XIX. Heat and Cold Related Emergencies
When the body is overwhelmed in its attempt to regulate body temperature, a heat- or
cold-related emergency can occur. A heat- or cold-related emergency can happen anywhere
(indoors or outdoors) and under a variety of conditions. The signals of a heat-or cold-related
emergency are progressive and can quickly become life threatening. A person can develop a
heat- or cold-related emergency, even when temperatures are not extreme.
The following effects determine an individual’s susceptibility:
1. Humidity
2. Wind
3. Clothing
4. Living and working environments
5. Physical activity
6. Age
7. Health
The three main factors affecting how well the body maintains normal body temperature are—
1. Air temperature
2. Humidity
3. Wind
Other factors affect how well your body manages temperature extremes. These factors include—
1. Clothing
2. Breaks from exposure to extreme temperature
3. Water intake
4. Intensity of activity
People more susceptible to a heat- or cold-related emergency include—
1. Those involved in strenuous activity in warm or cold environment.
2. Elderly people.
3. Young children.
4. Those who have predisposing health problems.
5. Those who have had a previous heat- or cold-related emergency in the past.
6. Those who have cardiovascular disease.
7. Those who take medications to eliminate water from the body (diuretics).
Heat-Related Emergencies
Conditions associated with overexposure to heat are—
1. Heat cramps
2. Heat exhaustion
3. Heat stroke
Heat Cramps
Heat cramps are painful spasms of skeletal muscles. Heat cramps usually affect the legs
and the abdomen.
To recover from heat cramps—
1. Rest
2. Lightly stretch the affected muscle
3.Replenish fluids
Heat Exhaustion
Heat exhaustion is the earliest stage and the most common form of heat-related illness.
Heat exhaustion is an early indicator that the body’s temperature-regulating mechanism is
becoming overtaxed.
The signals of heat exhaustion include—
1. Cool, moist, pale, ashen or flushed skin.
2. Headache, nausea, dizziness.
3. Weakness, exhaustion.
4. Heavy sweating.
Heat exhaustion in its early stage can usually be reversed with prompt care.
Heat Stroke
Heat stroke is the least common and most severe heat-related illness. Heat stroke most often
occurs when people ignore the signals of heat exhaustion. Heat stroke develops when the body
systems are so overtaxed by heat and begin to stop functioning. Sweating often stops because
body fluid levels are low. Heat stroke is a serious medical emergency.
The signals of heat stroke include—
1. Red, hot, dry skin
2. Changes in level of consciousness
3. Vomiting
If you recognize heat-related illness in its early stages, you can usually reverse it. Follow these
general steps:
1. Cool the body.
2. Give fluids if the victim is conscious.
3. Take steps to minimize shock.
Care for Heat-Related Illness
Care for someone in the late stages of heat-related illness involves—
1. Calling 9-1-1 or the local emergency number immediately.
2. Cooling the body.
3. Monitoring breathing and consciousness.
4. Being prepared to give rescue breathing or CPR, if needed.
Cold-Related Emergencies
Frostbite and hypothermia are two types of cold-related emergencies. Frostbite occurs in
body parts exposed to cold. Hypothermia develops when the body can no longer generate
sufficient heat to maintain normal body temperature. Frostbite is the freezing of body tissues.
Frostbite
Frostbite usually occurs in exposed areas of the body, depending on—
1. Air temperature.
2. Length of exposure.
3. Wind speed.
Frostbite can be either superficial or deep.
1. Superficial frostbite—The skin is frozen but the tissues below are not.
2. Deep frostbite—Both the skin and the underlying tissues are frozen.
Signals of frostbite include—
1. Lack of feeling in the affected area.
2. Skin that appears waxy.
3. Skin that is cold to the touch.
4. Skin that is discolored (flushed, white, yellow or blue).
When caring for a victim of frostbite—
1. Call 9-1-1 or the local emergency number.
2. Attempt to remove jewelry or restrictive clothing.
3. Handle the affected area gently; never rub the affected area.
4. If there is no chance that the frostbitten part will refreeze, you may begin re-warming
the affected area.
5. Loosely bandage the area with a dry, sterile dressing.
6. If fingers or toes are frostbitten, place dry, sterile gauze between them to keep them
separated.
7. Avoid breaking blisters.
Hypothermia
Hypothermia is the general cooling of the entire body. Body temperature drops below 95°
F (35° C).
