this slide contain inteoduction, definition, causes, risk factor, clinical manifestaion, types , treatment, medical management, nursing management, nursing care given in the intial stage, in case of emergency .

1. THERMAL EMERGENCY
SUBMITTED TO
MRS. MAMTA TOPPO
ASSOCIATED PROFESSOR
RIMS RANCHI. SUBMITTED BY
RENU KUMARI
ROLL NO.-28
BASIC BSC
NURSING 3RD
COLLEGE OF
NURSING

2. CONTENT
• Introduction
• Definition
• Stage of thermal emergency
• Heat stroke
• Cause of heat stroke
• Predisposing factors
• Sign and symptoms
• Emergency care e
• Treatment
• Heat exhaustion
• Cause of heat exhaustion
• Risk factors of heat exhaustion
• Sign and Symptoms
• Treatment
• Heat cramps
• Cause of heat cramps
• Signs and symptoms
• Heat edema
• Prickly heat
• Heat tetany
• Heat syncope
• Treatment
• Managment
• Complication of
treatment
• Research
• Summary
• Evalution
• Reference

3. INTRODUCTION
Thermal or heat emergencies fall into three
categories of increasing severity : heat stroke ,
heat exhaustion and heat cramps . Heat
emergencies are caused by prolonged exposure
to extreme heat. The following are Common
Heat emergencies : alcohol use , Dehydration
,heart Disease , High temperature and humidity .
Medication Such as diuretics neuroleptic
,phenothiazines,and anti cholinergic,prolonged

4. DEFINITION
Heat emergencies are health
crises caused by exposure to
hot weather and sun .heat
emergencies have three stages :
heat cramps , heat exhaustion

5. HEAT STROKE
• Heat stroke is defined as increase in body temperature or
hyperthermia that exceeds 41°C or 104°F with lack of sweating
associated with mental confusion. This is the most serious type
of heat emergency. It is life- threatening and required
Immediate and aggressive treatment. Heat stroke occurs when
the body’s heat regulations mechanism fails..
• Heat stroke usually results from doing heavy
work in hot environment usually accompanied by inadequate
fluid intake. Infant, children, obese adult and elderly people are
more prone to heat than young and healthy issue.

8. CAUSE OF HEAT STROKE
•Working or exercising in hot condition or
weather with out drinking enough fluid is
the main cause of heat stroke. Heavy
clothing and some skin conditions can
also contribute to the occurrence of heat
stroke.
• Heat stroke by not replacing lost fluid
over days or weeks
•Few hours by exercising strenuously on a

9. PREDISPOSING FACTORS
• Non-acclimatization to high temperature
• Pre – existing illness with fever
• High humidity
• Obesity
• Diabetes
• Alcoholism
• Birth defect with absence of sweat gland
• Excess physical exertion or exercise
• Administration of sweat inhibiting drug .

10. SIGN AND SYMPTOMS
•Skin is hot ,red ,and usually dry
•Body temperature is very high
•Deep breathing by shallow breathing ,
•Rapid pulse ,
•Week pulse,
•Dilated pupils ,
•Headache

11. CONT......
•Dizziness
•Restlessness
•Loss of consciousness / possible coma ,
•Hallucinations
•Confusion
•Agitation
•Disorientation
•Possible seizure or muscular twitching

12. EMERGENCY CARE PROCEDURE
1.Remember, heat stroke is a life-
threatening emergency and required
prompt action.
2.Repidly cool the victim in any manner
possible.
3.Get victims out of the sun into a cooler
area.
4.Remove clothing and wrap with wet towel
or sheet if possible.
5.If coled pack or ice backs are available,

13. CONT......
6. The patient‘s clothes have to be loosened so as to allow active
air Circulation.
7. Body and limbs have to be massaged in order to improve the
bloo circulation with body.
8. Do not give victim anything by mouth.
9. Provide victim high concentration of oxygen.
10. Victim must be transported to definitive care as soon as
possible.
11. Drugs to treat epileptic fits are administered, if the need
arises.
12. Shock is treated by supplying the body with sufficient fluids

14. TREATMENT
• Immediate treatment for heat strok is essential as death or
permanent brain damage can occur whithin minute. Emergency
treatment is focused on cooling the patient as quickly as to
possible to a core body temperature of 102°F (38.9°C).
Cooling may be done by spraying water on the body, covering
the patient with sheets soaked in ice water, or placing ice packs
in the patient ‘s armpits and groin area.
• if the patient is conscious , they may be given additional
oxygen to brathe and intravenous fluids to restore their blood
volume .
• Patients who are haven muscle or convulsions are usually given

15. HEAT EXHAUSTION
•Heat exhaustion is less dangerous than heat
stroke. It is caused by fluid loss which in turn
causes blood flow to decrease in vital organs,
resulting in a form of shock.

