Prehospital Management of Heat stress.pdf

Heat Stress and Management.

1. HEAT STRESS

2. Disclosures
 The speaker has no financial arrangement or affiliation with a
corporate organization offering financial support or grant monies
for, or related to, this activity.
 The speaker has no financial relationship with a manufacturer of
a product discussed in my presentation at this continuing
medical education program.
 The speaker has no relationships to disclose.
 The speaker has read the Disclosure Policy and agree to abide by
it.

3. Learning objectives
At the end of the discussion, the learners will be able to:
 Define heat stress and its impact on health.
 Identify signs and symptoms of heat-related illnesses.
 Discuss prevention strategies in clinical and community
settings.
 Describe nursing interventions for managing heat
stress.

4. Introduction
DEFINITION OF HEAT STRESS
IMPORTANCE OF AWARENESS AND EDUCATION
OBJECTIVES:
1- UNDERSTAND WHAT HEAT STRESS IS AND HOW IT AFFECT THE HUMAN BODY
2- IDENTIFY THE VARIOUS TYPES AND SYMPTOMS OF HEAT STRESS
3- RECOGNIZE POPULATION AT RISK FOR HEAT STRESS
4- EXPLAIN EFFECTIVE NURSING MANAGEMENT STRATEGIES FOR HEAT STRESS
5- DISCUSS MEDICATION AND TREATMENT OPTION FOR MANAGING THE HEAT
STRESS
6- OUT LINE PRACTICAL PREVENTION MEASURES FOR INDIVIDUALS AND
COMMUNITIES

5. Meaning of Heat Stress
 TO UNDERSTAND WHAT IS HEAT STRESS FIRST WE SHOULD UNDERSTAND HOW IS THE
BODY THERMOREGULATION WORKS
 THE HUMAN BODY CONSTANTLY WORKS TO MAINTAIN AN INTERNAL
TEMPERATURE AROUND 37°C (98.6°F) A PROCESS CALLED THERMOREGULATION
THIS BALANCE IS CONTROLLED BY TOW FACTORS





HYPOTHALAMUS
AN AREA IN THE BRAIN THAT
ACTS AS THE BODY
THERMOSTAT
MECHANISMS OF THERMOS
REGULATION
-WHEN THE BODY TEMPERATURE RISES,
THE HYPOTHALAMUS ACTIVATES
COOLING MECHANISMS

6. Mechanisms of thermoregulation
1. Sweating:
Sweat glands release sweat onto the skin’s surface, which evaporates and cools the
body .
2. Vasodilation:
Blood vessels near the skin expand, increasing blood flow to the surface. This releases
heat through radiation and convection.
3. Behavioral responses:
Seeking cooler environment, reducing physical activity , or drinking fluids to cool
down.

7. When all the previous cooling mechanism
become overwhelmed due to prolonged
exposure to heat, or excessive physical activity,
the body cannot adequately release heat,
leading to heat stress and related illnesses

8. Environmental Factors Contributing to
Heat Stress

• High temperature and humidity
• Lack of airflow
• Direct sun exposure

9. Occupational Factors Contributing to Heat Stress
• Working outdoors in hot conditions
• Lack of proper protective gear
• Extended physical exertion

10. Physiological Factors Contributing to Heat
Stress

• Age (children and elderly)
• Health conditions (heart disease, obesity, hypertension)
• Medication side effects

12. Common Medication Categories Affecting Heat Stress Risk:
• Antihypertensive medications (especially diuretics and beta-blockers)
• Psychiatric medications (antipsychotics, antidepressants)
• Anticholinergics (medications for allergies, urinary problems, gastrointestinal issues)
• Cardiovascular medications
• Recreational drugs and alcohol
Recommendations for Nursing Care:
Medication review:
• Regularly review patient medication regimens, especially in elderly or vulnerable populations.
Education:
• Inform patients about potential medication-related heat risks and preventive measures.
Monitoring:
• Carefully monitor patients on these medications during periods of high heat and humidity.

