Heat Illness

Minor Heat Illness

Minor heat illness is an elevation in the core temperature above normal, but to less than 40°C. Patients with this condition will often have mild symptoms and it is important that the first aider maintains a high index of suspicion.

Signs and symptoms

Patients with heat illness may develop muscle cramps. These can be severe in nature, and often affect large muscle groups such as quadriceps, hamstrings or abdominal wall.

As the condition progresses, the patient is likely to be hyperventilating in an attempt to maximise heat loss and may develop spasm of their hands. 

Dilation of the blood vessels (Vasodilation) is another compensatory mechanism to maximise heat loss, , this can result in peripheral pooling of blood, with relative low blood pressure (distributive shock), causing the patient to feel dizzy and lead to collapse.

If left unrecognised or inadequately treated, these individuals will become exhausted and may progress to major heat illness.

Steps to manage Minor Heat illness:

1. SABCDE and help the player to a cool, shady place, encouraging them to lie down and then raise and support their legs.
2. Give them plenty of water to drink. Rehydration powders added to the water or isotonic drinks will help with salt replacement.
3. Monitor and record the players vital signs. Even if they recover advise them to seek medical advice.
4. If they deteriorate call for emergency help and continue to monito vital signs.

Major Heat Illness

Major heat illness is a serious medical emergency with a death rate approaching 10%. It is vital that this condition is recognised early and managed appropriately. A patient with major heat illness will have a core temperature of 40°C or higher. There will be neurological features, as well as multisystem problems.

As the condition progresses, the body fails to control its temperature resulting cellular dysfunction, swelling, collapse and ultimately death may occur.

Signs and symptoms

In the early stages, patients will be confused and irritable, but this may rapidly progress to collapse with a reduced conscious level, seizures and unresponsiveness.

The patient will also be have a high heart rate and breathing fast. They develop signs of shock. If left untreated, cardiac arrest is likely.

Steps to manage major Heat illness:

1. Early recognition is vital, and as soon as the diagnosis is suspected, the player should be actively cooled, while arrangements are being made to transfer them to an appropriate emergency department as soon as possible.
2. They must be moved to a cool environment. An assessment of the patient ABCDE should take place, with any necessary interventions made.
3. The patient should be sprayed with lukewarm water and fanned or wrap in a cold wet sheet, keeping it wet by continuously pouring cold water over it
4. Ice packs can be applied to pulse points in the armpits, groin and neck.
5. Call for help to enable transfer to an emergency department