Heat and Cold EmergenciesShelley Westwood, RN, BSN

Exposure to Heat

Overexposure to heat can cause a chemical imbalance that prevents the body’s cooling system from working properly.

Causes of overexposure to heat include:

▫ Being in extreme heat for too long

▫ Working or exercising on a hot day

▫ Illnesses, such as heart conditions, diabetes, and high blood pressure

Heat Cramps

Heat cramps occur when a person perspires a lot, usually through working or exercising on a hot day.

A heat cramp is essentially a painful muscle cramp. Most often occur in calves, arms, stomach muscles and back.

Symptoms:

▫ Muscle pain

▫ Muscle spasm

▫ Sweating

▫ Headache

First aid for heat cramps

Make sure scene is safe, get first aid kit and wear appropriate PPE.

Have the person rest and cool off.

Have the person drink something that contains sugar and electrolytes such as juices or a sports drink, or water if the others aren’t available.

First aid for heat cramps

Once symptoms stop, the person may exercise again

Stretching, icing and massaging painful muscles may be helpful.

A bag with ice and water and wrapped in a towel may be applied to sore area for up to 20 minutes as tolerated.

Heat-related signs are a warning that the person’s condition may get worse if you don’t take action.

Heat Exhaustion

Similar to heat cramps, heat exhaustion also occurs when the body loses too much water and salt through perspiration.

Symptoms:

▫ Pale and clammy skin

▫ Excessive perspiration

▫ Weakness and tiredness

▫ Headache

▫ Muscle cramps

▫ Nausea and dizziness

▫ Vomiting or fainting

Treatment for heat exhaustion

Make sure the scene is safe. Get first aid kit and wear appropriate PPE.

Call or have someone call 9-1-1

Have the person lie down in a cool place

Remove as much of the person’s clothing as possible

Cool the person with cool water spray

If cool water spray is not available, place cool damp cloths on the person’s neck, armpits and groin areas

Have the person drink something with sugar and electrolytes (juice or Gatorade) or water if the others aren’t available.

Heat Stroke

A heat stroke occurs when heat causes high blood pressure and very high body temperature. Similar to heat exhaustion but is life-threatening.

You need to act quickly.

Key signs are

Confusion

Dizziness

Fainting

Seizures

Other symptoms:

▫ Red, dry, flushed skin

▫ Rapid, shallow breathing

▫ High temperature

▫ Fast, strong pulse

▫ Irritability

▫ Muscle cramps

First aid for heat stroke

Make sure scene is safe, get first aid kit and AED, wear appropriate PPE

Call or have someone call 9-1-1

Put the person in cool water, up to their neck if possible.

Check to see if the person needs CPR. If so, perform CPR.

Important points about heat stroke

Begin cooling person immediately. Every minute counts

If you can’t put person in cool water up to their neck, use cool water spray.

Stop cooling them once their behavior is normal again.

Only put water on the person’s skin

If they can drink, have them drink a sports drink if available and water if it’s not.

If they can’t drink, stay with the person until EMS arrives.

Exposure to Cold

Cold temperatures cause the body to shiver, which helps to keep it warm. However, even shivering is unable to keep the body warm in some conditions.

Causes of exposure to cold include:

▫ Improper dress

▫ Immersion in very cold water

▫ An affect of illnesses

Hypothermia

A patient with hypothermia will have a temperature reading below 95°F.

Hypothermia can be caused by submersion in extremely cold water. It can also result from spending too much time in cool, damp environments.

Symptoms:▫ Shivering

▫ Skin is cool to the touch and bluish in color

▫ Numbness

▫ Drowsiness/Confusion

▫ Personality may change, no concern about their condition

▫ Muscle stiff and rigid

▫ Poor coordination

▫ Unconsciousness

Signs of hypothermia cont.

As the body’s temperature continues to drop

The person stops responding

Their breathing slows

It may be difficult to tell whether or not the person is breathing

The person may appear dead

Treatment of hypothermia

Get the person out of the cold.

Remove wet clothing and pat the body dry.

Put dry clothes on the person and cover with a blankets.

Phone or have someone phone 9-1-1 and get the AED, if available.

Wrap the person up with anything you have—clothing, towels, newspapers, etc. Cover the head but not the face.

See if person needs CPR. If so, perform CPR.

Rewarming a victim with hypothermia

Place person near a heat source. And containers of warm, but not hot, water in contact with the skin.

Get follow-up medical care ASAP.

Frostbite

Frostbite occurs when skin and the tissues and fluids beneath it freeze from exposure to extremely cold temperatures.

Symptoms:

▫ Redness and tingling

▫ Numbness and white or gray/yellow, glossy skin

▫ Skin is cold and hard and doesn’t move when pushed

▫ Blisters

▫ Confusion

▫ Fatigue and weakness

▫ Unconsciousness

First aid for frostbite

Move person to a warm place.

Call or have someone calll 9-1-1

Remove tight clothing and jewelry from frostbitten area

Remove wet clothing and pat body dry.

Put dry clothes on victim and cover with blanket.

Do not try to thaw frozen parts if you think there is a chance for refreezing.

If you touch area, be gentile. Do Not rub it, it may cause tissue damage.