Environmental Hyperthermia / Heat Stress (Adult)
 
 
Assess
• Accurately assess temperature
• BGL if altered conscious state
Perfusion status
   
Stop
This guideline is not intended for the management the febrile patient due to infection
   
Cooling techniques - initiated and maintained until temp. is <38˚C
- Shelter / remove from heat source
- Ensure airflow over Pt
- Remove all clothing except underwear
- Apply tepid water using spray bottle or wet towels

If significant dehydration or poor perfusion, treat as per Hypovolaemia

Provide initial Normal Saline 20ml/kg IV and reassess VSS and temp
Continue to administer Normal Saline if pt remains poorly perfused or significantly dehydrated
 - If treating with IV fluid and pt temp is >40°C, cool fluids are preferred if available (stored usually at <8°C)
 - Use cooled fluid until temperature is <39°C. If ongoing fluid administration is required change to ambient temp fluid
Treat low BGL as per Hypoglycaemia
Airway and ventilation support with 100% O2 as required
   
Assess response to Mx
   
Adequate response
BLS
Transport
 
 
   
Poor response after 10 minutes
• Severe cases - Temp. >39.5˚C
• GCS <10
Consider intubation
If intubated, sedation and paralysis essential to prevent shivering and reduce heat production
 
Special Notes
• Patient body temperatures of < 40°C, can normally be managed with basic cooling techniques alone
• During cooling, the patient should be monitored for the onset of shivering. Shivering may increase heat production and cooling measures should be adjusted to avoid its onset
• Gentle handling of the patient is essential. Position flat or lateral and avoid head up position to avoid causing arrhythmias
• Be wary of fluid volumes in renal dialysis patients causing fluid overload. Administer judicious increments with volumes not usually exceeding 10 ml/kg
• This guideline is not intended for the management the febrile patient due to infection