16. CAUSES
• Heat exhaustion occurs when body gets too hot . The
hypothalamus , the part of the brain that control thirst
and hungry ,also controls the body’s core
temperature. Normally, the body cools itself by
sweating. But if you are exposed to high temperature
for a long time ( working outdoors in the summer ,for
example ) and don’t replace the fluids you lose, the
body system that regulate temperature become
overwhelmed. As a result your body produces more he
than it can release. Heat exhaustion requires

17. RISK FACTORS
• Being dehydration
• Age (the elderly and children under five years of age )
• Illness or chronic disability
• Obesity
• Pregnancy
• Cardiovascular disease
• Hypertension
• Respiratory disease
• Drinking alcohol
• Physical exertion in hot or humid environment (athletes,

18. SIGNS AND SYMPTOMS
• Heavy sweating
• People with heat exhaustion may experience the following signs
and symptoms
• Fatigue
• Headache
• Pale, clammy skin
• Thirst
• Rapid heartbeat
• Dizziness , fainting
• Nausea , vomitting
• Muscle and abdominal cramps

19. TREATMENT
• The primary treatment for heat exhaustion is to rest in cool
environment. Get the victim out of the heat and into a cool
place . Place in the shock position, lying on the back with feet
raised. Remove or loosen clothing. Cool by fanning or applying
cold packs or wet towel or sheet.

20. HEAT CRAMP
•Heat cramps are The most common,but
list serious injury. Heat cramps are strong
muscle contractions, usually in the muscle
at the abdomen and back of calves during
exercise or work in a hot environment it is
generally thought this condition is caused
by loss of water and salt through sweating.

21. CAUSES OF HEAT CRAMPS
• Heat cramps are the muscular spasms that occur when the
body loses too much salt during excessive sweating and not
enough salt is taken in . With too much water and not
enough salt, electrolyte imbalance takes place and the
already stressed muscles are further affected.
• In order for the muscle to function properly ,
they need a strict balance of water , calcium , and sodium .
Heat cramps seem to be connected to heat , dehydration ,
and poor condition ,rather than to lack of salt or other
mineral imbalance . The cramps usually improve with rest
drinking water and cool environment .

22. SIGNS AND SYMPTOMS
•Muscle spasm
•Rapid heartbeat
•Hot , sweaty skin
•Dizziness
•Fainting and Exhaustion
•Nausea and vomiting

23. TREATMENT
• Oral rehydration and electrolyte replacement is usually sufficient to
treat heat cramps .
• Get victim to a cool place .
• Give one –half glass of water every 15 minutes .
• Heat cramps can usually be avoided by increasing fluids intake when
active in hot Weather .
• Massage affected muscle ( firm pressure massage )
• Apply moist towels to forhead and cramped muscles.

24. HEAT EDEMA
• Self- limited process manifested by mild swelling of feet,
ankles ,and hands that appears within the first few day .
• Increase in the Secretion of aldosterone and diuretics hormone
in response to the heat stress contributes to the mild edema .
• No specific treatment is necessary .
• Diuretics are not effective.

25. PRICKLY HEAT
• Prickly heat is a pruritic ,maculopapular , erythematous rash
over normally clothed areas of the body
• Also known as lichen tropicus , miliaria rubra, or heat rash .
• Itching is the predominant clinical features during this phase
and can be treated successfully with antihistamines.
• Chlorhexidine can be apply for relief .

26. HEAT TETANY
• Heat Tetany consist of typical hypherventilation resulting in
respiratory alclosis , paresthesia of the extremities, circumoral
prareasthesia , and carpopedal spasm.
• Heat Tetany can be differentiate from heat cramps-little pain or
cramping in the muscles compartments and paresthesias of the
extremities and parioral region are most prominent

28. HEAT SYNCOPE
• Heat syncope is a variant of postural hypotension resulting from
the cumulative effect of relative volume diplation, peripheral
vasodilatation and decreased vasomotor tone.
• It occurs most commonly in nonacclimatized individual during
the early stage of heat exposure.
• Highest insidense- eardaly .
• Treatment consist of removal from the heat source, peroral or
intravenous rehydration and rest.

