Well if we are going to talk about heat illnesses lets talk about them...
There are 3 classes (major ones) of heat illness which one may encounter while working outside in the heat, during physical training or real world operations. I have added a couple of the more minor ones.
I will briefly run down their s/s and treatment of each. Remember the best treatment is prevention. Proper hydration and acclimatization to the environment you are working/training/operating in is the key to avoiding the illnesses listed below. The only exception to this is the first illness. That being said:
Prickly Heat:
s/s:
1) Red rash that develops over actively sweating skin
2) Prickly sensation/pain over same area (caused by dysfunction of the sweat glands when blocked by salt crystals)
tx:
1) Cool and dry affected area
2) DO NOT apply creams to the area
3) Wash area with soap and a loufa(sp?)
4) If itching is severe, 25mg Benedryl PO q 4-6 hours for itching
Heat Syncopy:
s/s:
Self-explanatory
tx:
1) Cool victim and give cool fluids (powerade/gatorade, cut 50/50 with water) once he/she is alert and awake. The colder the fluid the better as its more easily absorbed by the stomach, however warm fluids are better than no fluids.
Heat Cramps:
s/s:
1) Painful muscle cramps which generally occur in the more heavily worked/exercised muscle groups
2) Onset during or immediately after work/training
tx:
1) Move to a shaded/cool area
2) Rest
3) Drink cool fluids (powerade/gatorade, cut 50/50 with water)
Heat Exhaustion:
s/s:
1) Malaise, headache, weakness, nausea, vomiting (flu-like symptoms)
2) Tachycardia (rapid pulse > 100 bpm)
3) Sweating (usually profusely)
4) Temp usually normal (100.4 to 102.2 range)
5) Normal mental status
tx:
1) Move to shaded/cool area
2) Remove tight clothing
3) Drink cool fluids (powerade/gatorade, cut 50/50 with water)
4) Place ice/cold packs on the neck, groin, chest wall, under arms, in groin (dont place ice directly on skin)
Heatstroke: This is a true medical emergency and should be treated as such. The death rate is 80% when not treated effectively and properly.
s/s:
1) High temp (usually over 105)
2) Confused, disoriented, seizures, unconsciousness
3) Rapid breathing
4) Rapid pulse (over 100 BPM) and often very weak
5) Sweating may be present or absent
tx:
1) Call 911 if you are in an area where they can reach you. (Obviously this precludes operational environments as well as many training environments, however if training you should have an emergency plan ICO an accident.)
2) RAPID cooling (the faster the better). Place ice/cold packs on the neck, groin, chest wall, under arms, in groin (dont place ice directly on skin) or immerse in cool water if possible only until body temp has fallen to 102.2
3) Maintain the airway / NOTHING by mouth
4) Administer IV fluids (1-2 liters NS)
5) Treat for shock
Hyponatremia: Caused by drinking large volumes of h2o or other hypo-osmotic fluids. Often times it can be difficult to differentiate hyponatremia from heat exhaustion/stroke in a field setting because of the over lap of s/s. The most major difference is hyponatremia patients generally have a normal temp (less than 101) and heat exhaustion patients are generally greater than 102. This is a true medical emergency as well.
s/s:
1) Weakness
2) Lack of appetite
3) Nausea/Vomiting
4) Muscle Cramps
5) Lethargy, apathy, confusion, agitation, seizures, disorientation, unconsciousness
tx:
1) Call 911 if you are in an area where they can reach you. (Obviously this precludes operational environments as well as many training environments, however if training you should have an emergency plan ICO an accident.)
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HTH,
Crip
Tell us about the leaches/bleedings and brandings you got at the RAP and what drill is like with a SMLE.
