Heat Related Illness and Injuries

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Heat-related illness and injuries are the most frequent cause of environmentally related death, occurring more often than illness or injury related to lightning, tornado, hurricane, flood, cold, and winter-related fatalities.

Such illnesses and injury range from minor conditions such as heat rash, edema, cramps and fainting to moderate conditions such as heat exhaustion. Heat stroke is a major heat emergency, representing complete breakdown of the body's ability to regulate its temperature.

Presentation prepared by John W. Lyng, MD, FACEP, NREMT-P. Dr Lyng is Medical Director or North Memorial Ambulance & Air Care and an Emergency Department Physician at North Memorial Medical Center in Minneapolis.

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Heat Related Illness and Injuries

  1. 1. Heat Related Illness and Injuries John W. Lyng, MD, FACEP, NREMT-P Medical Director, Office of the Medical Directors North Memorial Ambulance & Air Care Emergency Physician, Dept. of Emergency Medicine North Memorial Medical Center
  2. 2. Heat Related Illness and Injuries Most frequent cause of environmentally related death  More than lightning, tornado, hurricane, flood, cold, and winter-related fatalities Incidence:  ~ 1 per 1 million for 5-44 y/o  ~ 5 per 1 million for >85 y/o  Males and females are equally affected ~400 deaths annually (about 8 per state!!)  Risk of death from Heat Stroke 10-75%, and increases if treatment is delayed >2 hours after onset of severe symptoms ~60,000 cases seek medical attention each year in the US
  3. 3. Risk Factors Not drinking enough water  Dehydration  Results in decreased ability to cool the body by sweating  Each 1% decrease in body weight due to dehydration can = a core temp increase of 0.2-0.5°F  Athletes voluntarily drink only 50% of volume lost via sweating Obesity Constant exposure to heat without air conditioning or night cooling Certain medications used to treat high blood pressure, heart conditions, and fluid retention in the legs
  4. 4. Minor Heat Injury  Heat Edema, Heat Rash (Prickly heat)  Heat Cramps  Due to deficiency in electrolytes and fluids  Heat Fainting  Dizziness when sitting or standing  Does not represent significant dehydration  Treat with fluids, rest, and removal from hot environments
  5. 5. Moderate Heat Injury: Heat Exhaustion Significant dehydration  Weakness, lightheadedness, dizzyness, nausea, vomiting, headache, muscle aches Fast pulse, fast breathing, sweating, fainting Core temperature from normal (98.6°F) to 104°F Mental Status is NORMAL  Treat with fluids, rest, and removal from the hot environment
  6. 6. Major Heat Injury: Heat Stroke Mental Status Change (confusion, disorientation, lethargy, unconsciousness) Core temp >104°F Lack of sweating is present in about 50% of cases Represents complete breakdown of the body’s ability to regulate its temperature Primary cause is increased heat production but can be related to inability to escape excessively hot environments
  7. 7. Heat Illness: Prevention  Ensure adequate hydration with water  For every 2 bottles of water drink 1 bottle of sports beverage  Avoid energy drinks, pop/soda, and other beverages that contain caffeine  Schedule sports practices, games, yardwork and other outdoor physical activities during cooler times of day  Provide shade  Provide cooling/misting fans  Take frequent heat breaks  Encourage use of sunscreen
  8. 8. If you suspect someone is suffering from aIf you suspect someone is suffering from a heat-related injury or illness:heat-related injury or illness: Call 911 Remove the victim from the hot environment if possible Loosen and/or remove clothing Spray the victim with with room temperature water and use a fan to blow air across the victim’s body Apply cold packs to the groin, neck, and armpits Do not fully immerse in cold water
  9. 9. You can prevent dangerous injuries andYou can prevent dangerous injuries and illness from excessive heat:illness from excessive heat: Do not allow children or pets to sit in any motor vehicle unattended for any period of time Check in on older adults to ensure they have access to a cool environment Drink plenty of fluids Limit consumption of caffeine and alcohol Make sure pets have access to plenty of fresh water and shade Avoid outdoor activities during the hottest part of the day

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