Heat Illness - 2019 Guidelines with Dr. Mel Otten
/On today’s podcast, we are taking a new direction in talking with authors about their work and no better place to start than discussing the Wilderness Medical Society (WMS) 2019 Guidelines on Heat Illness with Dr. Mel Otten, Past President of the Wilderness Medical Society.
Guideline Timeline:
2013 WMS releases first guidelines based on evidence rather than expert opinion
2019 revisions with an emphasis on exertion relation heat illness in addition to updated research
Defining the Disease
70,000 people killed in 2003 from a European heat wave
This will only be increasing as climate change becomes more tangible
Spectrum of disease, from self limited heat cramps, heat edema and heat syncope to heat exhaustion (typically exertional) and heat stroke
Heat Stroke = CNS involvement + 104 F core temperature
10% mortality once it progresses to CNS involvement
Duration of exposure and temperature of exposure are both critical to mortality
Treatment
Anything is better than nothing - your goal is 102 F core temp
Treat agressively based on what you have
Cold Water Immersion (in ice bath) is the most effective way to reduce core temperature
Ice packs apply to the palms and soles (highest vascular surface area)
Exposure and evaporative cooling (fans and misting)
Other Fast Heat Illness Facts
Shivering does a minimal amount of core warming and will not inhibit your cooling
Rectal temperature is the best initial measurement, if immersed, consider esophageal monitoring
Your body can acclimatize to hot environments - try 1 hour of exertion for 10-14 days before your activity, as can adapt your body to:
Sweat at a lower temperature
Increase the amount of sweat glands
Decrease the concentration of sodium in sweat
