General Prevention of Heat-Related Illnesses
Avoid drugs (including medical) and alcohol.
Maintain adequate hydration and nutrition.
Take the time to acclimatize.
Most heat-related illnesses can be prevented with proper acclimatization, i.e., the body will be able to deal with the heat if introduced to working in it in a controlled manner.
Acclimatize in similar conditions to what you will be in, e.g., if you are going somewhere hot and humid, it is best to acclimatize somewhere hot and humid.
Exercise moderately for 1 to 2 hours a day for 8 to 10 days.
As the days go on, gradually increase intensity and time spent working.
A burn is a flesh or skin injury caused by exposure and/or contact to/with heat, electricity, chemicals, friction or radiation.
The seriousness of burns is often categorized by their degree.
Superficial/First Degree:
Affects only the superficial skin (the epidermis).
Red, warm and dry.
Painful to touch.
Discomfort usually diminishes after 24 to 48 hours.
Partial Thickness/Second Degree:
Affects some underlying layers of the skin.
Blisters.
Clear or whitish fluid.
Moist.
Swollen.
Full Thickness/Third Degree:
Affects all layers of the skin and possibly even fat and/or muscle.
May appear charred or white.
May appear indented.
May cause shock.
First, remove the heat source:
If clothing is on fire, roll on the ground or suffocate the flames, e.g., with a blanket.
If it is a chemical burn, or the eyes are involved, flush with copious water for at least 10 minutes.
If phosphorous, keep burn immersed in water.
Next:
Remove watches, jewelry, constrictive clothing etc.
Apply cool (not ice cold) water for at least 10 to 15 minutes.
Note: after 30 minutes cooling has no benefit other than comfort.
Consider draining large blisters; Diagnoses and Treatments - Integumentary System – Blisters.
Clean, cover and monitor; Must Read - Open Wounds, Skin Infections and Sepsis - Open Wounds.
Hydrate.
Wear loose, light clothing, e.g., cotton.
Full thickness burns may require a skin graft to heal.
Do Not:
Use lotion, grease, butter etc.
Remove embedded, charred material that will cause burned areas to bleed.
Move or rub the burned part.
Pharmaceuticals:
Burn cream.
Alternative/Natural Remedies for Burns:
There are a number of well known alternative/natural remedies to help heal and/or soothe first or perhaps even second degree burns.
Aloe Vera: split open a leaf and rub the gel directly on the burn every couple of hours.
Baking Soda: put 1/4 cup of baking soda into a warm bath, bathe in until the water cools off.
Black Tea: make yourself a cup of tea and then apply the used teabag topically.
Honey (raw):
Ø Pour clean honey liberally over and all around the burned area.
Ø Wrap with plastic wrap and secure with a bandage.
Ø After 48 hours check for infection; treat if present, although it is not likely.
Ø Remove charred or loose flesh; do not force removal if stuck to the wound.
Ø Pour more honey over the wound and re-cover.
Ø Repeat process every 2 days. Every time you open the dressing, add more honey. Do not wash off the honey.
Ø After 7 to 10 days, the wound will begin to granulate. Do not wash. Leave the dressing off for an hour, then apply more honey and re-cover.
Ø Remove dressing every 2 hours, and leave open for an hour longer each day.
Ø After 3 weeks of doing this, you can wash the honey off. Do not use anything but clear, running, drinking quality water.
Ø Continue to lightly dress.
Plantain: poultice.
Tannin: compress.
Vinegar:
Ø A diluted 50/50 mix of vinegar and water will cool the burn and also help disinfect it.
Ø Soak material in the mix and apply it to the burn.
Ø Reapply as needed.
Ø Vinegar could also be added to a cool bath, to soak clothing the patient will wear etc.
Yoghurt:
Ø Use full fat yoghurt.
Ø Smother the burn in yogurt.
Ø Wait 15 minutes then bathe in cool water.
Ø Could also be used as a compress.
