40 y/o female heat exhaustion
- Thread starter musicislife
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You don't have to over think it.
It sounds like somebody who is overexerted in heat distress.
First, cooling is what is needed. Which may or may not be done in a hospital.
If this is a sanctioned event, there is probably a mechanism for treating this sort of thing on scene.
Usually after a person vomits a few times they feel better. Often they will be observed, get some oral rehydration, maybe a meal, and be on their merry way.
mycrofft
Still crazy but elsewhere
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You might be able to find vomitus with an otoscope, (as in "OTOscope") after that. Especially if they cough on the rebound.
R
Remo
Guest
I am no expert as this is just the beginning of my EMS knowledge but I was under the impression that cooling a patients body too rapidly will cause shivering, which will actually cause a spike in core body temp.
Slowly cooling the patient via shade or in the back of an air conditioned ambulance would be suffice.
Her vitals signs are a bit elevated, so I would try to keep her calm by having a conversation with her, explain why this is happening to her and reassuring her that everything will be alright.
*The use of oxygen would be beneficial to the patient for it REDUCES nausea and vomiting.
*Transport the patient to the hospital where she will receive fluids and further care.
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NomadicMedic
I know a guy who knows a guy.
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I think we've beat this one to death, but for the last time, oxygen does NOT reduce nausea and vomiting. Antiemetics, like Zofran, do that. And yeah, if she wanted to go to the hospital I'd put her in a cool ambulance, start a line and give her Zofran. Other than that, she doesn't need much from EMS. (unless, of course, we want to play the "what if she had a cardiac event" game, but I don't think that's where the OP was going with this)
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R
Remo
Guest
No one told me that but... A lack of oxygen due to over overexertion may cause
nausea as there is a change in the composition of blood being circulated
through the body. If supplemental oxygen was given I only assumed it would
help reverse the effect. I don't know, maybe it doesn't work that way. I was
just thinking of a quick and simple intervention off the top of my head :unsure:
Could I point you in the direction of Guyton's Medical Physiology.
Still have my Guyton's text.
AnthonyM83
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I actually read that study back in 2005-ish or so.
NomadicMedic
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What study is that? One that says oxygen is an antiemetic? got any citations?
Melclin
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Surely a bit of common sense comes into this.
I've often told my first aid/FR chaps and chapettes that what they do is medically flavoured common sense. Mostly you just do what is reasonable and sensible and occasionally use a bit of extra learnin to know when to call an ambulance and what to do in the mean time.
But its often a battle. It seems like you give a person a first aid cert and all of a sudden everything is massively over thought in some of the oddest and most confusing ways. "Oh he was pale and sweaty, so he was obviously going into shock. We wrapped him in blankets and put his legs up". "Ah...yeah cool...Soooo you don't think the fact he just came out of a mosh pit had anything to with the pallor and sweatiness?
Really guys, sink 9 beers and jump about to some absurdly loud music...run too far with too little water...during the heat...on a stomach full of curried sausages. See how good you feel. You'll chunder your guts up until you're ready for a another beer. Seriously has no one every done a bit of exercise and found themselves to be nauseated, flushed, tachy and hot..maybe had a bit of cramping. Its really no great mystery whats wrong. You can probably cancel the chopper. Give them a moment in the shade to grow a pair, cool down, drink a bit more water and send them on their way.
I've often told my first aid/FR chaps and chapettes that what they do is medically flavoured common sense. Mostly you just do what is reasonable and sensible and occasionally use a bit of extra learnin to know when to call an ambulance and what to do in the mean time.
But its often a battle. It seems like you give a person a first aid cert and all of a sudden everything is massively over thought in some of the oddest and most confusing ways. "Oh he was pale and sweaty, so he was obviously going into shock. We wrapped him in blankets and put his legs up". "Ah...yeah cool...Soooo you don't think the fact he just came out of a mosh pit had anything to with the pallor and sweatiness?
Really guys, sink 9 beers and jump about to some absurdly loud music...run too far with too little water...during the heat...on a stomach full of curried sausages. See how good you feel. You'll chunder your guts up until you're ready for a another beer. Seriously has no one every done a bit of exercise and found themselves to be nauseated, flushed, tachy and hot..maybe had a bit of cramping. Its really no great mystery whats wrong. You can probably cancel the chopper. Give them a moment in the shade to grow a pair, cool down, drink a bit more water and send them on their way.
AnthonyM83
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Nope. Didn't think to save it and don't care enough to go lit searching
But I do remember someone posted it in context for not just giving everyone O2...have a reason whether it be for hypoxia, hypoperfusion, nausea, etc.
:rofl:
Common sense is an uncommon virtue.
At risk of sounding condecending, many providers of all stripes are educated to regurgitate information, not to extrapolate it.
This is especially true of EMS.
The best teachers I have ever had have taught me how to apply theory to practicality.
The worst are the ones who professed practicality at the expense of theory.
Somewhere in the middle were the theorists who never mentioned the practical because they thought if you knew the theory the practical was so obvious it didn't need to be said.
AnthonyM83
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Definitely something that we're lacking in current education models at least for EMTs. You get a crash course to barely learn the skills, then thrown in. Locally get 3-5 12hr shifts where you more just show basic functioning ability, and off you go to learn how to apply the theory and skills to the patient.
zzyzx
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True, but how much education do you really need to be an EMT in L.A.? For those that work on 911 cars, they always run calls with multiple paramedics on scene. And of course most EMT's working for the zillion ambulance companies in L.A never do anything but BLS transports.
NomadicMedic
I know a guy who knows a guy.
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Nope. Didn't think to save it and don't care enough to go lit searching
But I do remember someone posted it in context for not just giving everyone O2...have a reason whether it be for hypoxia, hypoperfusion, nausea, etc.
Yeah... I'm not a big fan of the "I read it somewhere" posts. If you're going to make a claim that it was published research, at least post the citation.
Yeah... I'm not a big fan of the "I read it somewhere" posts. If you're going to make a claim that it was published research, at least post the citation.
Everyone knows O2 is an antiemetic....in patients older than 60 with minor trauma.
http://www.ncbi.nlm.nih.gov/pubmed/11794455