Heat Stroke: Recognition and Treatment. Rodney S. Gonzalez, MD MAJ, MC, USA. Case 1. 25yo AD male Ranger Student (28Jul08) Arrived Ft. Drum, NY three days prior Day 0 – Fitness Test 4 mile mark noted to be fatigue and dizzy Individual sought cadre care Medic did rectal temp: 105.7
Rodney S. Gonzalez, MD
MAJ, MC, USA
H – Heat Category past 2 days
E – Exertion Level past 2 days
A – Acclimatization/Individual risk factors
T – Temperature/Rest overnight
Cluster of heat injuries on prior 2 days = HIGH RISK
Note: 40% of heat injuries may occur under “green flag” conditions. This is probably due to previous days’ heat, work load and dehydration.
Bouchama & Knochel NEJM 2002
(dizziness, headache, dry mouth, nausea, weakness, muscle cramps)
Mental status changes?
Vomits 2x or more?
Unconsciousness > 1 minute?
Rectal temperature >104º F (Medic or EMT task)?
TREAT: Stop, Cool
Soldier gets worse or does not improve
in 30 minutes?