1. Lesson 13: Heat Related Illnesses Emergency Reference Guide p. 59-64

2. Objectives Define heat exhaustion, heat stroke & hyponatremia Describe prevention techniques List signs/symptoms for heat related illnesses Describe emergency treatment Describe situations that require emergency evacuation

3. Heat Related Illnesses Overview Range of problems associated with very warm to hot air temperatures Other factors involved: –Humidity –Being overweight/out of shape –Very young or very old –Unaccustomed to heat –Certain drugs such as antihistamines –Continued exercise –Dehydration

4. Heat Related Illnesses Overview (cont’d.) Heat exhaustion: result of combination of factors. –Heat stress –Water/electrolyte loss –Inadequate hydration Heat stroke: when core produces heat faster than it can be dissipated. –Over-exerting or dehydrated Hyponatremia: low blood sodium level. Caused by drinking too much water or failing to eat

5. Preventing Heat Related Illnesses What can you do to prevent heat related illnesses? –Stay well hydrated, consume water prior to exercising & during exercise –Wear baggy, loosely woven clothing to allow evaporation –Keep head covered & face shaded –Keep fit, start slowly –Avoid exercise during hottest part of day –Drugs may increase risk –Rest in shade often

6. Signs/Symptoms for Heat Exhaustion –Sweating –Tiredness & feeling lethargic –Skin appears pale & sweaty or flushed –Headache –Nausea, sometimes vomiting –Muscle cramps –Thirst/decrease urine output –Dizziness –Elevated heart rate –Possible slight increase in core temp

7. Caring for Heat Exhaustion Stop activity, rest in cool/shady area Replace lost fluids: –Quart of water with pinch salt added. Drink over a 20 minute period –Do not use salt tablets, too concentrated Wet the patient down Gently stretch & massage cramped muscles Allow drowsy patient to sleep Recovery may take 24 hours When patient feels ok, allow to continue

8. Signs/Symptoms for Heat Stroke Core temperature rising to 105F Disorientation, bizarre personality changes Skin turning hot and red, may be dry Elevated heart and respiratory rate Headache Seizures

9. Care for Heat Stroke True emergency, rapid cooling is essential –Remove from hot environment –Remove heat retaining clothing –Immerse in cool water or drench in cool/cold water Concentrate cooling on head & neck Use cold packs on neck, armpits, groin, hands, feet Fan patient to increase evaporation

10. Care for Heat Stroke (cont’d.) Monitor patient closely & cease cooling efforts when normal status returns Give cold water to drink, if patient can accept it Do not give fever reducing drugs Have patient see health care provider as soon as possible Keep careful watch on patient, relapses common

11. Signs/Symptoms for Hyponatremia Appears to have heat exhaustion, but giving more water makes it worse Also called “water intoxication” Looks like heat exhaustion, but: –Urinated recently, urine clear –Claims drinking all day, denies being thirsty Headache Weakness & fatigue Light headedness

12. Signs/Symptoms for Hyponatremia (cont’d.) Muscle cramps Nausea with/without vomiting Sweaty skin Normal core temp Normal/slightly elevated pulse/respiration rate Increasing level of anxiety More severe symptoms include disorientation, irritability, combativeness If untreated, can lead to seizures, coma & death

13. Caring for Hyponatremia Mild to moderate cases can be cared for in the field Rest in shaded area Eat salty foods. Do not let them drink anything If patient is well hydrated, restricting fluid intake is harmless Once patient has normal hunger/thirst and normal urine output, the condition is resolved

14. Scenarios A 24 yr old, slightly overweight, competing in short distance tri-athalon. Says he drank 3 - 4 quarts water. Stumbling while running up a hill & stops at your first aid station

15. Scenarios A 68 yr old woman in excellent condition is working on wilderness survey. She is sweating while carrying camera equipment then becomes confused & vomits

16. Guidelines for Evacuation GO SLOW for patient who does not fully recover from heat exhaustion or mild hyponatremia GO FAST for patient with altered mental state due to heat related issues, hyponatremia or experiences seizures

17. Questions??? What else could you add to your First Aid Kit?