The two most common causes of burn injury are the sun and cooking accidents.
Prevention of Sunburn:
Be sun-safe. Minimize time in the sun, and when you are in the sun, Slip, Slop, Slap, Seek:
Ø Slip on a shirt and long clothes in general.
Ø Slop on lots of sunscreen regularly when exposed to the sun. Minimum SPF 30.
Ø Slap on a wide brimmed hat and sunglasses.
Ø Seek out shade and minimize time in the sun.
Prevention of Cooking Burns:
Protect yourself while cooking, e.g., hand protection.
If you need to test if something is hot, use the back of your hand.
Heat edema is the swelling of extremities due to the heat. It may develop in the first few days of being in a hot climate.
Avoid diuretics, e.g., coffee.
Elevate affected limb.
Swelling will depreciate in time.
Heat exhaustion occurs when fluid loss is greater than fluid intake. It often occurs after strenuous activity in high temperatures.
The patient may also be dehydrated; Diagnoses and Treatments - Circulatory System - Dehydration and Volume Shock – Dehydration.
Chills.
Dizziness.
Elevated respirations, pulse and temperature.
Headache.
Nausea.
Sweating.
Vomiting.
Rehydration; Diagnoses and Treatments - Circulatory System - Dehydration and Volume Shock – Rehydration Plan.
Place a moist, cold compress on the armpits, chest, groin and neck.
Remove restrictive clothing.
Rest in a cool environment.
Heat rash (prickly heat) occurs when the sweat ducts become blocked and swell. It is usually found on body areas covered by clothing.
Itching.
Red or pink rash-like dots or tiny pimples.
Avoid ointments or other lotions.
Dry and cool affected site.
Heat rash will usually dissipate within 10 days.
Loosen or remove clothing.
Pharmaceuticals:
Antihistamine.
Heat stroke is when the body produces more heat than it can expel. It may or may not be preceded by heat exhaustion. It is life threatening.
Body temperature above 40.5 °C (105 °F).
Decreased blood pressure.
Decreased mental state.
Elevated pulse.
Elevated respiration.
Flushed or pale skin.
Seizures; Diagnoses and Treatments – Head – Brain – Seizures.
Sweat may or may not be present.
Elevate legs above the heart.
Rapid cooling (e.g., cold water immersion, saturating and fanning, lying in a stream). Be careful not to overcool.
Rest.
Rehydration; Diagnoses and Treatments - Circulatory System - Dehydration and Volume Shock – Rehydration Plan.
Continue to cool until core temperature returns to normal, i.e., 38 °C (100.4 °F) to 39 °C (102.2 °F); check every 30 minutes.
Maintain airway, breathing and circulation; Must Read – Immediate First Aid - Critical First Aid.
Pharmaceuticals:
Benzodiazepine to treat seizures and shivering.
Avoid drugs (including medical) and alcohol.
Maintain adequate hydration and nutrition.
Take the time to acclimatize.
Heat syncope is fainting as a result of low blood pressure due to overheating. It usually occurs due to standing in a hot environment for too long or standing up too fast.
Cool the patient.
In case of a fall, perform a full secondary assessment.
Lay the patient flat and elevate his/her legs 15 to 30 degrees above the heart.
Oral fluids when alert.
If recovery does not occur after treatment, assess for more serious heat illnesses, e.g., heatstroke; Diagnoses and Treatments – Environmentally Induced – Heat and/or Sun Induced – Heat Stroke.
Hyponatremia occurs when there is excessive water consumption with inadequate salt replacement, e.g., when someone sweats a lot and drinks water to stay hydrated, but does not eat to replace salts.
Decreased mental status.
Dizziness.
Headache.
Muscle Cramps.
Nausea.
Loss of co-ordination.
Tremors.
Vomiting.
Vital signs and core temperature are often normal or only slightly irregular.
Drink a full strength sports drink, but only if mental status is okay.
Eat when able.
If unable to drink, intravenous therapy may be needed.