Heat Related Emergencies

1. HEAT CRAMPS
   A. Heat Cramps are muscle spasms that result from the loss of a large amount of salt and water when working out or working in a hot environment.
   B. May be delayed or occur a few hours later. Heat Cramps usually occur in the muscles that get fatigued by heavy work, such as calves, thighs, abdominal muscles and shoulders.
   C. The direct cause is unknown but is most likely related to electrolyte deficiencies.
   D. Muscle spasms are the only sign of heat cramps.
   E. Cramps are, painful, involuntary, they come and go and usually resolve on their own. F. Treatment: Remove pt from hot environment, encourage to drink cool water or Gatorade/ administer IV fluids.
   
2. HEAT EXHAUSTION
   A. Under normal conditions the body cools itself off by sweating. However, if you’re in high temperatures for a long period of time and don’t replace the fluid you lose, the hypothalamus (controls things such as thirst hunger and body’s core temperature) gets overwhelmed and as a result has the body produce more heat than it can release.
   B. Common S&S:
   -Confusion -Dizziness -Fainting -Fatigue -Headache
   - Heat cramps - N&V
   -Pale skin -Profuse sweating -Rapid HR
   C. Treatment:
   -Move pt in to a cool (well ventilated if possible) environment and laid down
   - If pt has normal LOC and is not nauseated, encourage pt to drink a cool electrolyte
   beverage or water. If pt has decreased LOC or is vomiting administer normal saline IV -Cool pt slowly (wet cloths, or fanning) Watch for shivering.
   

III. HEAT STROKE
A. If untreated, heat exhaustion can turn into heat stroke very quickly.
B. Heat Stroke results when the pt’s ability to regulate heat stress shuts down and the core body temperature elevates dramatically.
C. Often causes confusion, seizures or coma. Can also sometimes result in death.
D. Common S&S:
-Flushed, hot, dry skin -Increased HR -Shallow breathing -Dizziness or fainting -Headache
-N&V
E. Treatment:
-Remove pt from hot environment into a cool place
-Pt needs to be cooled immediately. Covered icepacks can be placed in places such as under the arms and groin area. (heat loss areas) Watch for shivering.
- Administer normal saline IV
-Mist pt’s skin and move air over it (evaporative cooling)
F. Heat stroke pt’s are at risk of seizure and potential aspiration, be sure to be on top of airway management. 

(Posted by Sembra Winkle.)