Heat Stroke FAQ's

[Beth n Rod 1,279]

This was on ABC's news site......

Heat Exhaustion and Heat Stroke

Heat exhaustion develops when the body encounters excessively high temperatures that it is not used to managing. It occurs at body temperatures that are very high, but usually less than 40 degrees Celsius, or 104 degrees Fahrenheit. The symptoms of heat exhaustion are not very specific, but ultimately relate to a state of dehydration, which is the condition's primary characteristic. Symptoms may include weakness, headache, and nausea.

Heat stroke is severe injury from high body temperatures that causes damage to many organs, particularly the central nervous system, which include the brain and spinal cord. In contrast to heat exhaustion, patients suffering from heat stroke will have temperatures that are usually greater 104 degrees. Heat stroke may be divided into two categories-exertional and classic.

Exertional heat stroke

Exertional heat stroke patients are usually people who are exercising in excessively warm conditions. Their bodies cannot manage the stress of the physical activity and the hot environment together.

Classic heat stroke

Classic heat stroke patients are often elderly or debilitated people who are in warm environments for too long. The elderly are especially vulnerable to the heat, as the body is less and less able to handle heat as it ages. Elderly people may also have pre-existing illnesses that make them more susceptible to heat stroke, or they make take medications that affect the body's ability to manage hot temperatures. Elderly people, who, for economic reasons, are not able to get out of the heat, are at great risk for heat stroke.

Heat Transfer

In order to understand heat-related illnesses you need to know something about the way the body normally gets rid of heat. There are four ways the body transfers heat: radiation, evaporation, conduction, and convection.

Radiation

Radiation occurs when the body turns heat into electromagnetic waves. In other words, waves of heat can escape from the body directly into the surrounding air. This is the primary way that human beings are able to lose heat from their bodies in very hot environments.

Evaporation

Evaporation is the transfer of heat that occurs during the transformation of liquid to gas. Evaporation of sweat (even of sweat you cannot feel, called insensiblelosses) is another significant method that the body uses to cool down.

Convection and conduction

Convection and conduction are secondary ways for the body to lose heat after radiation and evaporation. Convection is the passage of heat into the air and into the vapor that surrounds the body. It is different from evaporation in that the heat does not transform to the gas phase, as it does in evaporation. Conduction is the transfer of heat through physical contact.

What Happens When it Gets Too Hot

In hot environments, the body initiates several processes to lose heat. First, the anterior hypothalamus, the body's thermostat in the brain, signals the body to open up blood vessels near the skin's surface so that heat can be transferred outside by the methods listed above. This vessel dilation is possible because blood is shunted away from the body's core. The hypothalamus also mediates sweating and tells the body to respond to the heat by taking off clothes and seeking a cooler environment.

When it becomes too hot, however, the body's ability to cool down becomes overwhelmed. Symptoms like fatigue, headache, muscle aches, confusion, and even coma can occur, depending on the severity of the condition.

This overwhelming of the body's means of handling heat can be caused by a very warm environment or excessive exercising in the heat, as discussed before. Also, though, patients may get overheated because of certain illnesses like hyperthyroidism (high thyroid hormone level) or infections causing fever. Additionally, some medications can cause high body temperatures. A class of drugs called anticholinergics can decrease the body's ability to sweat and, therefore, to lose heat. Other drugs called sympathomimetics can decrease skin vessel dilation. There are other classes of drugs that may also interfere with body temperature regulation through various, sometimes complicated, mechanisms.

Symptoms and Signs

There are a variety of symptoms associated with heat-related illnesses. Heat exhaustion patients may have vague complaints of symptoms that come on slowly. These can include:

Headache

Weakness

Lightheadedness

Muscle aches

Muscle cramps

Agitation

Heat stroke patients can have the same complaints as heat exhaustion patients, but they also suffer central nervous system problems, which can include:

Confusion hallucinations

Bizarre behavior

Seizure

Coma

It was once thought that heat stroke patients did not sweat, but this inability to sweat is variable, and often strikes the patient at the latest stages of the condition.

Heat stroke patients, because of the resulting multi-organ damage, may also complain of blood in the urine or stool, decline in the amount of urine produced and shortness of breath, among other problems.

Other symptoms

There are secondary categories of heat-related illnesses to watch out for:

Heat syncope occurs when a person overheats and then faints.

Heat cramps are muscle contractions associated with electrolyte or mineral abnormalities caused by the heat.

Heat edema is characterized by swelling in the arms and legs because of the heat.

Prickly heat is a heat rash that is red and very itchy.

Treatment

There is a lot that you can do for a person suffering from a heat-related illness. If you see someone who appears to be suffering from a heat-related illness, you should call for help immediately. In the most rare, severe cases, you should start cardiopulmonary resuscitation (CPR), if necessary. If the person is not a trauma patient (has not been in an accident, fight, or fall), you should move the individual from the hot environment to a cooler location. Next you can sprinkle lukewarm water on the skin and fan the patient; this will encourage evaporation. You can also apply ice packs to the neck, underarms, and groin.

