Let’s break this down and make it easy to remember with examples.

Imagine you’re out in the field, and dealing with a patient who is cramping up. They’ve lost water and sodium. They’re feeling faint and showing symptoms like altered mental status or even unresponsiveness. This scenario helps you understand the different levels of heat emergencies.

Let’s go through the three types of hyperthermia: heat cramps, heat exhaustion, and heat stroke, and then discuss classic versus exertional heat stroke.

Heat Cramps

These are painful muscle spasms usually occurring in the legs or abdomen. They are caused by dehydration and the loss of electrolytes through sweating. For example, a construction worker out in the sun all day might experience these cramps after not drinking enough water.

Heat Exhaustion

This is more serious than heat cramps and includes symptoms like heavy sweating, weakness, cold, pale, and clammy skin, a fast and weak pulse, nausea or vomiting, and fainting. Imagine a hiker who has been trekking uphill in the heat for hours without adequate hydration. They might start to feel dizzy, nauseous, and weak.

Heat Stroke

This is the most severe form of hyperthermia and is a medical emergency. Symptoms include a high body temperature (above 103°F), hot, red, dry, or moist skin, rapid and strong pulse, and possible unconsciousness. This can be fatal if not treated promptly.

Types of Heat Stroke

Let’s talk about classic versus exertional heat stroke. It’s important to know the difference because it affects how we respond to and treat these patients.

Classic Heat Stroke

This typically affects the very young and the elderly. It’s caused by prolonged exposure to a hot environment. For example, think of an elderly person who lives alone and doesn’t have air conditioning during a heatwave. They’ve been in the heat for too long, and their body can’t regulate temperature anymore. Another example could be a young child left in a parked car on a hot day.

Exertional Heat Stroke

This usually happens to athletes who have been training too hard or playing a game for too long in the heat. Consider a football player during summer training camp who collapses after running drills in high temperatures. Another example is a marathon runner who suddenly becomes disoriented and collapses after pushing too hard in a race under the sun.

Remember, classic heat stroke is about long exposure in vulnerable populations, while exertional heat stroke is about intense activity in generally healthy, active individuals. Both are serious and need immediate attention, but knowing the context helps us identify and treat them more effectively.

Treatment

Treatment of Heat Cramps

  • Get the patient out of the heat and into a cool, shaded place.
  • Remove clothing as needed
  • Plenty of fluids every 15–20 minutes, either water or electrolytes. Mix half an electrolyte drink with water.
  • Massage the cramping area.
  • Stretch the affected area through a full range of motion if possible.
  • Apply ice to the affected area.

Treatment of Heat Exhaustion

  • Get the patient out of the heat and into a cool, shaded place.
  • Remove clothing as needed.
  • Plenty of fluids every 15-20 minutes, either water or electrolytes. Mix half an electrolyte drink with water.
  • Cool the skin. Use a cool towel around the neck and cold ice packs under the armpits and in the groin area.
  • Monitor the patient

Treatment of Heat Stroke

  • Get the patient out of the heat and into a cool, shaded place.
  • Remove clothing as needed.
  • Plenty of fluids every 15–20 minutes, either water or electrolytes. Mix half an electrolyte drink with water.
  • Cool the skin. Use a cool towel around the neck, cold ice packs under the armpits and in the groin area, misting fans, or cool water immersion if possible. The goal is to quickly lower the patient’s core body temperature.
  • Monitor and transport as soon as possible. This is a true emergency.

AEMTs and Paramedics should consider starting IV fluids, putting the patient on a monitor, and observing for any cardiac rhythm changes.

Stay sharp and keep these distinctions in mind when you’re out in the field!