Thermoregulation

Heat-related illness common causes

High environmental temperature & high humidity

Heat Related Illness at risk populations

Older adults

Those with mental/behavioral health conditions

Those who work outside

Homeless individuals

Those who use substances

Outdoor athletes

Military members in hot climates

Older Adult Heat related Illness teaching

teach how to eliminate risk and minimize risks before participating in hot weather activities

teach them to have friends and family check on them regularly

Heat Exhaustion Cause

Results primarily from dehydration caused by heavy perspiration, and inadequate fluid and electrolyte intake

Heat Exhaustion Symptoms

Flu-like symptoms

Headache

Weakness

Nausea

Vomiting

Body temperature may not be elevated

If untreated, can lead to heat stroke, a true medical emergency

Heat Exhaustion Community setting treatment

Stop physical activity, move to a cool place

Cooling measures on neck, chest, abdomen, groin

Soak in cool water or fan while spraying water on skin

Remove constriction clothing

Provide sports drink or oral rehydration therapy

Plain water can worsen sodium deficit

Do not give salt tablets

Call ambulance to transport to hospital if symptoms persist

Heat Exhaustion Clinical Treatment

Monitor Vital Signs

Rehydrate with IV 0.9% saline as prescribed

Draw blood for serum electrolyte analysis

Admission may be indicated

Heat Stroke Description

Medical Emergency

Body temp may exceed 104 F (40 C)

If untreated organ dysfunction or death can result

Heat Stroke (Exertional)

Sudden onset from strenuous physical activity (especially wearing to heavy clothing) in hot humid conditions

Heat Stroke Classic

occurs over a period of time from chronic exposure to hot, humid environment

Heat Stroke Assessment

Profoundly elevated body temp of above 104° F (40° C)

Mental status changes

Confusion, bizarre behavior, seizures, coma

Hypotension, tachycardia, tachypnea

Elevated cardiac troponin

Heat Stroke Treatment Community Setting

Ensure patent airway

Contact emergency medical services

Do not give food or liquid by mouth due to aspiration risk

Remove from hot environment

Immediate medical care using life support is essential

Heat Stroke Treatment in Clinical Setting

Oxygen

Insert at least one IV with large-bore needle or cannula

Normal saline as prescribed (cooled if possible)

Cooling blanket

Laboratory tests

Rectal probe to measure core temperature

Cold Related Injuries Teaching

wear synthetic clothing

Strictly avoid cotton in cold weather

layer clothing

wear a hat, to avoid heat loss through the head

use sunscreen and sunglasses

keep water, clothing, blankets, food, and medications in the car when driving

refrain from restricting food or fluid intake

When Hypothermia First Occurs

Body Temp of <95 F (35 C)

Mild Hypothermia Temp

Body temp of 90 - 90 F (32-35 C)

Moderate Hypothermia Temp

Body Temp of 82.4 - 90 F (28 - 32 C)

Severe Hypothermia Temp

Body Temp <82.4 F (<28C)

Conditions that Promote Hypothermia

Cold-water immersion

Acute illness (e.g., sepsis)

Traumatic injury

Shock states

Immobilization

Cold weather (especially for the homeless and people working outdoors)

Older age

Selected medications (e.g., phenothiazines, barbiturates)

Inappropriate alcohol and substance use

Malnutrition

Hypothyroidism

Inadequate clothing or shelter (e.g., the homeless population)

Hypothermia Community Treatment

Shelter from the cold

Remove wet clothing

Engage in rewarming (monitor skin if heating blanket is used)

Drink warm high-carbohydrate liquid (no alcohol or caffeine) if hypothermia is uncomplicated

Hypothermia Clinical Treatment

Protect from further heat loss

Place in supine position

Standard resuscitation efforts

Adapted based on condition

External and core (internal rewarming)

Warm IV fluids

Heated oxygen or inspired gas

Heated peritoneal, pleural, gastric, or bladder lavage

Frostbite Description

Main risk factor is inadequate insulation against cold weather

Occurs when body tissue freezes and causes tissue integrity damage

Frostnip

Frostnip is a superficial cold injury

Frostbite Grade 1

hyperemia and edema

Frostbite Grade 2

large clear to milk fluid filled blisters with partial thickness necrosis

Frostbite Grade 3

small blisters containing dark fluid

body part is cool, numb, blue or red, and doesn’t blanch

Frostbite Grade 4

blister over the carpal or tarsal (not just the digit)

numb, cold, bloodless

necrosis extends to hip and bone.

Frostbite Community Treatment

Recognition is essential - have another person frequently observe skin

seek shelter from wind and cold

Use body heat to warm the affected area

Frostbite Clinical Treatment

Rapid rewarming

Swirl part in water; do not allow to touch the side of the container to prevent tissue damage

Analgesics, IV opiates, IV rehydration

Ibuprofen every 8 hours as prescribed

Elevate part above heart level if possible

Assess for compartment syndrome

Tetanus immunization

Loose, nonadherent sterile dressings

Avoid compression of injured tissue

Topical and systemic antibiotics

Arteriography may be needed

Debridement of necrotic tissue or amputation may be needed