Class for Heat injuries. Made for the army setting to be given to medics, could also be given to laypeople about to train in hot enviornments.

1. By Sarah-Beth Roach

2. 3 Categories of Heat Injuries
 Heat Cramps
 Heat Exhaustion
 Heat Stroke

3. Situations Where Heat Injury Is Likely
• Prolonged exposure to extreme heat from the sun or
high temperatures.
• Wearing too much clothing in hot climates.
• Wearing MOPP gear or Body Armor in hot climates
• Inside closed spaces such as an armored vehicle.
• Is wearing body armor in hot weather

4. Individual Risk Factors
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History of prior heat injury.
Poor fitness.
Large body mass.
Minor illness.
Recent alcohol use.
Skin conditions.
Improper conditioning.
Poor diet.
Medications (perscription and OTC).
Illecit drug use.
Age over 40.

5. Risk Mitigation and Controls
 Work within an acceptable work to rest cycle.
 Accessible water points.
 Loosen or downgrade clothing.
 Formations held in shade.
 Avoid cumulative training.
 Identify high risk soldiers.
 Track wet bulb globe temperatures.

6. Cooling Mechanisms of the Body
The body maintains its temperature by balancing heat gain with heat loss
regulated by the hypothalmus.
As the major heat-dissipating organ, the skin can transfer heat to the environment
through conduction, convection, radiation, and evaporation.
Factors that interfere with heat dissipation
 Inadequate intravascular volume
 Cardiovascular dysfunction
 Abnormal skin.
 High temperatures and humidity
 Drugs
 hypothalamic dysfunction

7. Medications Can Affect Heat Regulation
Drugs may affect:
 Ability to sweat.
 Renal function.
 Vasodilatation.
 Cardiac output.
 Ability to perceive heat.
 The hypothalamus (portion of the brain that regulates body temperature).
The most dangerous of possible affects is the reduction in sweat rate. 90% of the body’s ability
to cool itself is the evaporation of sweat.

8. Medication Classes Affecting Heat Regulation
CLASS
MEDICATION EXAMPLE
EFFECT
Antihistamines
Benadryl, Zyrtec,
Loratadine
Sweating
Antidepressants
Lithium, Elavil, Prosac
Perception
Antipsychotics
Abilify, Seroquel
Sweating
Diuretics
Hydrochlorothiazide
Dehydration
Natural Health Products
Ephedra, Energy Drinks
Perception
Sympathomimetics
Pseudoephedrine
Recreational Drugs
Fentanyl, Cocaine
Sweating.
Sweating.
Vasodilation
Hypothalamus Function

9. Heat Cramps
Heat cramps are painful muscle spasms most often caused by
loss of electrolytes from physical exertion in extreme heat, or
prolonged exposure to heat without adequate hydration.
Muscles most often affected are those in the lower legs, arms,
abdominal wall, and back.

10. Heat Cramps Continued
Prevention
 Acclimate prior to strenuous activity,
 Wear appropriate clothing
 Hydrate and maintaining diet rich in sodium.
Signs and Symptoms
 Muscle spasms
 Thirst
 Sweating
 Fatigue & dizziness

11. Heat Cramps Continued
Treatment
 Move soldier to a cool or shaded area to rest
 Loosen the soldiers clothing
 Hydrate soldier orally
 Ice massages affected muscle

12. Heat Exhaustion
Heat exhaustion is caused by loss electrolytes without
proper fluid replacement.
Heat exhaustion can affect even those who are not
identified as having risk factors for heat injury.
Otherwise fit individuals can be affected when involved
in strenuous physical activity in a hot climate,
especially if they haven't been acclimated.

13. Heat Exhaustion Continued
Prevention
 Acclimate prior to strenuous activity.
 Wear of appropriate clothing.
 Hydrate maintainin diet rich in sodium.
 Following work/rest cycle.
 Use shaded areas when available.
Signs and Symptoms
 Excessive sweating & fatigue.
 Headache & dizziness.
 Loss of appetite & cramping.
 Nausea & vomiting.
 Chills.
 Tachypnea & tingling in hands or feet.
 Altered mental status.

14. Heat Exhaustion Continued
Treatment
 Move soldier to a cool or shaded area to rest.
 Loosen the soldiers clothing.
 Hydrate soldier orally with cool water
 Elevate the legs

15. Heat Stroke
Heatstroke (also known as hyperthermia) is the most severe form of the heat-related
illnesses.
There are two forms of heatstroke.
 Exertional heatstroke (EHS)
 Nonexertional heatstroke (NEHS).
In the United States, heat waves claim more lives each year than all other weather-related
exposures combined (hurricanes, tornadoes, floods, and earthquakes).

16. Heat Stroke Continued
Prevention
 Acclimating prior to strenuous activity
 Wear appropriate clothing
 Hydrate
 Use work/rest cycle
Signs and Symptoms
 Weakness
 Headache & dizziness,
 Loss of appetite
 Cramping & nausea
 Seizures,
 Tachypnea & weak pulse
 Tachycardia & altered mental status.

17. Heat Stroke Continued
Treatment
 Heatstroke is a medical emergency and can be
fatal. Soldiers should be medevaced to the nearest
MTF ASAP!
 Position the soldier in the shade and begin cooling
immediately.
 Elevate the legs
 Massage the limbs to promote blood flow

18. Cooling Techniques for Heat Injury
Evaporative Cooling
 Remove excess clothing
 Mist the skin constantly and fan.
 Complications: None.
Ice Sheets
 Remove excess clothing
 Wrap soldier in cold wet sheet. Include the head.
 Monitor the soldier closely.
 Complications: discomfort or shivering, hypothermia.
Strategic Ice Packing
 Remove excess clothing
 Place ice packs in the patient’s groin, in the axillae, and around the anterior neck.
 Complications: discomfort or shivering.

19. Strategic Ice Packing

20. Sources
National Collaborative Center For Environmental Health
http://www.ncceh.ca/en/major_projects/heat_advice/drugs
FM 4-25.11
Heatstroke Treatment & Management by Robert S Helman, MD
http://emedicine.medscape.com/article/166320-treatment
Cooling Techniques for Hyperthermia by Erik D Schrage
http://emedicine.medscape.com/article/149546-overview#a01