Heat Emergencies/Cold

Anticholinergic, phenothiazines, tricyclic antidepressants, MAO inhibitors, diuretics, LSD, amphetamines

Acute heat injury with hyperthermia caused by dehydration

Dehydration, temp >37.8 (100.4), fatigue, weakness, HA, N/V, sweating, pilerection, tachy, hyperventilation

Cool enviornment, hydration, salt replacement, active cooling, 24 hr rest

Life threatening emergency from failure of thermoregulatory mechanism

Temp >106F, tachy, decre CO,DBP,SVR, arrhythmias, incr RR, resp alkalosis, resp failure RDS, hematuria, oliguria

Seizures, coma, delirium, hallucinations, incr LFTs, hepatocellular necrosis, diaphoresis, anhydrosis late

Incr BUN, anuria, proteinuria, hematuria, acid base abnormalities, inc LA, decr CA,MG,K, Phos, Thrombocytopenia, incr bleeding &clotting

CBC, complete metabolic panel, CPK, ABG, UA, CXR, CT head, foley, PA cath

Stabilize ABCs, Ow, IV crystalloid, thorazine, valium, mannitol/lasix

Reddened skin, pain at site, only dermis involved

Partial-thickness, intense pain, white to red skin, blisters, epidermis and dermis involved

Full-thickness, dry, leathery skin (white, dark brown, charred), loss of sensation, all dermal layers involved

Architectual cellular damage from ice-crystal formation, microvascular thrombosis and stasis

Prefreeze phase, freeze-thaw, vascular stasis and progressive ischemia

Superficial tissue "cooling", increased viscosity of vascualr components, microvascular construction, endothelial plasma leakage

Extracellular fluid ice-crystal formation, water diapedesis across cell membrane, cell dehydration & hyperosmolaity, cell denatured, shrinks

Vasospasticity & stasis coagulation, AV shunting, endothelial cell damage, necrosis of cell, interstitial leakage/ tissue hypertension

Numbness, clumsiness, "chunk of wood" sensation, acute anesthesia in once painful digit