In the emergency room

Once a patient has been taken to the emergency room, the cooling process will be continued. The doctor may use a cooling blanket and some other more aggressive methods, but in general, treatment is similar to the methods that should be initiated immediately, including fanning and ice packs.

The doctor may order tests to assess organ damage. These tests can include electrolytes or minerals, blood-clotting tests, a urine analysis, creatine phosphokinase (a muscle enzyme quantification), and a head computed tomography (CT or cat) scan. Heat stroke patients are admitted to the intensive care unit. Heat exhaustion patients are admitted to a regular floor bed in the hospital. When patients are released from the hospital, they should have a place to go to avoid the heat, and they must be able to rehydrate themselves.

If caretakers are aggressive with these cooling techniques before delivering the patient to the hospital, and the emergency department is able to treat any related organ damage, then there is a good possibility that the prognosis will be excellent.

Prevention

Heat-related illnesses are often preventable. When hot weather is expected, the elderly and debilitated must be ensured access to cool, air-conditioned shelter. People should be encouraged to wear light-colored, loose clothing and bathe in tepid water. Also, hydration is critical, and people in hot weather should increase their fluid intake substantially.

To avoid exertional heat stroke, athletes should not exercise in extreme heat, and coaches should be aware of the symptoms of heat-related illnesses. Athletes also must stay well-hydrated.

Summary

Heat-related illnesses are a continuum of conditions but have traditionally been divided into heat exhaustion-characterized by dehydration-and heat stroke, in which organs, particularly the central nervous system, are damaged. Heat exhaustion patients may have vague complaints like weakness, nausea and headache, whereas heat stroke patients often have these symptoms plus confusion or hallucinations. Heat-related illnesses present a potentially severe-even fatal-set of conditions that can often be prevented if treated early and aggressively. Learning about the symptoms and preventive care can help you help someone else.

[Aplus 525]

I know I've come close to heat exhaustion a couple times this season.

The symptoms can sneak up on you when you're busy concentrating on something else.

It's the headache that usually makes it too uncomfortable for me to continue working. That's when I know I've had enough, and quit for the day.

It's nothing to fool around with.

[Beth n Rod 1,279]

This is important stuff. Before you know it, it will be 90 degrees out there. Be safe all!

Beth

[R L S 14]

Good article.

Being on a Hotshot crew fighting fires all over the country we dealt with this ocassionaly and a few times had to medavac crew members via helicopter. It is very important to stay hydrated.

One thing to remember is that you can be TO HYDRATED and the symtons of being overly hydrated are purt near the same as heat exhaustion symptoms. Maybe Carlos can chime in here as well on this matter.

Happy washing all I know my season is in full effect and I am loving it.

Richard

[Gadgetki 14]

true, if you don't drink water. you will get headache, heat stroke, etc.

drinking lot of water is very important

[R L S 14]

gadgetki,

Welcome back!!

[beyoungsr 14]

Use of a Camelbak hydration system can help keep a heat stroke from happening. Light weight, easy access, and you don't have to stop working to take a drink.

I beleive Beth sells them.

[Beth n Rod 1,279]

We don't sell anything anymore...

But you can find them either from Steve Rowlett (at one point I think he was selling them), or on Ebay.

They are a GREAT tool on a HOT day.

Be safe.

Beth :groovy:

[Adrian 155]

My 2 cents= I was a medic in the field for 6 years in Texas (some serious heat) and on several occasions such as , racetrack, rodeo's, concerts have treated heat exhaustion.

The one thing I didn't notice on the article was any type of field treatment while waiting for medical help.

I have seen people that do nothing until help arrives. Wrong wrong wrong.

You do not have to be a medic or even have much knowledge in this area.

It's very simple....... you already know the signs to look for to determine and evaluate the situation. Too Hot!!!!!! cool them down in just about any means possible.

But here are a few vital steps you can take while waiting for help to arrive for (let's say ) your employee, :

1. undo clothing to promote ventilation

2. put wet towels under the armpits and groin areas, around the neck (don't choke them though) and forehead.This will help reduce the body's core temp. because that is where the major arteries are. Once organs are cooked..... well the patient might be stuck with some permanant damage. Cool cool cool the head.

3. Fan the patient

4. shade the patient

5. if available, get the patient indoors or in an auto or truck with air conditioning.

6. If the patient has fainted and is still breathing, keep them supine (on their back)

and make sure airway is not blocked off by tilting head back far enough where the chin is almost pointing straight up. If they are not breathing, it is an entirely different issue. You need to learn CPR

7. reassure the patient that help is on the way and comfort them, because they are probably about ready to freak out at their own condition.

8. be calm as a caregiver, if you let your own nerves show it transfers to the patient

and could worsen their condition. Trust me .... you do not want to add phsycogenic shock to the situation.