Signals of hypothermia include—
1. Shivering (may be absent in the later stages of hypothermia).
2. Numbness
3. Glassy stare
4. Apathy
5. Weakness
6. Impaired judgment
In the case of severe hypothermia—
1. The victim may be unconscious.
2. Breathing may have slowed or stopped.
3. The body may feel stiff as the muscles become rigid.
To care for hypothermia—
1. Check and care for life-threatening conditions.
2. Call 9-1-1 or the local emergency number.
3. Carefully remove wet clothing and dry the victim.
4. Warm the body.
5. Move the victim to a warm environment.
6. If available, apply hot water bottles, chemical heat packs or other heat sources to the
body.
7. If the victim is alert, give him or her warm nonalcoholic and decaffeinated liquids to
drink.
8. Rewarm the victim gradually and handle him or her gently.
9. Monitor breathing and signs of circulation and continue to warm the victim until EMS
personnel arrive.
10. Be prepared to give rescue breathing or CPR if necessary.
Emergencies resulting from overexposure to extreme temperatures are usually preventable.
You can prevent overexposure to extreme temperatures by following these guidelines:
1. Avoid being outdoors.
2. Dress appropriately.
3. Change your activity level.
4. Take frequent breaks.
1. Drink large amounts of nonalcoholic or decaffeinated fluids.
Scenarios
Twenty-year-old Todd Wilson is doing construction work for his uncle this summer.
Todd is putting fiberglass insulation in an attic. He is wearing long pants, a long-sleeved shirt,
goggles, a face mask and a hat to protect him from contact with fiberglass.
Outdoor temperatures have been running about 95º F and this day is exceptionally humid as well.
Todd had hoped to have finished this job the evening before but has to return to the job around
noon the next day. He expects that it will take about 5 ½ hours to complete the work. Because
Todd is in a hurry, he is working quickly to finish the job. He figures he can save some time if he
does not take any breaks. About 2 hours later, drenched with sweat, Todd starts to feel dizzy,
weak and nauseated. He barely has the energy to get down from the attic.
Scenario 1
Conscious Person with Serious Head, Neck or Back Injury
At work, you are called to give care for a co-worker who has fallen from an 8- foot ladder. As
you arrive, you see the victim lying on the ground. She is crying and moaning in pain. A
bystander says that she landed on her back. The victim has not moved from this position. She
says that she has tingling and numbness in her legs and feet and pain in her back. She also has a
2-inch laceration on the side of her head.
You want to help. How do you proceed?
Scenario 2
Conscious Victim with Extremity Injury
You are coaching a little league baseball team. The pitcher is struck with a line drive to the ankle
and falls to the ground. He is crying and in pain, unable to move the limb. Slight swelling and
discoloration are already present. You are about 3 minutes away from the nearest hospital. The
player’s parents are not at the game. You have a signed consent form from the parents to give
care to all of the kids.
You want to help. How do you proceed?
Scenario 3
Sudden Illness
For several hours, your 60-year-old aunt has been complaining of indigestion while at your home
for a seafood cookout. She now says that she has severe stomach pain and feels nauseous. She
thinks pain and nausea relate to the food she ate. You notice that her skin is rather pale, she is
breathing rapidly and she looks ill.
You want to help. How do you proceed?
Scenario 4
Heat-Related Emergency
It is late in the afternoon, and your team is finishing its third match of the volleyball tournament
on the beach. The day has been hot with temperatures in the 90s. Suddenly, a teammate
collapses. She does not appear to be fully conscious, but is breathing rapidly. You notice that her
skin is very warm, sunburned and moist. Her pulse is very fast. She is unable to get up from the
ground.
You want to help. How do you proceed?
Scenario 5
Substance Abuse
A dangerous ritual is about to begin—21 drinks for the 21st birthday. A group of close friends
has gathered for a special party for the “birthday boy.” Everyone knows it is a dangerous game,
but, because each of these friends went through it, they believe it is a rite of passage into
adulthood. The activities begin and the guest of honor is soon chugging beers and downing shots
of liquor at a rapid pace. Two hours after the drinking began, you arrive at the party. The guest of
honor is vomiting violently in the bathroom. He slumps to the floor and begins violent
convulsions, then stops moving. He seems to stop breathing and then takes a deep breath.
You are called to help. How do you proceed?