External Heat Illness

Early s/s of Hyponatremia (5)

1) Altered mental status 2) Disorientation, confusion, incoordination 3) exhaustion, weakness 4) Nausea, vomiting 5) Headache, dizziness

Educate those involved (3)

1) Athletes, coaches, parents, ect 2) Let them know to inform someone if they feel lightheaded or sick 3) Inform them what to look for and do

Replace fluids Regularly (2)

1) Before, during, and after px 2) Thirst is not good (already dehydrated)

S/S of Exertional Heat Stroke (17)

1) CORE TEMP >104*** 2) ALTERED CONSCIOUSNESS** 4) Irritability, confusion 5) Dizziness, headache 6) Disorientation 7) Convulsions/seizures 8) LOC/Collapse 9) Rapid pulse, decrease BP 10) Rapid Breathing 11) Nausea, vomiting, diarrhea 12) Dehydration 13) Hysteria 14) Weakness, malaise 15) Unsteady gait 16) Red, hot, flushed skin 17) Decreased sweating (?)

What can low sodium levels lead to? (3)

1) Coma 2) Pulmonary/Cerbral Edema 3) Death

Predisposing factors of heat exhaustion (8)

1) Dehydration 2) Diarrhea 3) Vomiting 4) Inadequate fluid replacement 5) Heavy sweat rates 6) GI illness 7) Electrolyte loss 8) Non-acclimated

S/S of Heat Syncope (6)

1) Dizziness 2) Nausea 3) Tunnel Vision 4) Fainting 5) Pale and sweaty skin 6) Body temp NOT elevated

Predisposing Factors of Exertional Heat cramps (4)

1) Excessive sweat loss 2) Electrolyte loss/imbalance 3) Dehydration 4) Vomiting, diarrhea, and GI illness

Predisposing factors for excertional hyponatremia (4)

1) Excessive sweating 2) Excessive sodium loss 3) Inadequate dietary sodium 4) Over indulgence of water

S/S of exertional heat exhaustion (15)

1) Fatigue, weakness 2) Dry mouth, thirst 3) Headache 4) Dizziness, fainting 5) Collapse bc of physical exhaustion 6) Sweating 7) Decrease in urine volume 8) Nausea/vomiting 9) Decreases appetite 10) Weight loss 11) Rapid and shallow breathing 12) Rapid pulse 13) Decreased blood pressure 14) SLIGHT DECREASE IN MENTAL STATUS **** 15) CORE TEMP <104****

Predisposing Factors Heat Stoke (12)

1) High Temperatures, humidity, solar radiation, and low wind 2) Older athletes 3) Obese athletes 4) Not acclimated 5) No rest periods 6) Untrained/unconditioned 7) Use of antihistamines & other meds 8) Athletes with sunburn, psoriasis, skin infections/rashes 9) Fever 10) Lack of sleep 11) Dark, heavy, non breathable clothing 12) Heavy muscled athletes

Preventions of Heat Illness (10)

1) Identify athletes at risk 2) Educate those involved 3) Replace fluids regularly 4) Replace electrolytes regularly 5) Weigh in.. Weigh out 6) Appropriate uniforms 7) Ensure adequate sleep 8) Allow 7-10 d's for acclimatization 9) Take days off between practices 10) Apropriate timing and type of activity

Identify athletes at risk (8)

1) Larger muscle mass (insulator) 2) Higher body fat (insulator) 3) Out of shape 4) PMH (Past medical history) 5) Sunburned 6) Fever 7) People who live up north 8) Monitor everyone

Tx of Heat Syncope (3)

1) Laying down in cool area 2) Elevate legs 3) Drink fluids

Appropriate uniforms (5)

1) Lightweight 2) Mesh 3) Cotton 4) light color 5) Adjust wearing pads and helmets based on current environment/temperature

TX of Exertional Heat Stroke (4)

1) Maintain ABCs 2) EMS 3) Rapid cooling in ice water (41-59 degrees) - ice packs on head, neck, axilla, groin, and knees, fans, cool until temp at 100-102 4) IV

Effects of Exertional Heat Stroke (5)

1) Medical Emergency 2) Systems begin to shut down 3) Organ damage 4) CNS Damage 5) Death

Factors of Heat Balance (5)

1) Metabolic heat production 2)Conductive heat exchange 3)Convective heat exchange 4)Radiant heat exchange 5)Evaporative heat loss

Appropriate timing and type of activity (4)

1) Monitor temp, humidity, wind, sun 2) Dont px at the hottest/most humid times 3) Alter activity, time, uniform, duration, intensity 4) Periodic rest periods out of the sun

Later s/s of Hyponatremia (4)

