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Hyperthermia Standing Order

Hyperthermia Standing Order. HYPERTHERMIA (Heat Illness). State of unusually high core body temp Predisposing Factors: 1. Age of the patient : less tolerable in peds and geriatric.

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Hyperthermia Standing Order

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  1. Hyperthermia Standing Order

  2. HYPERTHERMIA(Heat Illness) • State of unusually high core body temp • Predisposing Factors: 1. Age of the patient: less tolerable in peds and geriatric. 2. Health of the patient: i.e. diabetics can become hyperthermic more easily because of the damage DM inflicts on their autonomic nervous system (thermoregulatory input, vasodilation, perspiration) 3. Medications: i.e. diuretics >dehydrartion,Beta Blockers<vasodilation, psychotropic's< CNS regulation

  3. Predisposing factors continued: 4. Level of acclimation: adjusting to environment change 5. Length of exposure 6. Intensity of exposure 7. Environmental factors such as humidity and wind

  4. Organ Systems Responsible for Heat Loss • Skin: vasodilatation and perspiration • Cardiovascular: increased cardiac output to compensate for peripheral vasodilatation with increased volumes of blood to periphery • Respiratory: some degree of evaporation

  5. Humidity • Evaporation and perspiration are the primary and most effective methods of cooling • At very high humidity, perspiration is totally ineffective

  6. The Range of Heat Illnesses Heat Cramps: Painful, easily treated, acclimation occurs Heat Exhaustion: Serious but no organ damage, mild hyperpyrexia Heatstroke: Critical organ damage, significant mortality, markedly elevated body temperature, usually > 105’

  7. Heat Cramps • Painful contractions of larger muscle groups during or shortly after strenuous exercise in the heat • Usually caused by replacement of water without adequate salt resulting in a low sodium state in the muscles • Treated with cooling measures, fluid and electrolyte replacement via IV. • No changes in mental status or fever

  8. Heat Exhaustion • Salt or water depletion in the face of heat stress • Mild hyperpyrexia, nausea, vomiting, lightheadedness, dehydration with only minimal altered mental status • Leads rapidly to heatstroke if not rapidly reversed • Treated with cooling measures, also IV Normal Saline, further electrolyte replacement guided by serum electrolyte levels

  9. Heatstroke • Heatstroke results when the body’s thermoregulatory mechanisms are overwhelmed by the heat stress. The body’s temperature rises markedly with eventual multisystem organ failure.

  10. Exertional and Classic Heatstroke • Exertional: younger, physically fit with normal thermoregulatory systems • Frequently not dehydrated and may be wet with perspiration • Significantly elevated body temperature • Classic: older or debilitated exposed passively to significant thermal stress over hours or days. • Ability to respond is compromised by CV disease, drugs, alcohol. • Usually perspiring for significant time and profoundly dehydrated

  11. Organ Systems Affected by Heatstroke

  12. Treatment of Heatstroke • ABC’s • Cooling measures to lower the patient’s temp to <101ºF within 1 hour. • Prevent shivering as this raises the core body temperature • Keep patient NPO. • IV NS, fluid bolus’, O-2, cardiac monitor, • Anticipate seizures: Rx valium • True life threatening emergency so load and go to the closest E.D.

  13. Take the test now. Must pass with 90%.

  14. 1. Review answers to test if made available.2. Make sure your test info is completely filled in.3. Collect test and mail to your Prehospital Manager.4. Will receive 1 hour SAEMS CEUwith in one week of mailing. 5. May begin using SAEMS Hyperthermia Standing Order as soon as you pass test with 90% & confirmed by your Prehospital Manager. 6. Questions? Call your Prehospital Manager.

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