Environmental Emergencies- HEAT

Question 1

Death occurs below and above what temps?

Answer 1

106 F

Question 2

If the body is at 98 and room is at 70 what temp is the skin?

Answer 2

86

Question 3

Tepid water temp

Answer 3

86

Question 4

What is the hematocrit during exercise

Answer 4

45% (pudding)

Question 5

Tonicity

Answer 5

How tonic a substance is

Question 6

5 drugs that increase heat production

Answer 6

Amphetamines 
Tricyclics antidepressants 
LSD
thyroid hormone
MDMA

Question 7

1 drug that decreases thirst

Answer 7

Haldol

Question 8

Hypothalamus max temp

Answer 8

104 degrees

Question 9

4 Drugs that decrease sweating (add to heat load)

Answer 9

Antihistamines
Phenothiazines (Thorazine, haldol)
Atropine
Cogentin(taken with phenothiazines)

Question 10

Heat illness does not progress from one illness to the next

What is the exception?

Answer 10

Heat syncope can progress to heat exhaustion

Question 11

How much water is lost in sweating?

Answer 11

1 1/2 unacclimatized

2 1/2 acclimatized

Question 12

What is heat syncope?

Answer 12

Feeling weak and faint in a hot environment
Fainting due to central hypovolemia
(Blood shifting to surface)

Question 13

S/S of heat syncope

Answer 13

Similar to exhaustion but temp water and salt balance are all normal
Earlier onset

Fatigue, malaise, drowsy
Headache, confusion 
Weakness, dizzy, syncope 
Rapid, thready pulse, hypotension
Pale, cool, soaked skin
Thirst 
Muscle cramps, abd cramps 
N/V/D

Question 14

Heat Syncope TX

Answer 14

Remove from heat
Oral fluids (1-2L) over 2-4hrs 
Remove clothing 
Shock position 
Prevent shivering

Question 15

What is heat exhaustion= exercise hypovolemia

Answer 15

Dehydration(often severe) with loss of large amounts of water and salt due to prolonged exposure to high heat
Usually with exercise

Question 16

S/S of heat exhaustion

Answer 16

Fatigue, malaise, drowsy
Headache, confusion 
Weakness, dizzy, syncope 
Rapid, thready pulse, hypotension
Pale, cool, soaked skin
Thirst 
Muscle cramps, abd cramps 
N/V/D

Question 17

Heat exhaustion TX

Answer 17

Remove from heat
Oral fluids (1-2L) over 2-4hrs 
Remove clothing 
Shock position 
Prevent shivering

Question 18

What are heat cramps?

Answer 18

Water toxicity due to exercising in a hot environment with heavy sweating and large replacement of water(w/o salt)
Muscle cells cramp as they become hypotonic and expand As the pick up too much water from surrounding fluids
Often occur while cooling down

Question 19

S/S of heat cramps

Answer 19

Pale
Cramps in legs and used muscles and sometime abdomen
Hx of prolonged heavy exertion in high heat
Nausea
Body temp normal

Question 20

Heat cramps Tx

Answer 20

Replace electrolytes fluid
Remove from heat
Put at rest
Don’t massage or squeeze!

Question 21

What is heat stroke?

Answer 21

Complete failure of body’s cooling system
Temp >105 F
(Brain cooks at 104)

Question 22

What is the classic S/S of heat stroke

Answer 22

Hot, dry, flushed skin

Question 23

What are the S/S of exertional heat stroke?

Answer 23

Hot, wet, pale skin
ALOC-bizarre behavior 
Tachycardia, hypotension
Seizure 
Dilated pupils

Question 24

Heat Stroke Tx

Answer 24

Remove from heat
Remove clothing 
Rapid cooling tepid water & fan 
No oral fluids 
O2
Shock position 
Fluid challenge if hypotensive 
ECG

Question 25

Ref. 1227 Hyperthermia

ADEQUATE PERFUSION

Answer 25

Encourage oral fluids
I.V. prn

BASE CONTACT

NS fluid challenge
10ml/kg IV at 250ml increments

Question 26

Ref. 1227 Hyperthermia

POOR PERFUSION

Answer 26

I.V.

If BGL