9. Keep stats on the patient i.e. when instance occurred, what lead up to the cause,

signs and symptoms, what meds they are on ,if any, have they eaten lately, have they been hydrated, and let the medics know when they arrive. This really helps the medics.

10. Probably most important, get fluids in them asap. water water water water.

hope this helps,but most of all, hope that you never have to deal with it, but be prepared if you do have to deal with it.

11. the worst thing you can do on the patient's behalf is nothing. In most cases medics will arrive anywhere from 7-15 minutes. A person's organs shuts down one organ at a time. It's the bodies defense system. saving the brain and heart for last.

But one can't work for very long without the other. So don't just wait on the medics.

In alot of heat exhaustion cases I have worked the patient was literally saved or at least corrected to some degree by the witnesses around. It is very very important to act quickly when you see the signs approaching.

good luck

Adrian

[Claude Hawkins 14]

Great information. It can happen when and where you least expect it. I once experienced heat exhaustion paddling in a kayak on a sunny afternoon.

Because I was surrounded my water I didn't think about heat exhaustion and I didn't hydrate sufficiently. Once I realized what was happening I drank all the water I carried but the effects don't go away immediately. For a while I didn't think I would make it back to the launch point.

Claude

[squirtgun 122]

Try this trick for a quick cool down,I have been using it for years playing softball.

add 1 small bottle of aromatic ammonia(buy it at a drugstore) to a small cooler of water and ice.Dip a hand towel in and squeeze out the excess water then drape over your neck.Also wipe your face and inhale the aroma of the towel for refreshing boost.

[seymore 90]

Last summer i had a bad case of heat exaustion staining both sides of a 8ft.tall 1400lft.cedar fence.Before i knew it i had the chills when leaving the job at 3 p.m.

Later that night i thought my head was gonna explode with the headache i had.That's one feeling i don't want to ever have again thought i was gonna die!!

Start early and finish early in the Texas summer!!

Even working the Texas summers for the last 8 years I still never get used to them.

[Dave O 15]

I am bringing these up for the newbies and for the many of us that forget and put safety to the side.

Remember this is one subject that can be prevented or get you hospitalized or worse. I still love my competitors and hope they stay safe during the hot months. I don't want to hear that you have to go to the bathroom alot when you drink, since everyone carries some form of bottle in the truck LOL. Do it for everyone that loves you and needs you around. Especially your family.

Also it is what you drink that matters alot.

[seymore 90]

I am bringing these up for the newbies and for the ones of us that forget and put safety to the side.

Also it is what you drink that matters alot.

I hear ya Dave it's not a good to feeling to overheat!!

Thanks :cool:

[Beth n Rod 1,279]

Thanks Dave!

Everyone be safe out there!

Beth

[Thad 135]

I don't want to hear that you have to go to the bathroom alot when you drink, since everyone carries some form of bottle in the truck LOL.

And if you're like me if you wait 10 minutes you won't have to go anymore- you'll sweat it out!

[Chappy 138]

i usually go through at least a gallon a day, and sweat out every bit of it. 96Deg today. right on time topic.

[mas3372 14]

Whats even worse than heat exhaustion is heat stroke. I had it about 3 years ago while fighting a brush fire. Being an EMT as well, I should have know what was happening, but in the heat of the moment I didn't care to much. but then it caught up and off to the hospital.

When you get hot and dizzy and light headed, take a break, grab some water and losen your clothing. When you stop sweating, that is bad. This is when heat stroke takes effect. Your body stops sweating therefore it loses its ability to cool itself. Not good.

Avoid it. Take breaks, drink water or sports drink with electrolytes in them.

Sunblock as well.

[Beth n Rod 1,279]

Bump!

This is especially important if you are new to this business, and always serves as a good reminder even for those who have been around the block....

Beth :cup: :sunshine:

[Mathew Johnson 123]

This is important stuff. Before you know it, it will be 90 degrees out there. Be safe all!

Beth

Agreed...... I have taken care of folks that suffered heat stroke. It isn't a pretty picture...

I have written another course for Contractor Education Services that Jack Kramer and myself operate. In my first life I worked as a Paramedic for 15 years and taught EMT's and Paramedics for the Department of Health: Bureo of Emergency Medical Services.

The course will is called Emergency First aid for the Power Washer; Repairing the Operator, Not the machine. It covers all of Heat and cold Emergenies, Chemical Injuries (eye, skin and ingestion), Water Jet injuries and basic immediate first aid for burns, cuts and falls, plus a little more. I have also put together a list to put a basic first aid items list together that will allow contractors to put together a first aid kit for less than 25 dollars.

The final part of the class deals with PPE. I will post more as I get it polished.

I am waiting to see if the American Heart Association will allow me to add CPR to the class. I am an instructor for CPR, I just need to find an Agency to issues cards.

[MMI Enterprises 289]

I stayed hydrated but didn't help much today. Just am not used to this spring heat yet. Job today had my face all flushed to where I had to soak my head twice under a hose..

[Dave O 15]

Bump bump again