Recently, it has been a period of continuous high temperatures, and if precautions are not taken, outdoor operations are prone to heat stroke safety incidents. Therefore, understanding the performance of heat stroke and preventive measures and emergency treatment measures can reduce the occurrence of safety accidents caused by heat stroke.
First, what is heat stroke
What is heat stroke? Heat stroke is an acute disease in which the human body is exposed to high temperatures, thermoregulation function is disturbed, and the central nervous system and circulatory system disorders are the main manifestations. Heat stroke is generally divided into heat stroke aura, mild heat stroke and severe heat stroke, according to the pathogenesis, severe heat stroke is divided into heat spasm, heat exhaustion and heat stroke. Among them, the mortality rate of heat stroke is very high. In July 2010, "heat stroke" was included in the national statutory occupational disease directory. (Severe heat stroke can be divided into heat cramps, heat exhaustion, and heat stroke.) ）
Second, the cause of heat stroke
When the body is unable to adapt to and tolerate environmental heat (>32 degrees Celsius), high humidity (>60%) and no wind, the body generates more heat than the heat dissipated, resulting in heat accumulation, body temperature rise, and then heat stroke. Common causes are as follows:
1. The body's own heat generation increases
Under high temperature, high humidity, impermeable air or strong thermal radiation, engaging in strenuous activities for a long time, the body's heat generation increases.
It is common in people who work hard, exercise, or undergo military training. Some disease states, such as fever, chills, or convulsions, can also lead to increased body temperature.
2, the ambient temperature rises
When the ambient temperature rises, some susceptible people, such as the elderly and frail people (schizophrenia, Parkinson's disease, chronic alcoholism), thermoregulation dysfunction, can not adjust their body temperature well, the body from the environment to obtain heat increased.
3. Heat dissipation obstacles
(1) Decreased sweating: sweat gland damage or lack, such as skin burn scars, sweat gland deficiency, etc.
(2) Decreased central nervous system or cardiovascular function, such as drinkers, the elderly, cardiac dysfunction, etc.
(3) Taking drugs that affect sweating, such as anticholinergics and antihistamines.
(4) Other factors: obesity and impermeable clothes.
Third, heat stroke classification
Heat stroke is generally divided into heat stroke aura, mild heat stroke and severe heat stroke, according to the pathogenesis, severe heat stroke is divided into heat spasm, heat exhaustion and heat stroke. Among them, the mortality rate of heat stroke is higher.
4. Symptoms and manifestations
After prolonged exposure to high temperatures, symptoms such as headache, dizziness, thirst, and hyperhidrosis occur, and the body temperature is normal or slightly elevated at first. When the core body temperature continues to rise to more than 38 degrees Celsius, in addition to the above symptoms, there will be flushing, a lot of sweating, burning skin, wet and cold limbs and other conditions. If not intervened in time, it can gradually develop into a coma with convulsions of the limbs, and in severe cases, multi-organ failure can occur.
1. Aura of heat stroke
When exposed to high temperatures, sweating, limb weakness, dizziness, thirst, headache, inattention, dizziness, tinnitus, uncoordinated movements, etc. with or without increased body temperature. If you get out of the high temperature environment, move to a cool place, ventilate and cool down in time to replenish cold brine, you can recover in a short time.
2. Mild heat stroke
Symptoms of aura heat stroke continue to worsen, body temperature rises above 38 degrees Celsius, and symptoms of burning skin, flushing, or dehydration (such as wet and cold limbs, pale face, decreased blood pressure, increased pulse, etc.) appear. It is treated in the same way as the aura heat stroke and can recover within a few hours.
3. Severe heat stroke
There are three types of heat spasm, heat exhaustion, and heat stroke. The condition worsens rapidly and the case fatality rate is high.
(1) Thermal spasms
It is more common in healthy young adults.
Manifested by transient, intermittent muscle twitches during or after training during or after training, which generally last about 3 minutes.
Patients often have no significant increase in body temperature, which may be related to heavy sweating, only hydration, no salt supplementation, a large amount of sodium deficiency in the body, or hyperventilation.
(2) Heat exhaustion
More common in the elderly, children, and people with chronic diseases. Patients present with a group of clinical syndromes characterized by volume depletion, manifested by hyperhidrosis, fatigue, fatigue, dizziness, headache, decreased judgment, nausea, and vomiting.
At this time, the patient's body temperature is elevated, and there is no obvious sign of nervous system damage. If it is not diagnosed and treated in time, it can develop into heat stroke.
(3) Heat stroke
It is divided into two categories: labor-type heat stroke and non-labor-type heat stroke.
(1) Heat stroke on exertion
It is more common in healthy young people (such as those who participate in sports, officers and soldiers who train), and are manifested as being exposed to high temperatures, high humidity, and no wind for a long time, and after a period of high-intensity training or heavy physical labor, fever, headache or sudden fainting, confusion, etc. Subsequently, the body temperature rises rapidly, reaching more than 40 degrees Celsius, and delirium, drowsiness and coma appear.
Patients may be accompanied by rhabdomyolysis, acute renal failure, acute liver damage, disseminated intravascular coagulation (DIC) and other manifestations of multi-organ failure, and the condition worsens rapidly and the case fatality rate is extremely high.