29. TREATMENT
• The goals of therapy are immediate cooling and support of
organ system function .
• Pre-hospital care .
• management

30. PRE-HOSPITAL
• Immediate patient must be removed from the environment .
• Cooling should be initiated by removing clothing and placing
wet towels or sheets over the patient’s body, or placing the ice
packs over the neck, groin, axilla .
• Transported by air-conditioned vehicle to the closet hospital .

31. MANAGEMENT
1. Initial resuscitation.
A. Standard resuscitation
measures
B. Cooling techniques
2. Treatment of complications.

32. INITIAL RESUSCITATION
• Airway, breathing, circulation maintain .
• Administration of high- folow oxygen;
• Initination of continuous cardiacs monitoring and pulse oxymetory,
establishment of IV access .
• Glucose levels should be evaluated on arrival.

33. CONT...........
• IV fluids should be initiated at a rate that ensures adequate
urine output , beginning with 250mL/h NS.
• In elderly patients, fluid therapy should be monitored using a
central venous pressure line or pulmonary artery catheter , if
possible.

34. COOLING TECHNIQUES
• Only physical methods of cooling are recommended.
• Antipyretics have no role.
• Dantrolene is ineffective in heat stroke.
• The choice of cooling method depends on the setting and
condition of the patient.
• With all cooling method, the goal is to reduce the core
temperature to 39°C (102.2°F) and then stop to avoid overshoot
hypothermia.

35. EVAPORATIVE COOLING
• Patient clothing is removed and cool water [15°C(59°F)] is
sprayed on most of the patient’s body surface .
• Directing a fan over the patient facilities evaporation.
• To prevent hypothermic overshoot , some recommend using
either tepid water warmed to 40°C (104°F).
• This method is the foundation of several cooling unit such as
the Makkah cooling unit.

36. CONT.....
• The Makkah cooling unit is composed of a large hammock with
built-in sprinklers that spray cool water [15°C(59°F)] over the
patient’s body and powerful fans that blow warm air
[45°C(13°F)] over the patient.

37. IMMERSION COOLING
• Placing the undressed patient into a tube of ice water deep
enough to cover the trunk and extremities , while keeping the
patient’s head out of the water.
• Shivering, displacement of monitoring leads , and inability to
perform defibrillation or resuscitation procedure.

38. OTHER METHODS
• The most rapid method of cooling a heat stroke victim is
cardiopulmonary bypass.
• Cold water gastric lavage , cold water urinary bladder lavage,
and cold water rectel lavage.
• Cold wate peritoneal lavage but not effective.
• IV infusion of cold fluid is not considered effective treatment.

39. TREATMENT OF COMPLICATIONS
• Hypotension is a common. Small flui bolus (500 mL NS) and
body cooling.
• Low cardiac output and elevate CVP warrants the use of
dopamine or dobutamine.
• Severe vasoconstiction by norepinephrine.
• Hypokalemia due to total-body depletion of potassium may be
noted.
• Hypernatremia seen in severely dehydrated patients.

40. CONT.....
• Hyponatremia occurs in patients who hydrate with oral
hypotonic solution.
• Coagulation studies may show thrombocytopenia,
hypoprothrombinemia and hypofibrinogenemia .
• Thermal injury to the liver is a common , always reversible ,
with a full recovery.
• Renal failure ,adult respiratory distress syndrome may also
occur.
• Seizure may occur during cooling and can be controlled with
benzodiazepines .

41. HOME REMEDY
• Lemon water
• Intake adequate water
• ORS
• Taking a cool shower or bath

42. RESEARCH

43. SUMMARY
•Thermal emergencies are health crises
caused by exposure to hot weather and
sun heat.
•The higher the heat and humidity ,
greater risk for illness .
•If regained :- rest and adequate
rehydration .

44. EVALUATION
• Defined themal emergencies ?
• What is heat stroke ?
• How many types of heat stroke ?
• What is heat syncope?
• What is the signs and symptoms of heat exhaustion?
• Explain about the emergency care of procedures of heat stroke?
• Explain about the classical heat stroke?

45. Book
Internet
Teacher
REFERENCE

46. BIBLIOGRAPHY
• PV A textbook of medical surgical nursing 11page no. 1020-
1024 .
• WWW. Wikipedia. Com .
• Thermal emergencies SlideShare.net
• www.resarchgate.net.