The past few days, it has been extremely hot with high heat index. Over the past few days, I have run into many heat-related 911 calls. All ranging from heat cramps to even a few heat strokes. It is important, as paramedics, that we recognize the different types of heat-related emergencies, so we are able to treat our patients, and hopefully, if possible, prevent the patient from suffering a heat stroke.
To start off, when a patient is working in the heat, or just in the heat in general, they need to stay hydrated. The problem with this is, that some people do not realize that alcoholic beverages, soda pop, juices, and what have you, are not "hydration" drinks. In turns, these people become patients. The best thing that patients need to drink is water and even Poweraide or Gatoraid. But, they need to drink the Poweraide and/or Gatoraide in moderation, because water is the best drink to stay hydrated. For a detailed dehydration post, click here.
Their are three types of heat-related emergencies: heat cramps, heat exhaustion, and heat stroke. Each one is a medical emergency, and should not be ignored. But, heat stroke is the most severe heat-related emergencies, and should be treated as such, but we will discuss this later. Heat cramps are usually the first signs of a heat-related emergencies. This consists of cramps, diaphoresis, weakness, dizziness, lightheadedness, tiredness. The best method for heat cramps is to administer water PO (by mouth), IV access with fluid bolus, and place ice packs where the cramps are located. We are not to concerned with "cooling the patient" more as hydrating the patient and relieving the cramps.* The second emergencies is heat exhaustion. This is when the body has been sweating for a long period of time, and the body is extremely dehydrated. Patients will experience weakness, excessive diaphoresis, lightheadedness, confusion, possible LOC, and tiredness. Management includes IV access with fluid bolus, cooling of patient with ice packs and A/C, and removing any clothing that you can (within reason). Thirdly, the most severe heat-related emergency is heat stroke. Heat stroke is when the body of severely dehydrated; the body has been sweating for so long, that the body has no more fluid to sweat out. In addition, patients can and/or will experience a seizure, and have an extremely elevated temperature. Patient's can become unresponsive and possibly go into cardiac arrest. Quick diagnosis and treatment is vitals for survival of heat stroke patients. two large bore IV accesses with fluid boluses, cooling of patient with ice packs and A/C, removing of all clothing (within reason), ECG monitoring, and rapid transport.*
It is important that all heat-related emergencies are treated, so that patient's will not continue into the next stage(s). Early diagnosis and treatment is vital to patient survival.
*Follow local protocol