(2) Non-exertional heat stroke
It usually occurs in the elderly, frail (children) and chronically ill populations, and is generally slower. Symptoms are not easy to detect at first, but after 1 to 2 days, symptoms worsen, and confusion, delirium, and coma appear. The patient's body temperature can reach 40 to 42 degrees Celsius, and the rectal temperature can reach up to 46 degrees Celsius, which may have heart failure, kidney failure and other manifestations.
Fifth, heat stroke is urgently handled
First, the patient should be immediately removed from the high fever and moved to a well-ventilated, shady place.
1. Unbutton the clothes, let the patient lie flat, fan the fan, and give a cup of cool drink or warm boiled water to the patient to drink slowly. When the patient develops a hot fainting condition, it can be slowly drunk with a teaspoon of table salt mixed with 600 ml of water.
2. Artificial cooling: for patients with mild disease, according to the characteristics of the on-site environment, use cold water or ice water towel to apply to their heads; when the patient has high fever, watermelon peel or wet towel can be used to wipe the armpits, groin and other places for the patient to achieve the effect of artificial cooling.
3. Mild patients can take 10 capsules of Rendan or 1 stick (5ml) of 10 drops of water orally.
4. Acupuncture massage: acupuncture therapy or massage the following acupuncture points: large vertebrae, Weizhong, Hegu or Quchi, Baihui, Renzhong, Yongquan and other acupuncture points.
Massage the temples (preferably with wind oil).
If syncope, use fingernails to stimulate the person's middle point (1/3 of the middle of the nasolabial center).
If you are uncomfortable with chest tightness, untie the collar and press the inner guan point (two inches on the wrist tattoo).
Massage or gua sha to stimulate the middle punch point (the tip of the middle finger), the Baihui point (the midpoint of the tip of the two ears at the top of the head), and the Fountain Point (1/3 of the anterior 1/3 of the center of the foot).
Special reminder: severe heat stroke patients, while urgently carrying out the above treatment, should be immediately sent to the nearest hospital for comprehensive treatment.
Sixth, the prognosis
The prognosis of heat stroke is related to the degree of hyperthermia, duration, rate of cooling, and degree of damage to vital organs. If treatment is delayed, the case fatality rate can reach 80%, and if early diagnosis and timely cooling treatment, the case fatality rate can be reduced to 10%.
7. Complications
In patients with heat stroke who develop coma, despite rapid cooling treatment, there are individual patients who may have permanent neuropsychiatric sequelae.
8. Preventive measures
So, how can high temperature weather prevent heat stroke? The following 8 measures can reduce the occurrence of heat stroke events.
1. Adjust the work and rest time. It is best not to work in the hot sun between 10 a.m. and 4 p.m. Because this time period is the most intense, heat stroke is 10 times more likely than other times.
2, to be equipped with anti-heat medicine and drinks. Such as: Ren Dan, ten drops of water, Huoxiang Zhengqi water, wind oil essence and so on. Prepare plenty of water and drinks, and replenish water before you get thirsty. Especially in the high temperature environment for physical labor or strenuous exercise, at least 500-1000ml per hour, take a small number of times to drink, outdoor work sweat more, you can drink light salt water in moderation, which is conducive to improving your physical strength.
3, wear clothes to choose cotton, linen, silk loose clothes, do not expose the skin, to avoid sunburn. Do not wear tight and airtight pants in order to reveal the figure, so as not to be able to dissipate heat in time when sweating a lot, causing heat stroke. When working in the sun, be sure to bring a straw hat or sun hat to block the direct sunlight from overhead.
4. Avoid sun exposure to the skin. Summer sunlight ultraviolet rays are very strong, easy to cause solar dermatitis. If the skin appears red and swollen and other symptoms, it should be rinsed with cool water, and the severe case should be treated in the hospital.
5, to avoid high temperature period exercise, do not rush in the sun, do not go to crowded places. After returning to the room from the outside, you should cool down naturally before turning on the air conditioner, and do not immediately turn on the air conditioner to blow cold air. Otherwise, due to the alternation of hot and cold, it is easy to have cold symptoms.
6. Pay attention to the care of special groups. Especially for the elderly and children, high temperature days are easy to induce cardiovascular and cerebrovascular diseases in the elderly and adverse symptoms in children.
7, to maintain adequate sleep, regular life and work, can enhance immunity. The best time to go to bed is 22-23 o'clock and the best time to wake up is 5:30 to 6:30. When sleeping, be careful not to lie under the air outlet and electric fan of the air conditioner, so as not to suffer from air conditioning disease and wind fever and cold.
8. In high temperature days, when headache, dizziness, nausea, dry mouth, confusion, palpitation, chest tightness, shortness of breath, flushing and other symptoms, you should first suspect whether there are early symptoms of heat stroke, you can immediately go to a ventilated and cool place to rest, drink some cool boiled water to cool down, take 5-10 capsules of Ren Dan or drink 1 stick of ten drops of water (5ml), and apply cold water or ice water towel to its head. If symptoms do not resolve, they should be immediately sent to the nearest hospital for treatment.