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ER Manager Offers Advice for Preventing Heat-related Emergencies

Posted on July 13, 2015

The full-blown heat of summer is fast approaching, and knowing how to help a person suffering from heat exhaustion or heat stroke can save a life, according to Barbara Riggs, R.N., manager of the Emergency Department at Methodist Medical Center of Oak Ridge.

“Heat-related illnesses are a special concern for older adults, young children, and people who work in hot environments, have a chronic illness, take certain medications, or are overweight,” Riggs said. “It’s important to identify heat hazards, prevent overheating when possible, and react promptly and properly when problems arise.”

In most cases, people can avoid problems by drinking plenty of water, staying in an air-conditioned area during the hottest part of the day, wearing lightweight clothing, and watching for signs of heat exhaustion such as heavy sweating, a weak pulse, pale and clammy skin, fainting and vomiting, she noted.

Take Care with Certain Medications

“A number of medications create problems on hot summer days. Antihistamines and drugs such as Cystospaz, Thorazine, Serentil, and Cogentin, for example, reduce your body’s ability to regulate temperature. Antidepressants such as Elavil and the thyroid hormone, Synthroid, may make you less tolerant of heat,” Riggs explained.

Drugs such as Donnatal, Levsin, Dyazide, Inderal, Cardizem, and Sinemet limit blood flow to the skin and affect your body’s ability to sweat. Haldol and Nembutal may affect your sense of thirst, and tetracycline, sulfa and certain other antibiotics may cause rashes on areas of skin exposed to the sun. 

Prevent Sunburns

Overexposure to ultraviolet rays in sunlight, sun lamps and tanning beds cause sunburns. In the short-term, sunburns may cause pain, swelling, redness and blistering. In the long-term, they may lead to premature aging of the skin, development of scaly red patches that are sometimes pre-cancerous, and skin cancer, Riggs said.

To prevent sunburns, the emergency department manager suggests that people avoid being in the sun between 10 a.m. and 4 p.m., if possible, because the sun’s rays are the strongest during those hours. She also encourages people to use a sunscreen of SPF 15 or higher when they are in the sun, to switch to waterproof sunscreens when they swim, and to apply sunscreen often. In addition, people should take precautions on cloudy days because sunburns are still possible.

“People can treat most sunburns at home with cool wet compresses, cool oatmeal baths, and aloe during the first 48 hours,” according to Riggs. “Avoid lotions and petroleum jelly during that time period, and do not use ice.  When fever, fluid-filled blisters, dizziness, or visual problems accompany the sunburn, call the doctor.”

Treat Minor Heat Problems at Home

“Home remedies are generally effective for heat rashes, muscle cramps, swelling and minor heat exhaustion. Fatigue, headache, dizziness, weakness, nausea and cool, moist skin are signs of heat exhaustion,” she added.

For minor symptoms, Riggs suggests the following:

  • Help the person to an air-conditioned space or shady area to rest.
  • Help them lie down, elevate their feet, and remove unnecessary clothing.
  • Apply ice bags under the arms and the groin area to quickly cool the large blood vessels located near the skin’s surface.
  • Encourage the person to drink water, sports drinks or juice. It’s a good idea for them to consume two quarts of these liquids within two to four hours after heat-related symptoms began.
  • Encourage the person to avoid strenuous activities and to continue drinking plenty of fluids for 24 hours.

Call 911 for Heat Emergencies

“Heat exhaustion can lead to a heat stroke, which is a life-threatening emergency,” Riggs emphasized. Someone who is suffering from a heat stroke may experience:

  • Seizures
  • Confusion
  • Fainting that lasts longer than one minute
  • Moderate to severe trouble breathing
  • Rapid heartbeat
  • Severe vomiting and diarrhea
  • Hot, dry and flushed skin with either no sweating or with excessive sweating

“When someone has one or more symptoms of heat stroke, call 911 immediately and then start first aid,” she said. “Do not give that person Tylenol-type products or aspirin to reduce fever.”

First aid should include:

  • Moving the person out of direct sunlight and to a cooler place
  • Removing all unnecessary clothing
  • Taking the person’s rectal temperature frequently, if possible, and trying to keep it below 102.3 degrees Fahrenheit.
  • Using cool water and fanning the person to lower the body temperature.
  • Applying ice packs to the person’s groin, neck and armpits
  • Giving the person fluids if he or she is alert (most people suffering heat stroke are not).

Beginning CPR only if the patient stops breathing and the person trying to help has CPR training. Do not attempt CPR, otherwise, because it may result in serious injury.


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