13. Types of Heat Stress
• HEAT EXHAUSTION
• HEAT STROKE
• HEAT CRAMPS
• HEAT RASH

14. • HEAT EXHAUSTION

 can occur when you exert yourself, especially in hot weather. Symptoms include heavy sweating,
headache, dizziness, nausea and fast heart rate. Immediately stop what you’re doing and move to a
cooler area. Cool your body and seek medical care. Untreated heat exhaustion can progress to life-
threatening heat stroke.

15.  Excessive loss of salt, water, or both causes heat exhaustion. People who
aren't acclimatized to a hot environment are at greater risk for heat
exhaustion.
 Someone suffering from heat exhaustion may be irritable, exhibit poor
judgment, and experience headache, nausea, vomiting, diarrhea, intense
thirst, vague malaise, and dizziness. the temperature probably will be
elevated (100.4° F to 102.2° F [38° C to 39° C]), but it may be normal. Other
signs of trouble include tachycardia, tachypnea, dry mucous membranes, and
low urine output.

 Cool, clammy skin indicates shock. Remember: The line between heat
exhaustion and heatstroke is thin!
 To treat heat exhaustion, move the patient to a cooler environment—a
shaded area or an air-conditioned car or building—as quickly as possible.
Remove as much of his clothing as practical and apply water to his skin. If
water isn't available, use other liquids. If the patient is conscious and can
swallow, provide small amounts of water or a half-strength sports drink at
frequent intervals.

16. HEAT STROKE
 Heat stroke is a life-threatening
condition in which heat overwhelms
your body’s ability to manage its
temperature.
 Symptoms include dizziness,
fainting, blurred vision, slurred
speech and confusion.
 Heat stroke causes reduced blood
flow and damage to vital organs.
 Seek immediate medical care for
anyone with symptoms of heat
stroke.

17.  The classic signs and symptoms of heatstroke include early disorientation similar to that
seen in heat exhaustion.
 Disorientation may range from irrational behavior to frank psychosis and
unconsciousness.
 The patient's skin will be hot and flushed and may be dry because he may stop sweating.
 The temperature may be as high as 109.4° F (43° C).
 Other signs include vomiting, diarrhea, tachycardia, and tachypnea, which may be
profound; his respiratory rate may be as high as 60. The resulting respiratory alkalosis
may cause tetany.
 Pulmonary edema also may occur.
 Tachycardia, with rates that may be as high as 180 beats/minute.
 The ECG may show nonspecific ST-segment and T-wave changes and various atrial and
ventricular dysrhythmias.
 Muscle breakdown caused by heatstroke is evidenced by elevated creatine kinase (CK)
values, which can measure in the tens of thousands. (The normal range is 5 to 200 units/L.)

18. • HEAT CRAMPS
 Heat cramps are painful muscle spasms that can happen during
activity in hot environments.
 People who sweat a lot may be prone to heat cramps. Because of
the fluid and electrolyte loss that occurs through sweating often
contributes to heat cramps.
 Muscle spasms that are:
 Painful
 Involuntary
 Brief
 Intermittent
 Usually self-limited (go away on their own)
 The doctor will check for more severe heat illness and possibly provide an IV fluid for
rehydration.
 If the patient works in a hot environment, He may experience heat cramps during the first few days on
the job. Once He get used to the environment, and make sure he have adequate fluid replacement,
he are less likely to have problems.

19.  Heat cramps:
 Are caused by hyponatremia exacerbated by drinking water without
taking in salt.
 Large muscle groups, particularly in the legs and abdomen, are most
often affected.
 Severe cramping usually is accompanied by thirst.
 Move the patient to a cool, shaded spot and provide water.
 Provide small amounts of simple carbohydrates, such as sugared
carbonated drinks.
 Because sports drinks contain glucose, mix equal parts of the sports drink
and water to prevent the patient from vomiting.
 Stretching the muscles also may help.
 Monitor the patient closely for worsening signs and symptoms.
 If the cramps don't respond to treatment or the patient doesn't feel
better, take him to a hospital.

