First aid for temperature related emergencies

Temperature related emergencies encompass both heat-related and cold-related conditions. Whether someone is suffering from heat exhaustion or heat stroke, or from hypothermia or frostbite, prompt first aid can help stabilize their condition until professional help is available.

Below is a comprehensive guide on the key steps to take for each type of temperature-related emergency.

Temperature Related Emergencies (Heat)

General Guidelines for Heat Sickness, Exhaustion, and Stroke

1.Recognize the Signs:

• Heat Sickness/Exhaustion: Symptoms may include heavy sweating, headache, nausea, muscle cramps, weakness, dizziness, irritability, and thirst.
• Heat Stroke: Look for signs of confusion or altered mental state, high body temperature (above 104°F/40°C), rapid heartbeat, and in severe cases, seizures or loss of consciousness. The skin may be hot and dry, or, in some types, still sweating.

2.Immediate Actions:

• Call for Emergency Help: If you suspect heat stroke or if the person shows severe symptoms (confusion, seizures, or loss of consciousness), call 911 (or the local emergency number) immediately.
• Move to a Cooler Area: Bring the victim into shade or an air-conditioned environment as soon as possible.
• Remove Excess Clothing: Remove or loosen clothing, take off unnecessary layers and any tight accessories, to help with cooling.

3.Cooling Measures:

Heat Exhaustion:

• Provide the person with cool water or a sports drink containing electrolytes.
• Fan the victim and apply cool, wet cloths to the head, neck, and wrists.
• Encourage rest while monitoring their condition for any worsening symptoms.

Heat Stroke:

• Initiate active cooling immediately by dousing the person with cool water. If available, immerse them (or parts of their body, such as arms and legs) in a cold water bath.
• Use cold, wet towels or ice packs on key areas like the armpits, neck, and groin, but avoid direct ice contact on skin.
• Continue cooling efforts until emergency services arrive.

Monitor the Victim: Stay with the person, watching for changes in breathing, response level, and other vital signs. If any symptoms worsen, be ready to perform CPR if trained and necessary.

Cold-Related Emergencies

Hypothermia

1.Recognize the Signs:

• Mild hypothermia may include shivering, pale and cool skin, and slight slurred speech.
• Moderate to severe hypothermia includes confusion, lethargy, clumsiness, weak pulse, shallow breathing, and in extreme cases, unresponsiveness.

2.Immediate Actions:

• Move the Person Indoors: Gently get the victim into a warm place, away from the cold environment.
• Remove Wet Clothing: Carefully remove any wet or constricting clothing. Replace them with warm, dry coverings.

3.Gradual Rewarming:

• Focus on rewarming the core of the body first—cover the chest, neck, and groin with warm blankets.
• Use warm compresses (placed on these central areas) rather than applying heat directly to the extremities. Rapid rewarming of arms and legs might force cold blood toward the core (afterdrop), which can be harmful.
• If the person is conscious and able to swallow, offer warm (non-alcoholic, non-caffeinated) fluids like broth or warm water.

Monitor and Reassure: Continue monitoring vital signs. Be cautious not to overheat the victim or to use direct heat sources (like hot water bottles or heating pads) without a barrier, as these can burn the skin.

Frostbite

1.Recognize the Signs:

• Affected areas typically appear white, waxy, or greyish and feel very cold and numb. Fingers, toes, ears, and the nose are common sites.

2.Immediate Actions:

• Move to a Warm Place: Gently move the person indoors to prevent further exposure.
• Avoid Rubbing the Area: Rubbing can damage tissue further.

3.Rewarming Procedure:

• Rewarm the frostbitten areas by soaking them in warm (not hot) water ideally around 99°F to 104°F (37°C to 40°C).
• Do not use direct heat, such as a heating pad, or immerse the area in ice-cold water.
• After rewarming, cover the area with sterile dressings. Do not break any blisters that form; these protect against infection.

Seek Professional Medical Care: Frostbite can have long-lasting effects. Even if symptoms improve after rewarming, a medical evaluation is recommended to assess tissue damage.

General Considerations

• Prevention: Encourage proper hydration and protective clothing to prevent both heat and cold emergencies. Educate individuals working or playing in extreme temperatures about the signs and preventive measures.
• Do Not Delay Medical Help: In severe cases of any temperature-related emergency, always err on the side of caution and seek professional medical treatment.
• Document and Communicate: Note the time when the symptoms first appeared and the first aid measures initiated, which may be useful information for emergency responders.

Preventing Heat-Related Emergencies

1. Stay Hydrated – Drink plenty of water throughout the day, even if you don’t feel thirsty. Avoid alcohol and excessive caffeine, as they can contribute to dehydration.
2. Dress Appropriately – Wear lightweight, loose-fitting clothing and a hat to protect against sun exposure.
3. Limit Outdoor Activities – Avoid strenuous activities during peak heat hours (typically midday to early afternoon).
4. Use Air Conditioning or Fans – Stay in air-conditioned spaces when possible. If you don’t have air conditioning, visit public cooling centers like malls or libraries.
5. Recognize Early Signs of Heat Illness – Watch for symptoms of heat exhaustion, such as dizziness, excessive sweating, and nausea. If symptoms worsen, seek medical help immediately.

Preventing Cold-Related Emergencies

1. Dress in Layers – Wear insulated clothing, including gloves, hats, and waterproof outer layers to retain body heat.
2. Stay Dry – Wet clothing can accelerate heat loss, increasing the risk of hypothermia.
3. Limit Exposure – Avoid prolonged outdoor activities in freezing temperatures, especially if wind chill is severe.
4. Keep Indoor Spaces Warm – Ensure heating systems are functioning properly and use blankets to stay warm.
5. Recognize Signs of Hypothermia – Symptoms include shivering, confusion, and slowed breathing. If someone shows these signs, move them to a warm place and seek medical help.

REFERENCES

1. Ramesh T, Wozniak GD, Yu H. County-Level Disparities in Heat-Related Emergencies. JAMA Netw Open. 2024;7(3):e242845. doi:10.1001/jamanetworkopen.2024.2845
2. Centers for Disease Control and Prevention (CDC). Heat-Related Deaths after an Extreme Heat Event—Four States, 2012, and United States, 1999–2009. MMWR Morb. Mortal. Wkly. Rep. 2013, 62, 433–436.
3. Charya, P.; Boggess, B.; Zhang, K. Assessing Heat Stress and Health among Construction Workers in a Changing Climate: A Review. Int. J. Environ. Res. Public Health 2018, 15, 247.
4. Stapleton, J.M.; Poirier, M.P.; Flouris, A.D.; Boulay, P.; Sigal, R.J.; Malcolm, J.; Kenny, G.P. Aging Impairs Heat Loss, but When Does It Matter? J. Appl. Physiol. 2015, 118, 299–309.
5. Aclscertification.org Temperature-Related Injuries https://aclscertification.org/courses/cpr-aed-first-aid-certification/lessons/chapter-5-environmental-emergencies/topic/temperature-related-injuries/

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