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 casualty's sweating mechanism breaks down and cannot eliminate excess body heat. If the body temperature rises too high, the brain, kidneys, and liver may be permanently damaged.
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 during transportation.
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 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 body's attempt to generate heat by repeated contractions of surface muscles. This