Heat Issues

sop

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How are you dealing with heat issues? How have you been keeping cool? Have you been training your body to handle the heat? If so, how? Now that it is hot outside and some areas don't have AC, it seems like more calls are being requested in those areas.
 

Linuss

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I'm confused--- are you asking how we handle PTs with heat issues, or how we stay safe ourselves?
 

LucidResq

Forum Deputy Chief
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I stay in my first aid station, which is a small building with AC and the rest of the works.

When I have to stay out in the heat at our water park first aid station, I get to wear shorts and sandals. I drink plenty of water, which I keep cool by storing in a cooler filled with ice that we primarily use to make ice packs.

As far as pts go, I see tons of heat exhaustion/dehydration/syncope every time I work at the amusement park. Our first priority is getting them out of the heat, so the AC in our little first aid station is usually cranked. Sometimes it's a bit chilly for us caregivers, but you gotta do what you gotta do. We give lots of PO fluids - cold water, but encourage them to sip slowly. Sometimes I'll take cool, damp paper towels and place them on the pts neck, forehead, etc. About 1 in 20 of heat/dehydration pts gets an IV - 500 cc + of NS, usually after PO fluids fail.

As far as eval. goes, we watch their BP and HR carefully and of course get a detailed medical / RX history. It's important to know what they've been doing today / yesterday as far as activity, fluid intake and output, and food. Because we are at altitude and are an "attraction", we see a lot of people coming from sea level that get pretty sick when they come up a mile higher suddenly and don't drink or eat enough.

A lot of people get all hot and dehydrated and syncope, then fall from standing. Were they caught by friends and assisted to the ground? Did they hit their head on anything? Was there any definite LOC? Any AMS? Retrograde / Anterograde amnesia? Any deformity or tenderness on the head or face? C-spine supple, nontender, non-deformed?... etc, etc. We try to avoid backboarding these pts when reasonable, because being strapped to a backboard is only likely to aggravate the primary cause of their c/c, which is very often simple hyperthermia and dehydration.

I have only seen one of these pts backboarded once and it was because she syncoped on a slippery surface and banged her face pretty good, giving her a 5-7 mm suturable lac straight down her forehead and a steady posterior epistaxis.
 
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sop

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MRE

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1. Keep yourself in good physical condition, no sense in carrying an extra 100lbs around, especially in heat.

2. Stay hydrated. Water is good, 50/50 water and gatorade is better. Drinking pure gatorade is generally considered too strong, your body will just expel all the extra electrolytes and salts before it can absorb them.

3. Dress correctly. Short sleeves and breathable materials make a world of difference. Light wool socks are really good believe it or not. A hat with a big brim helps too.

4. Don't overexert yourself if you don't have to.
 

ResTech

Forum Asst. Chief
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My advice is to always pre-hydrate prior to engaging in physical activity. If your working and on-duty, drink extra fluids throughout your shift during periods of high heat and humidity.

Anytime the ambient temp reaches above the body temp, the body absorbs heat and is much harder for it to dissipate.
 

Akulahawk

EMT-P/ED RN
Community Leader
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1. Keep yourself in good physical condition, no sense in carrying an extra 100lbs around, especially in heat.

2. Stay hydrated. Water is good, 50/50 water and gatorade is better. Drinking pure gatorade is generally considered too strong, your body will just expel all the extra electrolytes and salts before it can absorb them.

3. Dress correctly. Short sleeves and breathable materials make a world of difference. Light wool socks are really good believe it or not. A hat with a big brim helps too.

4. Don't overexert yourself if you don't have to.
Gatorade that you buy from the store is much too strong. Your body will absorb all the electrolytes and such, but it'll take a long time to do it. If you ever have a chance to mix some up from powder for athletes, you'll find that its much weaker tasting. You want to dilute the store bought Gatorade to that level. At that point, it'll be absorbed into your body at the same rate water is, and the Gatorade is essentially a flavored isotonic electrolyte solution, probably similar to Ringer's. The rest is good advice.
 

