Chart — Emergency Nursing
Environmental Emergency Recognition Chart
One capstone view of the exposure emergencies — the red flag that names each one and the single most important first action. The fast triage of heat, cold, water, gas, and venom.
Educational use only. A recognition aid, not a protocol. Each emergency has detailed management — follow provider orders and your facility’s guidelines. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Recognize & Act
| Emergency | Red-flag recognition | Immediate first action |
|---|---|---|
| Heat stroke | Core temp > 40°C + ALTERED mental status (vs sweaty/alert exhaustion) | Rapid active cooling now; ABCs; stop ~38–39°C; no antipyretics |
| Hypothermia (severe) | Core temp < 28°C, no shivering, may look dead; J wave on ECG | Handle gently, core rewarming, continue CPR ('not dead until warm and dead') |
| Frostbite | Hard, white/insensate digit; hemorrhagic blisters (deep) | Rapid warm-water rewarm ONLY if no refreeze risk; never rub; analgesia |
| Drowning | Submersion + hypoxia; respiratory distress that may worsen over hours | Oxygenate/ventilate first; observe even mild cases; consider C-spine |
| Carbon monoxide | Flu-like symptoms, whole household affected; SpO₂ falsely normal | Remove from source + 100% O₂ non-rebreather; check COHb; HBO if severe |
| Snakebite (pit viper) | Fang marks, rapid swelling, bruising, bleeding | Immobilize at/below heart, mark swelling, antivenom; NO ice/tourniquet/cutting |
| Sting anaphylaxis | Airway swelling, wheeze, hypotension, urticaria after a sting | IM epinephrine FIRST; airway, oxygen, IV fluids; watch for biphasic |
Exam Traps
- ✦Heat stroke vs exhaustion: the discriminator is altered mental status.
- ✦Severe hypothermia can mimic death — keep resuscitating until rewarmed.
- ✦CO poisoning: the pulse ox lies (falsely normal) — get a carboxyhemoglobin level.
- ✦Snakebite: immobilize and mark; never ice, tourniquet, incise, or suction.
- ✦Any sting can cause anaphylaxis — IM epinephrine is the first action.
Related Resources
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with Emergency Nurses Association (ENA) · AHA ACLS / PALS Guidelines · Advanced Trauma Life Support (ATLS). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →