Heat
What is the body's thermo regulator?
hypothalamus
What does WBGT measure?
heat stress in direct sunlight
it considers humidity, temp, wind, and solar radiation
What is the gold standard for temperature? What is the temperature for heat stroke?
rectal
104
What is piloerection?
shivering / the body's attempt to warm up
What is considered a safe location for lightning?
fully enclosed with wiring and plumbing
fully enclosed vehicles
What are the two purposes bodily cooling serves?
return blood flow from skin back to heart
lowering core body temp by reducing hypermetabolic state or organs
What are three ways to prevent heat illness?
acclimatization, lightweight clothing, weight charts, fluids readily available, well balanced diet, temp/humidity checks, practice at cooler times of day, take frequent breaks, avoid alcohol
What is the treatment for heat stroke?
cool with cold water immersion to at least 102 before transport (within 30 minutes)
water should be 39-59 degrees with continuous water movement
remove clothes
keep head above water
treat for shock and monitor vitals
What is the temp for hypothermia?
Below 95
What is the NCAA lightning rule?
30 seconds flash to bang = 6 miles = go inside and wait for 30 minutes from last flash to bang
What are the 5 ways your body loses or gains heat?
radiation: transfer heat from one object to another
convection: movement of air, water, or wind of different temperature across skin
conduction: direct contact with object
respiration: air is warmed by lungs and airway then exhaled
What are the serum sodium levels for mild EH, moderate EH, and severe EH? What is normal?
mild = 130-134 mEqL
moderate = 125-129 mEqL
severe = <124 mEqL
normal = 135-145 mEqL
What are the three most important things to look for with exercise associated muscle cramps?
normal mental state
profuse sweating
normal body temp
What are predisposing factors for hypothermia?
cold environment
high altitudes
water or wet environment
physically unfit
age or medical conditions
drug or alcohol use
inappropriately dressed
What is exertional hyponatremia?
sodium is diluted and too low in blood
usually caused by over hydration
can cause intracellular swelling from hypotonic intravascular and extracellular fluids which can lead to fatal dysfunction of CNS
Your ptient has an inability to continue exercise due to cardiovascular insufficiency, rapid weak pulse, rapid shallow breathing, profuse sweating, low BP, and a temp of 103. What is the problem, physiological cause, primary treatment, and recovery?
Problem = heat exhaustion
Physiological cause = high skin blood flow, heavy sweating, and or dehydration, causing reduced venous return
Primary treatment = cease exercise, remove from environment, elevate legs, provide fluids, cold water immersion
Recovery = often occurs within 24 hours; same day RTP not advised
Your patiend has a temp of 105 leading to the overwhelming of the thermoregulatory system. What is the problem, physiological cause, primary treatment, and recovery?
Problem = exertional heat strok e
Physiological cause = high metabolic heat production and or reduced heat dissipation
Primary treatment = immediate whole body cold water immersion to quickly reduce core body temp
Recovery = highly dependent on initial care and treatment
What are signs and symptoms of heat exhaustion?
cool clammy skin
flu like symptoms
rapid shallow breathing
rapid weak pulse
low BP
headache
exhaustion
dizziness
heavy sweating
excessive thirst
elevated body temp (up to 104)
normal mental state
What is the difference between mild/moderate hypothermia and severe hypothermia?
mild/moderate = the umbles, shivering, memory lapses, usually conscious, glassy stares, apathetic, impaired judgment, cold abdomen and back
severe = shivering has stopped, stiff and rigid, ice cold, blue appearance, decreased pulse, shallow and weak breathing
What is the managment of lightning injuries?
treat the trauma sustained
each patient is unique and should be treated as such
if pt is unconscious, always assume c-spine injury
activate EMS & CPR/rescue breathing
Your patient collapses in the heat and has loss of consciousness.. what is the problem, the physiological cause, primary treatment, and recovery?
Problem: heat syncope
Physiological cause: standing in a hot environment, causing postural pooling of blood in the legs
Primary treatment: lay the patient supine and elevate legs to restore central blood volume
Recovery: often occurs within hours
Your patient has acute, painful involuntary muscle contractions during and after exercise. What is the problem, the physiological cause of this, your primary treatment, and recovery outlook?
Problem = exercise associated heat cramps
Physiological cause = dehydration, electrolyte imbalances, and or neuromuscular fatigue
Primary treatment = stop exercising, provide sodium-containing beverages
Recovery = often occurs within minutes to hours
What are the medical consequences of exertional heat stroke?
Rising internal temp denatures proteins and cellular membranes which causes an inflammatory response. The body then relocates an aspect of bacteria that is usually found in the gastrointestinal system. This creates a sepsis reaction and leads to a coagulation reaction throughout organs. Multisystem organ failure begins leading to death.
What do you not want to do for hypothermia and/or frostbite?
hypothermia: DO NOT allow victim to exert themselves, delay medical care due to rewarming, give victim alcohol or caffeine, rub or massage extremities or put in warm bath
frostbite: DO NOT rewarm if potential to refreeze is present, break blisters, use water >105 or <100, use friction / massage, dry heat (heating pad / bottle, stove, sunlamp) allow to drink warm beverages (alcohol or coffee)
What are the medical consequences of altitude related emergencies?
hypoxia, cascade events (increased respiration: hyperventilation, cerebral responses: increased blood flow and headache, tachycardia and hypertension, hemoglobin concentration raises at altitude), eventually can lead to coma