EMS World

JUN 2015

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

Issue link: https://emsworld.epubxp.com/i/516933

Contents of this Issue

Navigation

Page 17 of 59

EMSWORLD.com | JUNE 2015 17 to get a pulse oximetry reading due to poor perfusion of the skin. The patient's pulse rate remains around 130, his blood pres- sure is 100/palpable, and his respiratory rate is around 28 a minute. The three-lead cardiac monitor shows a sinus tachycardia. The patient becomes unresponsive except to painful stimuli. The air conditioning is on high, and the back of the ambulance gets slippery due to water and ice being used for cooling. The paramedic directs the ambulance to transport to the regional heart center and calls ahead to notify the emergency department. Hospital Course On arrival at the ED, the patient has a rec- tal temperature of 105ºF despite about 30 minutes of prehospital cooling. The cardi- ac bypass operating room is opened, and he goes through that process. He's then placed in the intensive care unit and recov- ers slowly. His career in the fire service is complete. Case Discussion The most serious form of heat illness is often referred to as heatstroke. The most important symptom that differentiates severe heat illness is an altered level of consciousness. The risk factors for severe heat illness are: • Poor physical fitness/excessive body weight, and those who have had a previ- ous heat-related illness; • Older age. Persons over 40, even those in relatively good physical condition, have an increased potential for heat illness; • Medications or street drugs. Many medi- cations and a large number of illegal drugs can impact the body's temperature-regu- lating systems and hydration level; • Lack of heat acclimatization. This means severe heat illnesses often happen in the first few weeks or months after winter weather. By late August or September, most of the United States is acclimatized to hot weather, and severe heat illnesses are rare. Severe heat illness occurs when the body's temperature-regulating and cool- ing mechanisms are not operating normally. The victim's metabolic systems can run out of control, and the core temperature contin- ues to rise. The earliest signs of heatstroke are in the ability to think clearly. The victim will often get confused or disoriented or act in a way inappropriate for circumstances, such as donning clothes because they feel cold. Some patients get very agitated and Learning Point Incident rehabilitation is an important part of training operations with heavy physical activity. Altered mental status is the key symptom for recognizing patients in seri- ous trouble from a heat-related illness. • Prestan's most PORTABLE manikin • 4 complete manikins weighing only 13 lbs. • No small parts to break or buy • Realistic chest compressions to a 2" depth • Fast and easy setup • Compatible with AED Trainer pads • Afordable and durable training-on- the-go • 3-year warranty ® ® NATURAL RUBBER LATEX For More Information Circle 17 on Reader Service Card

Articles in this issue

Links on this page

Archives of this issue

view archives of EMS World - JUN 2015