Chapter 9: Care of Patients with common environmental Emergencies Heat Related Illnesses Most common environmental factors causing heat related illness: o High environmental temperature (above 95F/35C) o High humidity (>80%) o Thermoregulation related illnesses: heat exhaustion and heat stroke Most at risk populations: older adults, people w/ mental health conditions, people who work outside (such as construction workers and agriculture workers [higher incidence in men]), homeless, illicit drug users (especially cocaine), outdoor athletes, members of the military who are stationed in countries w/ hot climates Obesity, heart disease, fever, infection, strenuous exercise, seizures, mental health disorders and all degrees of burns (even sunburn) can increase a persons risk Lithium, neuroleptics, beta blockers, anticholinergics, ACE inhibitors and diuretics increase the risk for heat related illness Health promotion and maintenance Avoid alcohol/caffeine Prevent overexposure to the sun (use a sunscreen w/ an SPF of at least 30 w/ UVA and UVB protection) Rest frequently and take breaks from being in a hot environment (limit activity during the hottest time of the day) Wear clothing suited for the environment (light weight, light colored and loose fitting) Pay attention to personal physical limitations (modify activity accordingly) Take cool baths or showers to help reduce body temp Stay indoors in air conditioned buildings when possible Ask a neighbor, friend or family member to check on older adults at least BID during a heat wave Heat Exhaustion Pathophysiology o Syndrome resulting primarily from dehydration
o Caused by heavy perspiration and inadequate fluid and electrolyte intake during heat exposure over hours to days o Pt feels ill, manifestations resemble the flu o Leads to dehydration and hyponatremia (from sweating) o If untreated, can lead to heat stroke which is an emergency Patient centered collaborative care o Pt usually has flu like symptoms w/ HA, weakness, nausea/vomiting o Usually no fever o Pt may continue to sweat despite dehydration o Assess for orthostatic hypotension and tachycardia (especially in older adults) o Pt should immediately stop physical activity, move to a cool place, and use cooling measures (cold packs to neck, chest, abd, and groin, soaking in cool water, or fanning them while spraying water on the skin) o Remove constrictive clothing, provide oral rehydrating solution (such as a sports drink) Drinking plain water can worsen hyponatremia o Do NOT give salt tablets: they can cause stomach irritation, nausea and vomiting o Monitor v/s, rehydrate with NS, draw blood for serum electrolyte analysis Heat Stroke Pathophysiology o MEDICAL EMERGENCY o Body temp may exceed 104F/ 40C o Thermoregulation mechanisms fail and cannot adjust for critical elevations in body temp o Two major types Exertional heat stroke – sudden onset; often the result of strenuous physical activity in hot, humid conditions
You've reached the end of your free preview.
Want to read all 26 pages?
- Winter '16
- Cardiac arrest, pulmonary edema, Edema, Hospital Care