Hyperthermia

 

History

 

  • Age
  • Exposure to increased temperatures and/or humidity
  • Past medical history/medications
  • Extreme exertion
  • Time and length of exposure
  • Poor oral intake
  • Fatigue and/or muscle cramping
  • Alcohol/illicit drug use

 

Significant Findings:

 

  • Altered mental status
  • Unconsciousness
  • Hot, dry or sweaty skin
  • Hypotension/shock
  • Seizures
  • Nausea

 

Differential:

 

  • Fever (infection)
  • Dehydration
  • Medications/drugs
  • Hyperthyroidism (storm)
  • Delirium tremens (DT's)
  • Heat cramps
  • Heat exhaustion
  • Heat stroke
  • CNS lesions/tumors

 

Treatment:

 

 

 

  • Oxygen
  • Document patient temperature
  • Remove from heat source
  • Remove clothing
  • Apply room temperature water to skin and increase air flow around patient
  • Utilize cold water submersion if a dunk tank is available
  • Consider ice packs to groin and axillae

 

 

 

  • 12-Lead EKG
  • Obtain BGL

 

 

 

  • Initiate IV
  • Notify receiving facility or contact Medical Control

 

PEARLS:

 

  • Recommended Exam: Mental Status, Skin, HEENT, Heart, Lungs, Neuro
  • Extremes of age are more prone to heat emergencies (i.e., young and old).
  • Predisposed by use of: tricyclic antidepressants, phenothiazines, anticholinergic medications, and alcohol.
  • Cocaine, amphetamines, and salicylates may elevate body temperatures.
  • Sweating generally disappears as body temperature rises above 104⁰F (40⁰C).
  • Intense shivering may occur as patient is cooled.
  • Heat cramps consists of benign muscle cramping and is not associated with an elevated temperature.
  • Heat exhaustion consists of dehydration, salt depletion, dizziness, fever, mental status changes, headache, cramping, nausea and vomiting. Vital signs usually consists of tachycardia, hypotension, and an elevated temperature.
  • Heat stroke consists of dehydration, tachycardia, hypotension, temperature greater than 104⁰F (40⁰C), and an altered mental status.

NREMR

National Registry Emergency Medical Responder

NREMT

National Registry Emergency Medical Technician

NREMT-I

National Registry EMT-Intermediate