20. • HEAT RASH

21. Heat-Related Illness Symptoms and Signs
Heat stroke • Confusion
• Slurred speech
• Unconsciousness
• Seizures
• Heavy sweating or hot, dry skin
• Very high body temperature
• Rapid heart rate
Heat exhaustion • Fatigue
• Irritability
• Thirst
• Nausea or vomiting
• Dizziness or lightheadedness
• Heavy sweating
• Elevated body temperature or fast heart rate
Heat cramps • Muscle spasms or pain
• Usually in legs, arms, or trunk
Heat syncope • Fainting
• Dizziness
Heat rash • Clusters of red bumps on skin
• Often appears on neck, upper chest, and skin folds
Rhabdomyolysis (muscle breakdown) • Muscle pain
• Dark urine or reduced urine output
• Weakness

22. Immediate Management of Heat Stress

23. Assess Heat Stress

24. Nursing Management
 Assessment procedures (checking vitals, hydration status)
 TAKE THE AFFECTED WORKER TO A COOLER AREA (E.G., SHADE OR AIR CONDITIONING).
 COOL THE WORKER IMMEDIATELY. USE ACTIVE COOLING TECHNIQUES SUCH AS:
 THIS IS THE BEST METHOD TO COOL WORKERS RAPIDLY IN AN EMERGENCY.
 REMOVE OUTER LAYERS OF CLOTHING, ESPECIALLY HEAVY PROTECTIVE CLOTHING.
 PLACE ICE OR COLD WET TOWELS ON THE HEAD, NECK, TRUNK, ARMPITS, AND GROIN.
 USE FANS TO CIRCULATE AIR AROUND THE WORKER.
 NEVER LEAVE A WORKER WITH HEAT-RELATED ILLNESS ALONE. THE ILLNESS CAN RAPIDLY BECOME
WORSE. STAY WITH THE WORKER.
 MEDICATIONS TO STOP SHIVERING ( PARACETAMOL, DIAZEPAM OR LORAZEPAM )
 AN IV FLUIED FOR DEHYDRATION
 MONITORING AND DOCUMENTING PATIENT STATUS

25. Prevention of Heat Stress

Preventive Measures Employees Can Take:
 Drink small amounts of cool water frequently to prevent dehydration.
 Drink throughout the day to relieve thirst and maintain an adequate urine output.
 Wear appropriate clothing. During periods of elevated temperature, employees should wear loose-
fitting cotton clothing that allows ventilation of air to the body.
 Protect yourself from the sun by wearing a hat. (Sunglasses and sunscreen—SPF 30 or higher—are also
recommended.)
 Stand or sit up slowly. Flex leg muscles before moving.
 Take time to cool down. Rest often in shady areas. A few hours in air conditioning can help you stay
cooler later in the heat.
 Take time to use to heat and humidity. A heat wave is stressful to your body. You will have a greater
tolerance for heat if you limit physical activity until you become used to it.

26. Prevention of Heat Stress

27. Preventive Measures Supervisors Can Take
 Encourage employees to take breaks and hydrate any time they
feel necessary.
 Pace the job to allow more frequent breaks for fluid intake and
sufficient recovery time.
 Take a break in a shaded area or an air-conditioned building.

Work Schedule Changes
 When feasible, departments can schedule routine maintenance and repair work, which exposes
employees to heat-stressed conditions, until cooler periods of the day or cooler seasons. Limit sun
exposure during mid-day hours.
 If a job is essential for continuing university operations, consider implementing a worker rotation
schedule every hour or sooner. Allow sufficient recovery time for each worker.
 Implement summer work schedules (e.g., 6:00 a.m. to 2:00 p.m.).
 Permit heavy work only from 7:00 a.m. to 9:00 a.m. or earlier.
 Complete all other moderate to light work before 12:00 noon.
 If extensive PPE is required, then those jobs should be scheduled for the cooler part of the day (i.e.,
early mornings).