1) Muscle twitching, tingling, sensation 2) Swelling of hands/fingers 3) Seizures, DIB (difficulty in breathing) 4) Coma, cardiac arrest, respiratory arrest

Hyponatremia (2)

1) Oral Salt intake (increased daily NaCI consumption or sport drink) 2) Caution w/ IV

What are the MOI of heat syncope? (4)

1) Peripheral vasodilation 2) Blood pools in extremities 3) Common if standing in the heat 4) Common if immediately stop intense activity without cooling down

Weigh in.. Weigh out

1) Replace "weight"/water loss

TX of Heat Exhaustion (4)

1) Rest 2) Fluids/Electrolytes 3) Cooling for comfort (removing from heat, remove clothing, place in cold tub, apply ice to neck, groin, armpits) 4) f/u w/ physician, IV

Replace electrolytes regularly (2)

1) Sports drinks 2) Lightly salted foods

Predisposing factors of heat syncope (5) (factors that lead to..)

1) Unacclimated (not used to environment) 2) Standing in place in the heat 3) Immediately stopping after intense activity 4) Dehydration 5) GI Illness, diarrhea, vommiting

Tx of Heat cramps (6)

1) Water 2) Electrolytes 3) Ice (decreases pain and muscle spasm) 4) Stretch (light) 5) Massage (light) 6) IV (full body cramp)

What are the different types of heat illness? (5)

1)Heat syncope 2)Heat cramps 3)Heat exhaustion 4)Heat stroke 5)Hyponatremia

Heat loss is ___x _______ in water than in the air of the same temperature

2-4 Greater

Cautious if >__% lost

3

__% RH (relative humidity) decreases evaporation

65

Allow ___ days for acclimatization

7-10 Gradually increase work load and intensity Must slowly get used to environment

__% RH (relative humidity) ceases evaporation

75

When an athlete with EHS receives immediate tx (rapid cooling/rehydration), there is a ____% survival

90-95%

Alcohols, juice, sodas?

Alcohol= No Soda= Blood goes to the gut instead of muscles Juice= has fructose, which results in diarrhea and causes loss in water and electrolytes (Not the best but still helps with hydration if nothing else)

Convective Heat Exchange

Body heat can be lost or gained depending on the temp of the air or water

Heat Gain=Heat Loss

Body temperature maintained to keep the body functioning

Humidity ______ sweat evaporation potential

Decreases

Cold Towel?

Doesn't really cool you off Traps heat

Heat Syncope

Fainting caused by over exposure

F/U

Follow up

GI

Gastrointestinal illness

What prevents evaporation of sweat?

Humidity; no cooling

Exertional Heat Exhaustion

Inability to continue exercise in the heat because of cardiovascular insufficiency

What are other factors that cause an increase of metabolic heat production?

Increases with exercise (aerobically unfit, higher ambient temps, overweight, heavily muscled)

Exertional Heat Cramps

Involuntary muscle spasm because loss of electrolytes and fluids

S/S of Exertional Heat Cramps (1)

Involuntary muscle spasms

Is conductive heat exchange more significant in heat gain or loss?

Loss (ice)

Hypoatemia

Low concentration of Na (sodium) in the blood

Dry fans

Not the best, but helps Cools Drys sweat

Hyperthermia

Our core temperature increases to an unsafe level and our body overheats

Metabolic Heat Production

Our normal bodily functions produce heat (core=96.6)

Exertional Heat Stroke

Overloading or failure of our thermo-regulatory system Heat buildup via the environment and metabolic heat production exceeds the body's ability to dissipate the heat

Conductive Heat Exchange

Physical contact with surface can cause heat loss or gain

Radiant Heat Exchange

Radiant heat from the sun increases body temperature

Steps leading up to exertional heat exhaustion

Salt depletion+ Water Depletion -> Dehydration+Decrease in blood plasma volume -> Decrease in cardiac output (Like running out of gas in your car)

What naturally decreases body temperature?

Sweat

Evaporative Heat Loss

Sweat glands in the skin allow H2O to be transported to the surface, where it evaporates, taking heat with it

Causes of Hyponatremia

Sweat or if sodium not replaced through the athletes diet/ fluids,

Evaporative Heat Loss

Sweating alone does not dissipate heat; If sweat does not evaporate, heat is not lost

Heat Gain>Heat Loss

When body temperature exceeds the limits of that range, the body is unable to maintain normal functioning

When is Hyponatremia more common?

When hydration is mainly H2O Causes even more of an imbalance between Na and H2O

Cold tubs

YES #1 Choice

Misting Tents

Yes 20-25 degrees colder than outside Stay in it long enough

Misting fans

Yes But can also add to humidity

Cold showers

Yes Stay in it long enough bc only 70 degrees Better to get it colder (50-60) Sit down