Heat Injuries

Question 1

What issue tx?
1) Self-limited process manifested by the mild swelling of the feet, ankles, and
hands that appears within the first few days of exposure to a hot
environment.
2) Usually resolves spontaneously in a few days but may take up to 6 weeks.

Answer 1

Heat edema
tx
No special treatment is necessary. If a patient is insistent on treatment, elevation of the legs and the use of support hose will facilitate the removal of the interstitial fluid.

Diuretics are not necessary

Question 2

Signs and Symptoms:
1) Pruritic,
2) maculopapular,
3) erythematous rash over clothed areas of the body.

Answer 2

Prickley heat
(a) Treatment:
1) Chlorhexidine in a light cream or lotion.
2) Talc or baby powder is of no benefit
(b) Preventive Measures:
1) Wearing clean, light, and loose fitting clothing
2) avoiding sweat-generating situations

Question 3

What issue tx?
Painful, involuntary, spasmodic contractions of skeletal muscles, usually those of the calves, although they may involve the thighs and shoulders.

Answer 3

heat cramps
Treatment:
1) Fluid and salt replacement (Commercial Sport drinks)
2) rest in a cool environment.
3) Cases of heat cramps will respond to intravenous rehydration with NS.

Question 4

Signs and Symptoms
1) Hyperventilation resulting in respiratory alkalosis,
2) paresthesia of the extremities,
3) circumoral paresthesia,
4) carpopedal spasm.

Answer 4

Heat Tetany
-Removal from the heat and decreasing the respiratory rate

Question 5

heat cramps vs heat tetany

Answer 5

Heat tetany
1) the fact there is very little pain or cramps in the muscle compartments,
2) paresthesia of the extremities and perioral region are more prominent.

Question 6

What issue/ Tx
(a) Most commonly in non-acclimatized individuals during the early stages of heat exposure.
(b) Postural hypotension resulting from the cumulative effect of relative volume depletion, peripheral vasodilatation, and decreased vasomotor tone

Answer 6

Heat Syncope
Treatment:
1) Removal from the heat source
2) oral or intravenous rehydration,
3) Rest

Question 7

What issue/Tx
1) Malaise,
2) Lightheadedness,
3) Fatigue,
4) Dizziness,
5) Nausea and vomiting,
6) Frontal headache,
7) Myalgias.
8) Orthostatic hypotension,
9) Sinus tachycardia,
10) Tachypnea,
11) Diaphoresis,
12) Syncope.
13) Temperature is variable and can range from normal to 104°F (40°C)

Answer 7

Heat exhaustion
Treatment
1) Volume and electrolyte replacement and rest.
2) Mild cases may be treated with oral electrolyte solutions.
3) Rapid infusion of moderate amounts of intravenous fluids (1 to 2 L of saline solution) may be necessary in some patients who demonstrate significant tissue hypoperfusion

Question 8

What issue/ Tx?
Signs and Symptoms
1) Irritability,
2) Confusion,
3) Bizarre behavior,
4) Combativeness,
5) Hallucinations,
6) Seizures,
7) Coma
8) Core temperature higher than 104°F (40°C),
9) CNS dysfunction,
10) anhidrosis.
11) Any neurologic abnormality may be present in heatstroke, including
–a) Plantar responses,
–b) Decorticate and decerebrate posturing,
–c) Hemiplegia,
–d) Status epilepticus,
–e) Coma.

Answer 8

Heat Stroke
Treatment:
1) ABC’s;
2) High-flow oxygen;
3) Continuous cardiac monitoring
4) Pulse oximetry;
5) Intravenous access; NS or LR solution at a rate of 250 mL/h
6) IV Fluid Bolus
7) Actively cool the patient with evaporation or immersion in cold ice bath
8) May add cold packs to axilla, groin, and neck
9) May consider placing a foley catheter to measure urine output
10) Stop active cooling once temperature reaches 102 F
11) Serial monitoring of the patient’s core temperature