Heat and Cold Emergencies and Treating Snake Bites
Heat Related Illness
Heat cramps, heat exhaustion, and heat stroke are conditions caused by overexposure to heat. Heat cramps are the least severe, and often are the first signals that the body is having trouble with the heat. Heat cramps are painful muscle spasms. They usually occur in the legs and abdomen. Think of them as a warning of a possible heat-related emergency. To care for heat cramps, have the victim rest in a cool place. Give cool water or a commercial sports drink.
Usually, rest and fluids are all the person needs to recover. Lightly stretch the muscle and gently massage the area. The victim should not take salt tablets or salt water. They can make the situation worse. When the cramps stop, the per son can usually start activity again if there are no other signals of illness. He or she should keep drinking plenty of fluids. Watch the victim carefully for further signals of heat related illness.
Heat exhaustion is a more severe condition than heat cramps. It often affects athletes, fire lighters, construction workers, and factory workers, as well as those who wear heavy clothing in a hot, humid environment. Its signals include cool, moist, pale, or flushed skin, headache, nausea, dizziness, weakness, and exhaustion.
Heat stroke is the least common but most severe heat emergency. It most often occurs when people ignore the signals of heat exhaustion. Heat stroke develops when the body systems are overwhelmed by heat and begin to stop functioning. Heat stroke is a serious medical emergency. The signals of heat stroke include red, hot, dry skin; changes in consciousness; rapid, weak pulse; and rapid, shallow breathing.
When you recognize heat-related illness in its early stages, you can usually reverse it. Get the victim outof the heat. Loosen any tight clothing and apply cool, wet cloths, such as towels or sheets. If the victim is conscious, give cool water to drink. Do not let the conscious victim drink too quickly. Give about one glass (4 ounces) of water every 15 minutes. Let the victim rest in a comfortable position, and watch carefully for changes in his or her condition. The victim should not resume normal activities the same day.
Refusing water, vomiting, and changes in consciousness mean that the victim’s condition is getting worse. Call for an ambulance immediately if you have not already done so. If the victim vomits, stop giving fluids and position the victim on the side. Watch for signals of breathing problems. Keep the victim lying down and continue to cool the body any way you can. If you have ice packs or cold packs, place them on each of the victim’s wrists and ankles, on the groin, in each armpit, and on the neck to cool the large blood vessels. Do not apply rubbing (isopropyl) alcohol.
Cold Related Illness
Frostbite and hypothermia are two types of cold emergencies. Frostbite is the freezing of body parts exposed to the cold. Severity depends on the air temperature, length of exposure, and the wind. Frostbite can cause the loss of fingers, hands, arms, toes, feet, and legs. The signals of frostbite include lack of feeling in the affected area and skin that appears waxy, is cold to the touch, or is discolored (flushed, white, yellow, or blue) To care for any frostbite, handle the area gently. Never rub an affected area. Rubbing causes further damage to soft tissues. Instead, warm the area gently by soaking the affected part in water no warmer than 105° F. If you don’t have a thermometer, test the water temperature yourself. If the temperature is uncomfortable to your touch, the water is too warm. Keep the frostbitten part in the water until it looks red and feels warm. Loosely bandage the area with a dry, sterile dressing. If fingers or toes are frostbitten, place cotton or gauze between them. Don’t break any blisters. Get professional medical attention as soon as possible.
In hypothermia the entire body cools because its ability to keep warm fails. The victim will die if not given care. Signals of hypothermia include shivering, numbness, glassy stare, apathy, and loss of consciousness. The air temperature does not have to he below freezing for people to develop hypothermia. Elderly people in poorly heated homes can develop hypothermia at higher temperatures. The homeless and the ill also are at risk. Substances that interfere with the body’s normal response to cold, such as alcohol, may cause HYPERTHERMIA to occur more easily. Any medical condition that impairs circulation, such as diabetes or cardiovascular disease, can also make a person more likely to get hypothermia. Anyone remaining in cold water or wet clothing for a long time may also easily develop hypothermia.
To care for hypothermia, start by caring for any life-threatening problems. Call the local emergency number. Make the victim comfort able. Remove any wet clothing and dry the victim. Warm the body gradually by wrapping the victim in blankets or putting on dry clothing and moving him or her to a warm place. If they are available, apply heat pads or other heat sources to the body. Keep a barrier, such as a blanket, towel, or clothing, between the hear source and the victim to avoid burning him or her. If the victim is alert, give warm liquids to drink, no not warm the victim too quickly, such as by immersing the victim in warm water. Rapid re-warming can cause dangerous heart problems. Handle the victim gently.
In cases of severe hypothermia the victim may be unconscious. Breathing might have slowed or stopped. The pulse may be slow and irregular. The body may feel stiff because the muscles become rigid. Call for an ambulance. Keep checking breathing and pulse. Give rescue breathing if necessary. Continue to warm the victim until EMS personnel arrive. Be prepared to start CPK. In general, illnesses caused by overexposure to extreme tempera- tures can be prevented. To prevent heat or cold emergencies from happening to you or anyone you know, follow these guidelines:
- Avoid being outdoors in the hottest or coldest part of the day.
- Change your activity level according to the temperature.
- Take frequent breaks.
- Dress appropriately for the environment.
- Drink large amounts of fluids.
Snake Bites
Steps to Take for a “Poisonous” Snake Bite:
- Have the patient lie down on his or her back keeping patient quite and still with the bite area raised above the level of the Heart.
- Wipe the wound area with alcohol, soap and water, or hydrogen peroxide.
- If you do not have a sterile scalpel or razor blade, sterilize a knife in a match flame, in soap and water, in alcohol, or in hydrogen peroxide. Only make an incision if you are thirty minutes or more away from a medical facility.
- Find the fang marks. Wrap soft rubber tubing around the extremity both above and below the fang marks. Tubing should be tight enough to stop the flow of blood through the veins but not through the arteries.
- Make longitudinal (vertical) cut marks through each fang mark. Cut marks should be about one-eighth to one-fourth inch in length and should be parallel to each other; they should be made in the direction that the fang entered. The incisions should not be cross marks.
- Apply suction to the wound directly over the incisions. (A suction cup from a snakebite kit is ideal, but you can “milk” the incision with your fingers if necessary.) Note: There is some controversy about incising and suctioning a snakebite injury, using constricting bands, and when it should be done. Always follow local protocol and poison control center instructions.
- The most effective countermeasure is an antivenin shot obtained at a medical facility.
- Give the patient emergency care for shock. Monitor vital signs, keep the patient warm and lying down, and administer oxygen if needed.
- Transport him to the hospital as soon as possible.