in circulating water 37°C to 39°C.Seek expert toxicology advice if considering administration of antivenom in the management of injury incurred by Crotalidae (pit vipers), black widow spiders, or scorpions.A thorough physical examination will dictate the management of lightning injury, with specific attention paid to the integument, tympanic membrane, and eye.The physical examination can be misleading following electrical injury. Deep tissue injury may result in compartment syndrome and rhabdomyolysis.The acute radiation syndrome afflicts 3 systems: hematopoietic, gastrointestinal, and integument.