Treat heat exhaustion as if the victim were inshock. Move the victim to a cool or air-conditionedarea. Loosen the clothing, apply cool wet cloths to thehead, axilla, groin, and ankles, and fan the victim. Donot allow the victim to become chilled. (If this doesoccur, cover with a light blanket and move into awarmer area.) If the victim is conscious, give asolution of 1 teaspoon of salt dissolved in a liter of coolwater. If the victim vomits, do not give any morefluids. Transport the victim to a medical treatmentfacility as soon as possible. Intravenous fluid infusionmay be necessary for effective fluid and electrolytereplacement to combat shock.Heat StrokeSunstroke is more accurately called heat strokesince it is not necessary to be exposed to the sun for thiscondition to develop. It is a less common but far moreserious condition than heat exhaustion, since it carriesa 20 percent mortality rate. The most important featureof heat stroke is the extremely high body temperature(105F, 41C or higher) accompanying it. In heatstroke, the victim suffers a breakdown of the sweatingmechanism and is unable to eliminate excessive bodyheat build up while exercising. If the body temperaturerises too high, the brain, kidneys, and liver may bepermanently damaged.Sometimes the victim may have preliminarysymptoms such as headache, nausea, dizziness, orweakness. Breathing will be deep and rapid at first,later shallow and almost absent. Usually the victimwill be flushed, very dry, and very hot. The pupils willbe constricted (pinpoint) and the pulse fast and strong(fig. 4-50). Compare these symptoms with those ofheat exhaustion.When providing first aid for heat stroke, rememberthat this is a true life-and-death emergency. The longerthe victim remains overheated, the more likelyirreversible brain damage or death will occur. First aidis designed to reduce body heat fast.Reduce heat immediately by dousing the bodywith cold water or by applying wet, cold towels to thewhole body. Move the victim to the coolest placeavailable and remove as much clothing as possible.Maintain an open airway. Place the victim on his back,with the head and shoulders slightly raised. If coldpacks are available, place them under the arms, aroundthe neck, at the ankles, and in the groin. Expose thevictim to a fan or air conditioner, since drafts willpromote cooling. Immersing the victim in a cold waterbath is also very effective. If the victim is conscious,give cool water to drink. Do not give any hot drinksor stimulants. Discontinue cooling when the rectaltemperature reaches 102F; watch for recurrence oftemperature rise by checking every 10 minutes.Repeat cooling if temperature reaches 103F rectally.Get the victim to a medical facility as soon aspossible. Cooling measures must be continued whilethe victim is being transported. Intravenous fluidinfusion may be necessary for effective fluid andelectrolyte replacement to combat shock.Prevention of Heat Exposure InjuriesLEARNING OBJECTIVE: Determine thesteps needed to prevent heat exposureinjuries.The prevention of heat exposure injuries is acommand responsibility, but the medical departmentplays a role in it by educating all hands about themedical dangers, monitoring environmental health,and advising the commanding officer.On the individual level, prevention centers on waterand salt replacement. Sweat must be replaced ounce forounce; in a hot environment, water consumption mustbe drastically increased. Salt should be replaced byeating well-balanced meals, three times a day, salted totaste. In the field, āCā rations contain enough salt tosustain a person in most situations. DO NOT use salttablets unless specified by a physician.DO NOTconsume alcoholic beverages.At the command level, prevention centers on anawareness of the environment. The Wet Bulb Globe4-61Figure 4-50.āHeat exhaustion and heat stroke.
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