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
- Initiate IV
- Notify receiving facility or contact Medical Control
PEARLS:
- 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.