2-18 HYPERTHERMIA

Heat exhaustion is characterized by systemic symptoms such as weakness, dizziness, nausea, vomiting, muscle cramps and or syncope due to excessive loss of body fluids and salts while in a hot environment.  Heat Stroke is a medical emergency signified by very hot, dry skin with associated mental status changes such as decreased level of consciousness, confusion and/or seizures.  This condition occurs most frequently in the very young and old          

EMR - Emergency Medical Responder

1. Initial assessment
2. If patient has an altered mental status, apply oxygen and consider ALS Intercept
3. Treat hyperthermia
   1. Have patient cease all physical activity
   2. Move the patient to a cool environment
   3. Remove excess clothing
   4. Cool patient using mist with fan to promote cooling, if available, or apply cool damp towels and allow evaporation if misting not available
   5. Cold packs to groin, axilla and neck (central pulse points) as needed
   6. Avoid shivering.  This will counteract cooling mechanisms.
   7. Place supine or in slight Trendelenburg position as needed
4. If the patient is hypotensive and tachycardic, place the patient in the Trendelenburg position and initiate ALS Intercept.
5. Observe for seizure activity.
6. If alert, sips of water, Gatorade or other electrolyte solution is permissible if nausea is minimal or not a factor.

EMT - Emergency Medical Technician  Perform/Confirm All Above Interventions

1. Perform Glucometry and follow hypoglycemia protocol if indicated.
2. Apply cardiac monitor, print rhythm strip for reference
3. Transport with continued cooling measures and ongoing assessment

AEMT – Advanced Emergency Medicine Tech   Perform/Confirm All Above Interventions

1. If unable to drink fluids, establish IV access and administer 500 mL normal saline then contact Medical Control for further fluid orders.

Intermediate - Perform/Confirm All Above Interventions

1. If the patient develops any seizure activity, treat via the seizure protocol.
2. Consider appropriate pain medication for muscle cramps as per Pain Management protocol.

Paramedic - Perform/Confirm All Above Interventions