MRE

Forum Captain
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Gatorade that you buy from the store is much too strong. Your body will absorb all the electrolytes and such, but it'll take a long time to do it. If you ever have a chance to mix some up from powder for athletes, you'll find that its much weaker tasting. You want to dilute the store bought Gatorade to that level. At that point, it'll be absorbed into your body at the same rate water is, and the Gatorade is essentially a flavored isotonic electrolyte solution, probably similar to Ringer's. The rest is good advice.
Sounds good, I didn't know that it was mixed up weaker for athletes, but it makes sense. I wasn't sure about expeling the electrolytes as waste, your explanation makes sense though.
 

Akulahawk

EMT-P/ED RN
Community Leader
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In a former life, I was looking to be an Athletic Trainer. Yes, I even have a degree in Sports Medicine... but I found EMS to be quite fun and it pays better (around here).

Gatorade was originally made pretty "weak" tasting. As a fluid/electrolyte replacement, it's on par with water in terms of absorption rates and won't let your 'lytes go too far out of whack. You can drink LOTS of properly mixed Gatorade and you won't see electrolyte problems develop as you could see when you drink way too much water. Once you're full, you'll just pee it out...

What they found out was that in order to sell it to the general public, they had to make it much more strong tasting for it to be palatable. That way people will buy it because it tastes good. Unfortunately, there's too much sugar to allow it to rapidly be absorbed, so absorption time for a given volume is much slower than water. The 'lytes will stay suspended with the liquid, so that doesn't get absorbed very quickly either.

The proper Gatorade mix has a little sugar in it, and levels of potassium and sodium that are within normal physiological levels (isotonic) so absorption is very quick, as quick as water. (about 800cc/hr).
 
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hottrotter18

Forum Probie
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I work where it gets to be about 110 on an average day. I have grown up around it all my life, so i guess im used to it, but drinking plenty of fluids and gatorade is #1
 

HNcorpsman

Forum Lieutenant
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biggest thing... is making sure you keep your salt level up... it is important not to JUST drink alot of water... 4 liters of water can cause a person to become hyponatremic... you need to make sure you are eating properly as well.. gatorade is alright if you dont have anything else... but it has a lot of sugar which can cause the "hursey squirts" (which will lead to even more dehydration) ... oral rehydration salts (ORS) are the best...
 

46Young

Level 25 EMS Wizard
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It's typically in the 80's and 90's with oppresive humidity here in VA. Our medic unit is plugged in at our apparatus bay, and has the A/C running constantly, so it's always cool in there. The meds need to stay at room temperature, anyway. Our service authorizes us to wear t-shirts only in lieu of a class C shirt or polo if it's hot.

When I'm on the engine, we're getting dressed for calls frequently. An MVA can keeps us in bunkers for 15 minutes to a half hour or more if it's not Allstateitis. We could always get a fire, so getting a handle on hydration is vitally important.

I'll mix a little less than 1/2 the required mixture of Gatorade powder into a gallon jug, and mostly freeze it. I'll purposefully do hard metcon PT outside (tire flipping, kettlebells, sledgehammer shots, burpees, jump rope, etc.) to acclimate my body to the rigors of working in the heat. I'll do 20-30 minutes hard, rehydrate with the icy mixture, and go for round two after another 15 minutes. If I get a call, I'll chug a quart or so of the slurry, and it'll kick in after about 5-10 minutes or so.

Hydration starts the night before your shift. You should be drinking between 1/2 and 1 gallon of water every day, as a minimum for health. Staying away from sugary drinks and caffeine, both known to dehydrate, would be a good idea in the extreme heat.

If you just can't cool down, fill a bucket with ice water, and immerse your forearms in there. It'll help cool your core. Splash cool water on your face. A fan would be a good idea, as well.

Bring several changes of shirts, underwear, and socks at a minimum.

Anyone notice that Gatorade drinks have HFCS and the powder doesn't?
 
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