Telangana State Heat Wave Portal

Heat Wave Illness- Treatment Protocol

Recognizing the treatment protocols which may vary slightly according to the setting (EMS, health center, clinic, hospital emergency department, etc.), the following should apply generally to any setting and to all patients where there is a potential concern for heat illness. Special thanks to Drs. ArthurYancey and Nee-Kofi Mould-Millman of Grady Emergency Medical Services, Emory University Department of Emergency Medicine, Atlanta, GA USA.

     1. Initial patient assessment – primary survey (airway, breathing, circulation, disability, exposure), vital signs, including temperature.
     2. Consider heat illness in differential diagnosis if:

       a. Presenting with suggestive symptoms and signs (see table).
       b. Patient has one or more of the following risk factors:

             i. Extremes of age (infants, elderly)
            ii. Debilitation/physical de conditioning, overweight or obese
            iii.Lack of acclimatization to environmental heat (recent arrival, early in summer season)
            iv. Any significant underlying chronic disease, including psychiatric, cardiovascular, neurologic, hematologic, obesity, pulmonary, renal, and respiratory disease
             v. Taking one or more of the following:

                    1. Sympathomimetic drugs
                    2. Anticholinergic drugs
                    3. Barbiturates
                    4. Diuretics
                    5. Alcohol
                    6. Beta blockers

      3. Remove from environmental heat exposure and stop physical activity
      4. Initiate passive cooling procedures

         a. Cool wet towels or ice packs to axillae, groin, and around neck; if patient is stable, may take a cool shower, but evaluate risk of such activity against gain          and availability of other cooling measures.
           b. Spray cool water or blot cool water onto skin.Use fan to blow cool air onto moist skin.

    5. If temperature lower than 40°C, repeat assessment every 5 minutes; if improving, attempt to orally hydrate (clear liquids, ORS can be used but not necessary        cool liquids better than cold) and observe.
     6. If temperature 40°C or above, initiate IV rehydration and immediately transport to emergency department for stabilization.