ashen gray, the skin will be cold, moist, clammy, and
the pupils of the eyes may be dilated (enlarged). Vital
signs are usually normal but the casualty may have a
weak pulse, together with rapid, shallow breathing.
The body temperature may be below normal.
Treat the casualty as if the patient were in shock.
Move the person to a cool or air-conditioned area.
Loosen the clothing; apply cool wet cloths to the head,
neck, groin, and ankles; and fan the casualty. Do not
allow the person to become chilled. If they become
chilled, cover with a light blanket and move to a
warmer area. If the casualty is conscious, give a
solution of 1 teaspoon of salt mixed in a quart of cool
water. If the person vomits, do not give any more
fluids. Transport the casualty to a medical facility as
soon as possible.
Heat Stroke.Sunstroke is more accurately
called heat stroke because a person need not be
exposed to the sun for the condition to develop. Heat
stroke is a less common but far more serious condition
than heat exhaustion because it carries a 20 percent
mortality rate. The most important feature of heat
stroke is the extremely high body temperature (105°F
or 41°C) or higher. In heat stroke, the casualtys
sweating mechanism breaks down and cannot
eliminate excess body heat. If the body temperature
rises too high, the brain, kidneys, and liver may be
Sometimes the casualty may have preliminary
symptoms such as headache, nausea, dizziness, or
weakness. Breathing will be deep and rapid at first;
later it will be shallow and almost absent. Usually the
casualty will be flushed, very dry, and very hot. Pupils
will be constricted (pinpointed) and the pulse will be
fast and strong. Compare heat stroke symptoms with
those of heat exhaustion. (See figure 13-18.)
Figure 13-18.Symptoms of heat exhaustion and heat stroke.
When providing emergency treatment for heat
stroke, keep in mind that if the casualty remains
overheated, the more likely he/she will suffer
irreversible body damage or death. Your main
objective is to get the body temperature down as
quickly as possible.
Move the casualty to the coolest possible place, and
remove as much clothing as possible. Body heat can be
reduced quickly by immersing the casualty in a cold
water bath. If that is not possible, give the casualty a
sponge bath by applying wet, cold towels to the entire
body. Or you can expose him/her to a fan or air
conditioner. If cold packs are available, place them
under the arms, around the neck, at the ankles, and in the
groin. If the casualty is conscious, give him/her cool
water to drink. Do not give any hot drinks or stimulants.
Because of the seriousness of heat stroke, it is
important to get the casualty to a medical facility as
soon as possible. Continue the cooling measures
Cold Weather Injuries
When the body is subjected to severely cold
temperatures, the blood vessels constrict and body heat
is gradually lost. As the body temperature drops,
tissues are easily damaged or destroyed.
All cold weather injuries are similar, varying only
in the degree of injury to tissues. The extent of injury
depends on such factors as wind speed, temperature,
type and duration of exposure, and humidity. Freezing
of tissue accelerates with wind, humidity, or a
combination of the two.
Fatigue, smoking, drugs, alcoholic beverages,
emotional stress, dehydration, and the presence of
other injuries intensify the harmful effects of the cold.
In cold weather, wounds bleed easily because the low
temperatures keep the blood from clotting; increased
bleeding increases the likelihood of shock.
GENERAL COOLING (HYPOTHERMIA).
General cooling of the whole body is caused by
continued exposure to low or rapidly falling
temperatures, cold moisture, snow, or ice. Even though
well protected by clothing, a person exposed to low
temperatures for an extended period may suffer ill
effects because cold temperatures affect the body
systems slowly, almost without notice. As the body
cools, the casualty goes through several stages of
progressive discomfort and disability. The first
symptom is shivering, the bodys attempt to generate
heat by repeated contractions of surface muscles. This