Transcript Hyperthermia (PowerPoint presentation)

Hyperthermia Standing Order
HYPERTHERMIA
(Heat Illness)
• State of unusually high core body temp
• Predisposing Factors:
1. Age of the patient: less tolerable in peds and
geriatric.
2. Health of the patient: i.e. diabetics can become
hyperthermic more easily because of the damage DM
inflicts on their autonomic nervous system
(thermoregulatory input, vasodilation, perspiration)
3. Medications: i.e. diuretics >dehydrartion,Beta
Blockers<vasodilation, psychotropic's< CNS regulation
Predisposing factors continued:
4. Level of acclimation: adjusting to environment
change
5. Length of exposure
6. Intensity of exposure
7. Environmental factors such as humidity and
wind
Organ Systems Responsible for
Heat Loss
• Skin: vasodilatation and perspiration
• Cardiovascular: increased cardiac output
to compensate for peripheral
vasodilatation with increased volumes of
blood to periphery
• Respiratory: some degree of evaporation
Humidity
• Evaporation and perspiration are the
primary and most effective methods of
cooling
• At very high humidity, perspiration is totally
ineffective
The Range of Heat Illnesses
Heat Cramps: Painful, easily treated,
acclimation occurs
Heat Exhaustion: Serious but no organ
damage, mild hyperpyrexia
Heatstroke: Critical organ damage,
significant mortality, markedly elevated
body temperature, usually > 105’
Heat Cramps
• Painful contractions of larger muscle groups
during or shortly after strenuous exercise in the
heat
• Usually caused by replacement of water without
adequate salt resulting in a low sodium state in
the muscles
• Treated with cooling measures, fluid and
electrolyte replacement via IV.
• No changes in mental status or fever
Heat Exhaustion
• Salt or water depletion in the face of heat stress
• Mild hyperpyrexia, nausea, vomiting,
lightheadedness, dehydration with only minimal
altered mental status
• Leads rapidly to heatstroke if not rapidly
reversed
• Treated with cooling measures, also IV Normal
Saline, further electrolyte replacement guided by
serum electrolyte levels
Heatstroke
• Heatstroke results when the body’s
thermoregulatory mechanisms are
overwhelmed by the heat stress. The
body’s temperature rises markedly with
eventual multisystem organ failure.
Exertional and Classic Heatstroke
• Exertional: younger, physically fit with normal
thermoregulatory systems
– Frequently not dehydrated and may be wet with
perspiration
– Significantly elevated body temperature
• Classic: older or debilitated exposed passively
to significant thermal stress over hours or days.
– Ability to respond is compromised by CV disease,
drugs, alcohol.
– Usually perspiring for significant time and profoundly
dehydrated
Organ Systems Affected by
Heatstroke
CNS
Altered mental status always,
posturing, paralysis, seizures, coma
High-output CHF, pulmonary edema,
Cardiovasc
complete CV collapse
Hepatic
Central lobular necrosis (with
elevated Liver Function Tests)
Renal
Frequent rhabdomyolysis,
Treatment of Heatstroke
• ABC’s
• Cooling measures to lower the patient’s
temp to <101ºF within 1 hour.
• Prevent shivering as this raises the core
body temperature
• Keep patient NPO.
• IV NS, fluid bolus’, O-2, cardiac monitor,
• Anticipate seizures: Rx valium
• True life threatening emergency so load
and go to the closest E.D.
Take the test now. Must pass
with 90%.
1. Review answers to test if made available.
2. Make sure your test info is completely
filled in.
3. Collect test and mail to your Prehospital
Manager.
4. Will receive 1 hour SAEMS CEU
with in one week of mailing.
5. May begin using SAEMS Hyperthermia
Standing Order as soon as you pass test
with 90% & confirmed by your Prehospital
Manager.
6. Questions? Call your Prehospital
Manager.