The heat is on: Reducing the dangers of hyperthermia for your residents
Martie L. Moore, RN, MAOM, CPHQ
He stumbled into the room, sweating and vomiting, and then he slipped to the floor. I was 8 years old and he was my brother.
The day was hot and he had been outside all day fixing the fences on our parents' farm. Knowing there was no time to get our parents from the back pasture, I ran to the phone and — in a time before 911 and other systems — called the operator. She instructed me to look up sunstroke in the encyclopedia, where I read how I needed to cool him down and get fluids into him.
I proceeded to throw ice cubes on him and pour salt water down his throat. Some time later, my brother came back to me. I am not sure if my actions helped him; the story in our family is that they did. I am fairly sure, however, that that was when my road to becoming a nurse was set.
Every year I read and hear about tragic stories: People who are impacted by heat exhaustion or heat stroke. Just last month, my husband and I were in the Red Rock Canyon in Nevada. We were out in a remote area with no one around when three young teenagers stumbled out from the canyon walls. They were lost. One of the girls exhibited signs of heat exhaustion, rapidly deteriorating as I assessed her. Moving quickly, I got her cooled down and administered fluids. Their car was seven miles from where we found them.
The heat of summer must be approached with caution, especially for those who are more vulnerable. Health-related factors — some especially common among older people — can increase risk of hyperthermia. These include:
- Age-related changes to the skin, such as impaired blood circulation and inefficient sweat glands
- Heart, lung, and kidney diseases, as well as any illness that causes general weakness or fever
- High blood pressure or other conditions that result in changes in diet and/or reduced sweating caused by medications such as diuretics, sedatives, tranquilizers, and certain heart and blood pressure drugs
- Taking several drugs for various conditions (It is important, however, to continue to take prescribed medication and discuss possible problems with a physician.)
- Being substantially overweight or underweight
Recognizing the signs and symptoms of a rising core temperature in another person can mean the difference between health and illness. Do you know what to look for? The National Institutes of Health (NIH) offers the following list of things to note:
- Mental status changes (such as confusion or combativeness)
- Strong rapid pulse
- Nausea and vomiting
- Lack of sweating (This is a late sign and can be difficult to assess in the elderly as they decrease sweat production with aging.)
- Dry, flushed skin
- Faintness, staggering or coma
- If you suspect that someone is suffering from one or more of these heat-related symptoms:
- Move the person from the heat and into a shady, air-conditioned or other cool place. Urge them to lie down.
- If you suspect heat stroke, call for medical help.
- Encourage the individual to shower, bathe, or sponge off with cool water.
- Apply a cold, wet cloth to the wrists, neck, armpits and/or groin. These are places where blood passes close to the surface of the skin, and the cold cloths can help cool the blood.
- Think about using evaporation as a tool. Wetting hair down can help pull heat away from the body.
- If the person can swallow safely, offer fluids such as water or fruit and vegetable juices, but avoid alcohol and caffeine.
We all look forward to a break from the cold, harsh winter and long for the joy of warm, sunny summer days. But with the heat comes danger, and we all need to be keenly aware so we can avoid putting our residents and patients at risk and know what to do if signs of hyperthermia occur.
Martie L. Moore, RN, MAOM, CPHQ, is the Chief Nursing Officer at Medline Industries Inc. As CNO, she develops forward-thinking, solution-driven clinical programs, as well as new products and educational services. Previously, she was the chief nursing officer at Providence St. Vincent Medical Center in Portland, OR. Under her leadership, Providence St. Vincent earned its third and fourth Magnet designations for nursing excellence.