29. Workplace Prevention Strategies
• POLICY DEVELOPMENT AND IMPLEMENTATION
• TRAINING AND AWARENESS PROGRAMS
• PROVIDING FACILITIES AND RESOURCES
• PUBLIC EDUCATION CAMPAIGNS
• EMERGENCY PREPAREDNESS
• ROLE OF HEALTH AUTHORITIES

30. For Employers and Workplace Management:
• Develop clear heat-stress policies: Include guidelines on work-rest cycles, hydration breaks, and emergency
response procedures.
• Provide heat-stress training: Educate workers on identifying symptoms early, preventive measures, and
emergency first-aid procedures.
• Modify work schedules: Limit physically demanding tasks during peak heat hours; schedule tasks during
cooler morning or evening times.
For Healthcare Providers (Nurses and Medical Staff):
• Enhance patient education: Teach patients, particularly those at higher risk, about signs, symptoms, and
prevention of heat-related illness.
• Improve early detection protocols: Implement systematic assessments to quickly identify and treat heat-
stress patients.

31. For Individuals and Community Members:
• Stay hydrated: Regularly drink water or electrolyte-balanced beverages, even if not thirsty.
• Wear suitable clothing: Choose lightweight, breathable, and loose-fitting garments.
• Stay informed and proactive: Monitor weather forecasts, take necessary precautions during heatwaves,
and check regularly on vulnerable individuals (elderly, young children, chronically ill).


Public Health Authorities:
• Community awareness campaigns: Increase public awareness about heat stress through media and
educational programs.
• Emergency preparedness: Set up cooling centers and distribute educational resources during heatwave
periods.

32. ADNOC BEAT THE HEAT PROGRAM VIDEOS:
ACCESS HEAT STRESS.mp4
KEYS TO BEAT THE HEAT.mp4
ACCLIMATIZE GRADUALLY.mp4
BEAT THE HEAT WITH THE DIET.mp4
STAY HYDRATED.mp4
SCHEDULE YOUR REST BREAKS.mp4
BUDDY SYSTEM.mp4
MIDDAY BREAK RULE.mp4

33. Conclusion
• Understanding Heat Stress:
Recognizing heat stress and its severe health impacts is crucial for timely intervention and care.
• Identifying Risk Factors and Symptoms:
Awareness of environmental, occupational, and physiological factors helps prevent occurrences and
aids early detection of symptoms.
• Effective Management and Prevention:
Implementing appropriate nursing management, medical interventions, and preventive measures
greatly reduces heat stress cases and complications.
• Recommendations for Action:
It’s vital for healthcare professionals, employers, and individuals to work together proactively to
mitigate risks, establish safety protocols, and promote education about heat-related illnesses.
Call to Action:
Encourage everyone to prioritize heat stress education, prevention strategies, and preparedness plans
to protect themselves and others, especially vulnerable populations, from heat-related health risks.

35. References
1. Centers for Disease Control and Prevention (CDC)
Heat Stress – Heat-related illnesses
https://www.cdc.gov/niosh/topics/heatstress/default.html
2. World Health Organization (WHO)
Heatwaves and Health – Public Health Advice
https://www.who.int/health-topics/heatwaves#tab=tab_1
3. Occupational Safety and Health Administration (OSHA)
Heat Illness Prevention Campaign
https://www.osha.gov/heat
4. American Red Cross
Heat Wave Safety
https://www.redcross.org/get-help/how-to-prepare-for-emergencies/types-of-emergencies/heat-
wave-safety.html
5. National Institutes of Health (NIH) – MedlinePlus
Heat Emergencies
https://medlineplus.gov/heatemergencies.html