Quick Recognition
When discomfort occurs during prolonged activity in a hot environment with insufficient hydration, observe the patient’s consciousness and general condition, and quickly take appropriate measures to seek help.
Heat Stroke Recognition
Mild heat stroke
Headache and dizziness, flushed or pale face, poor concentration, self-reported thirst, weakness of limbs.
The body surface is hot to the touch, the skin is dry, and the heart rate (pulse) increases.
The above situations should be immediately removed from the hot environment, and hydration, cooling. Those whose symptoms improve after treatment can continue to be observed; if the above manifestations cannot be relieved, immediately call 120 or send yourself to the hospital emergency room.
Severe Heat Stroke
In addition to the above manifestations, sudden fainting, unconsciousness or unresponsiveness, coma, or nausea, vomiting, shortness of breath, cramps (muscle spasms).
Dry and hot to the touch or cold and clammy skin, fast heart rate (pulse).
If you experience any of the above symptoms, you should get out of the hot environment immediately, hydrate and cool down, and call 120 or send yourself to the hospital for emergency treatment.
120 call for help
If you find that the patient is unconscious, you should call 120 emergency immediately.
When there are more than two people at the scene, designate one person to make the emergency call.
120 will guide the first aid, do not hang up the phone voluntarily before the end of the call.
If possible, follow the 120 instruction to determine the patient’s vital signs.
First aid at the scene
Remove from the environment
Move to a ventilated, cool place.
Remove jacket or unbutton and unbuckle, while performing skin and muscle massage to promote heat dissipation. If muscle spasms (commonly known as cramps) occur, have the patient assume a comfortable position and stretch the localized spasms to relieve them.
Rapid cooling
For mild cases
Place ice packs on the head, armpits, and thigh roots, and wipe the skin repeatedly with cold water to help dissipate heat.
Wet the clothes on the patient with cold water and use a fan for cooling.
Seriously ill patients
If there are no signs of weakness such as pale skin and cold limbs, bathe the body (except the head) with cold water.
When bathing the whole body with cold water, stir the water to keep cold water on the surface of the skin. Putting ice cubes wrapped in wet towels on the head can rapidly lower the temperature (from 43°C to 40°C) within 20 minutes.
Closely observe the patient’s color and temperature during the cooling process, slow down the cooling rate when the body temperature drops to 39℃, and stop cooling when it drops to 38.5℃ within 2 hours to avoid hypothermia and defecation.
When the body temperature rises again, restart the cooling measures.
Supplementation of water and salt
Give salt-containing functional drinks or saline to the conscious person, and drink water in small amounts several times.
Do not feed water to unconscious persons.
Management of unconscious person
If the patient becomes unconscious, it is recommended that after helping the patient to get out of the hot environment, you keep accompanying the patient to wait for the arrival of rescuers.
During the process of accompanying the patient, you need to pay attention to the patient’s vital signs, such as respiration and pulse (heartbeat).
If the patient’s respiration and heartbeat are normal, the patient can be placed in a stable lateral position; if the respiration and heartbeat have stopped, CPR should be performed immediately.
Stabilized lateral position
When the respiratory rate is normal, tilt the patient’s head to one side or place him/her in a lateral position to prevent aspiration.
Place the patient on the near side (near the rescuer) with the upper arm bent in an “L” position; on the far side (away from the rescuer), bend the leg at the knee and place the foot underneath the knee on the near side.
The rescuer holds the patient’s opposite knee with one hand and grasps the patient’s opposite wrist with the other hand, pulling the patient toward the rescuer to make him/her lie on his/her side.
Cardiopulmonary resuscitation
When respiratory arrest occurs, perform CPR immediately (refer to CPR operation for details).
Special Tips
Heat stroke rapid cooling “golden half hour”
The most serious of the severe heat stroke is pyrexia, the onset of body temperature over 40 ℃, the mortality rate of 20% to 70%.
The speed of cooling within 30 minutes of the onset of the disease is a determining factor in the outcome of the patient. Seize the “golden half hour” rapid cooling, mortality is significantly reduced.
Severe heatstroke follows the principle of “cooling first, transferring second”, cooling and transferring at the same time.
Avoid wrong operation
Avoid replenishing a large amount of water for a short period of time, and remember not to forcibly give unconscious patients water and food.
It is unscientific to use alcohol to wipe the local skin, pinching and other methods to cure heatstroke, improper treatment will aggravate the condition.
First aid knowledge
Prevention of heat stroke
Wear a wide-brimmed sun hat, use sunscreen, wear loose, light-colored, breathable clothes, and avoid tight, non-breathable clothing when you’re out in the sun in the summer.
Minimize outdoor activities in hot weather, avoid being exposed to the sun for too long at noon (11 to 15 o’clock), carry heat-prevention and cooling medicines, and pay attention to water and salt supplementation.
Infants, young children, the elderly, frail, chronically ill patients and women in the puerperium indoor attention to ventilation and cooling, high temperatures pay attention to drinking water, these people should not participate in high-temperature work.
When traveling by car on hot days, do not leave children alone in parked vehicles.
Improve working conditions in hot environments and avoid long hours of heavy labor. Reasonable arrangement of work and rest, when a lot of sweat should drink salty drinks in time.
When stationed in a high-temperature area for training, heat acclimatization training should be organized to gradually adapt to the hot environment.
Dizziness, inattention and other early symptoms of discomfort, to leave the hot environment in a timely manner.
After recovering from heat stroke, patients should avoid strenuous activities under the sun for several weeks.
Classification of heat stroke severity
According to the performance of heat stroke, it is divided into three kinds of cases:
Aura heatstroke: manifested by discomfort such as thirst, dizziness, excessive sweating, chest tightness, panic and lack of concentration, with no or slightly higher body temperature.
Mild heatstroke: there have been signs of circulatory disorders, such as inattention, profuse sweating, apathy, dry skin, etc., and there is a rapid heartbeat and a mild increase in body temperature.
Severe heatstroke: the patient has developed neurological manifestations such as cramps, convulsions and coma. According to different degrees, it can be divided into three types: heat cramps, heat exhaustion, and pyrexia. At this point, the patient can no longer be improved by cooling and hydration, and must be given first aid, otherwise it may be life-threatening.