Heat injuries

Question 1

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

Question 2

Treatment for heat edema

Answer 2

No special treatment is necessary

Question 3

Should diuretics be used for heat edema

Answer 3

Not effective and can predispose to volume depletion

Question 4

also called miliaria, is a skin rash caused by trapped sweat travels to the surface become clogged. tends to be more common in warmer, more humid climates.

Answer 4

Prickly Heat (lichen tropicus, miliaria rubra, or heatrash)

Question 5

1) Pruritic
2) Maculopapular, erythematous rash over clothed areas of the body.

Answer 5

Prickly Heat

Question 6

Treatment of Prickly Heat

Answer 6

1) Chlorhexidine in a light cream or lotion
2) Talc or baby powder is of no benefit

Question 7

Painful, involuntary, spasmodic contractions of skeletal muscles, usually those of the calves, although they may involve the thighs and shoulders

Answer 7

Heat Cramps

Question 8

Treatment of Heat Cramps

Answer 8

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 9

1) Hyperventilation resulting in respiratory alkalosis

Answer 9

Heat Tetany

Question 10

Differences between heat cramps and heat tetany

Answer 10

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 11

Treatment of Heat tetany

Answer 11

Removal from the heat and decreasing the respiratory rate

Question 12

(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 12

Heat Syncope

Question 13

Treatment of Heat Syncope

Answer 13

1) Removal from the heat source,
2) Oral or intravenous rehydration,
3) Rest

Question 14

(a) Signs and Symptoms
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 14

Heat exhaustion

Question 15

Treatment of heat exhaustion

Answer 15

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
4) Move patient to a shaded area or air conditioned area
5) Place patient in supine position with their feet elevated abode the level of their head.
6) Remove excess clothing and equipment
7) Cool the patient until their core temperature is approximately 101F (38.3C)
8) Hydrate
9) Transport to ED if patient is not responsive to treatment

Question 16

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 deficit

Answer 16

Heat Stroke

Question 17

Treatment of heat stroke

Answer 17

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