By: Sally Plomley, Nurse office
sallyp@isb.ac.th
Living in Thailand, we need to always be aware of heat related illness. It is important to know that the risk of developing these conditions increases dramatically when we are in the hot season.
Heat related illness ranges from uncomfortable Heat Cramps to the potentially lethal Heat Stroke. We should be aware of these conditions and the treatment of them should someone be affected. Most importantly we all should be working to prevent anyone getting these conditions.
Prolonged periods outside also increase the risk of Heat Illness. Please ensure that your child does not have prolonged periods of time outside (especially with after school sports). If they do please discuss this with their coaches to ensure they have adequate rest time in a cool environment.
SIGNS AND SYMPTOMS OF THE THREE STAGES OF HEAT RELATED ILLNESS
Signs and Symptoms of Heat Cramps
- Profuse Sweating
- Fatigue
- Thirst
- Muscle Cramps
- Treatment:
- Move to cool environment
- Sip a drink containing electrolyte solution (or water if electrolyte not available)
- Massage area that has cramped
- When cramp resolves may continue exercise as long as drinking plenty of fluids and all symptoms have resolved
- If not improving with the above measures and on ISB campus whilst nurse is on duty, call the nurse. If no nurse is available arrange for the person to go for a medical review.
- Educate the person about heat illness and the need to drink water throughout the day and whilst exercising (to help prevent recurrence).
- Signs and Symptoms of Heat Exhaustion
- The signs and symptoms of Heat Cramps and…
- Headache
- Dizziness and Lightheadedness
- Weakness
- Nausea and Vomiting
- Cool Moist Skin
- Dark Urine
- Treatment:
- Move to a cool environment
- If on ISB campus whilst nurse is on duty call the nurse. If no nurse is available or delayed in attending, continue to care for the person as below.
- Apply cool wet cloths to the person’s skin rotating them regularly. Fan the person.
- Sip a drink containing electrolyte solution (or water if electrolyte not available). Do not drink too quickly
- Encourage them to rest in a comfortable position.
- Ensure they do not return to physical activity for several hours.
- Call for ambulance if recovery is slow, condition deteriorates or vomiting occurs.
- Signs and Symptoms of Heat Stroke
- Throbbing headache
- Dizziness and lightheadedness
- Lack of sweating despite the heat
- Red, hot, and dry skin
- Muscle weakness or cramps
- Nausea and vomiting
- Seizures
- Rapid, shallow breathing
- Unconsciousness or collapse
- Hyperventilation
- Rapid heartbeat-strong or weak
- Confusion, disorientation, or staggering
- Treatment:
- Call Ambulance immediately. Anyone with Heat Stroke must go to hospital. Start measures below whilst waiting for the ambulance
- Put in cool environment and fan patient.
- Rapid cooling with the use of iced towels or ice packs over groin, neck and axilla region rotating frequently for 20mins or until condition improves.
If any heat illness occurs whilst on campus, please call the nurse on 1111 or 081 544 8255 immediately to come and provide care for the person. Start immediate first aid as outlined above whilst waiting for the nurse to arrive.
When the nurse attends she will find out what has happened and review symptoms, signs and check blood pressure, pulse, respiratory rate and do a neurological assessment. After her review the nurse will determine whether the student has heat exhaustion or heat stroke. If the student has heat stroke, parents will be called and immediate transfer to hospital will be arranged. If they have heat exhaustion, parents will be called and they will be managed in the clinic until their condition improves and parents arrive to take the student home. Occasionally, it is difficult to determine if it is heat exhaustion or heat stroke. In these instances the student will be treated for heat stroke and transferred to hospital.
Prevention
- Heat illness is caused by prolonged exposure to heat. Being dehydrated will dramatically increase your risk of heat illness.
- It is important that everyone drinks water throughout the day to ensure they are adequately hydrated at all times.
- Students are encouraged to drink water regularly with an aim of staying hydrated. Students get water breaks during PE classes to replace increased losses that occur with increased ambient temperature and physical exertion.
- The ambient temperatures are monitored and with increasing temperatures and humidity the amount of rest/water breaks increases and the amount of physical exertion and time outside decreases.
- All student toilet blocks have information for students on the how the color of their urine reflects their hydration status. Students are encouraged to self monitor to ensure their urine is clear.
