The body temperature of 42°C exploded! Linkage treatment, a number of heat stroke patients escaped
High temperature and humidity, heat stroke is frequent
Recently, the hot and humid weather in Guangzhou has continued, and the outdoor temperature has exceeded 40°C. On July 25, the emergency department of the 74th Group Army Hospital successively received five heat stroke patients, including 2 people with mild heat stroke, 2 people with moderate heat stroke, and 1 person with severe heat stroke (heat stroke).
The medical staff of the emergency department quickly transferred the patient to the emergency room smoothly, continued to monitor the ECG and blood oxygen monitoring, infused him with low-temperature normal saline, and did overall physical cooling, paid close attention to vital signs, maximized the protection of organ function, and finally got out of the danger of life.
In the face of danger, 5 heat stroke patients were efficiently rescued
After the patient was admitted, the emergency department quickly adopted a heat stroke emergency plan for the diagnosis and treatment of 4 of the patients with mild to moderate heat stroke, and quickly guided the patients to an air-conditioned environment for evaluation and treatment. (Details of 4 people are as follows)
<左右滑动查看更多>Rapid disposal and efficient linkage
(The picture shows the ICU examination to evaluate the patient's recovery)
At 17:18 p.m. on the 25th, the most serious patient (Li, male, 51 years old) was sent to the emergency department of our hospital by 120 for emergency treatment. He was confused, unable to breathe, short of breath, his pupils were slow to reflex to light, and he was in a shallow coma, and was diagnosed with severe heat stroke (heat stroke).
Zhang Yu, the head nurse of the emergency department, and Li Yanping, the deputy head nurse, responded immediately when they heard the news and called the medical staff on duty to prepare for rescue. A green channel for acute and critical cases was opened, which was directly sent to the emergency room, and the emergency plan for heat stroke was activated.
The disease is progressing rapidly, and rescue is urgent. "Rapid intravenous infusion of ice saline, covering the whole body with ice water cotton pads, using a fan to blow the air, strong evaporation and cooling, blood drawing for testing, and opening the airway!" Bao Lizhi, director of the emergency department, commanded the rescue scene in a hurry, and after a set of "combination punches", the patient's body temperature dropped to 37 °C and tended to be stable.
During this period, the patient's breathing was rapid again, and there was more sputum secretion in the throat, and the doctor in charge, Wei Junbiao, performed endotracheal intubation in time and was successfully connected to the ventilator, and the patient's breathing gradually stabilized.
After an hour of active treatment, his condition was relatively stable, and after communicating with the ICU, Director Bao Lizhi of the Emergency Department and Director Wang Xianbing of the ICU agreed to transfer to the ICU for further diagnosis and treatment. The patient finally woke up in the early hours of the next morning, and no lesions were found on the neurological examination. Director Wang Xianbing introduced, "The timely escape of patients focuses on the rapid linkage rescue of 120 pre-hospital first aid, emergency department and ICU!" ”
Later, it was learned that the patient was a sanitation worker in Haizhu District, and at about 4 p.m. on the day of the illness, he suddenly vomited and became delirious at work, and the worker was sent to the nearby Pazhou Health Service Center, considering severe heat stroke, so he called 120 and sent him to our hospital for emergency rescue.
Proactive prevention is more effective than cure
From the above five cases, it is not difficult to see that the symptoms of heat stroke are staged, and the change from mild to severe is controllable and preventable, but the damage caused by severe heat stroke to the body is irreversible. Five main aspects are analyzed, which are not only the cause of the problem, but also the focus of prevention.
01
Environmental and climatic factors
The high temperature and high humidity environment is the main environmental factor that causes heat stroke, most people think that avoiding the direct sun will not cause heat stroke, but Guangzhou is affected by the subtropical high pressure, and the temperature of day and night is high for a long time in summer. In summer, the southern troops have field training, exercises, and sea training tasks, which are generally concentrated in May and September, and it is the hot season, with high temperatures and high humidity, and even if they train at night, they are prone to heat stroke.
02
Diet and sleep factors
High temperature and high heat in summer make people irritable and have a sharp decrease in appetite, such as long-term intake of insufficient nutrition, resulting in a decrease in resistance, coupled with lack of sleep, which leads to the body being in a state of stress, thereby reducing the secretion of melatonin in the body, affecting the function of the body temperature regulation center, and reducing the body's ability to adapt to temperature changes; During the training and exercise periods of the troops, the camping accommodation conditions are poor, the indoor ventilation is poor, the normal sleep of the officers and men is affected, the huge physical exertion during the day cannot be recovered, and it is easy to lead to excessive fatigue for a long time, and it will also cause loss of appetite and decreased digestive function, the supply conditions of food in the field are limited, the intake of calories and nutrients is relatively insufficient, and sometimes there is a shortage of drinking water, which makes the body's tolerance to the hot environment decrease, and it is easy to cause a large number of personnel to suffer from heat stroke.
03
Adaptive factors
Heat clothing is one of the most effective measures to prevent heat stroke. Its meaning is that when people live or work in a high-temperature environment for a long time, they will develop habits and adaptation to high-temperature environments. The main manifestations are the following changes in the human body in the high temperature environment: (1) the maximum sweating rate increases, and the increase of skin temperature and deep body temperature decreases; (2) The increase of heart rate and peripheral arteriolar diastolic decreases, the stroke volume increases and the blood pressure decreases, which not only reduces the burden on the cardiovascular system, but also promotes the heat transfer from the body core to the body surface; (3) the basal metabolic rate decreased, and the growth rate of labor metabolic rate decreased; (4) The release of adrenocorticotropic hormone from the anterior pituitary gland increases, which increases the secretion of aldosterone by the adrenal cortex, promotes the reabsorption of sodium and chloride by the renal tubule and sweat gland discharge duct, and reduces the concentration of sodium chloride in sweat. The above physiological reactions are conducive to the maintenance of the dynamic balance of heat production and heat dissipation functions and the balance of water and salt. After the hot habit, the person's thermal endurance will be enhanced, and the initial symptoms such as weakness, discomfort, irritability and muscle spasm will be reduced or disappeared when entering the high temperature environment, and the work performance will be improved; If there is no effective heat training in heat suits, the earliest severe heat stroke events can occur in late March or early April, which is a lack of heat adaptation.
04
Underlying disease factors
Through data analysis, obese people are a high-risk group for severe heat stroke, because when the human body is relatively obese, the fat content in the body is more, the metabolism is relatively slow, and it is easy to have dizziness, headache, thirst, heart rate and other heat stroke symptoms, in addition to obese people are prone to heat stroke, the elderly, pregnant women, children, patients with cardiac insufficiency, malnutrition, infectious diseases, people taking sleeping pills and antihistamines, and people who work indoors for a long time can increase the probability of heat stroke; If officers and men of the unit themselves suffer from various acute and chronic diseases, such as acute upper respiratory tract infections, the high temperature and high humidity environment will affect the body's ability to regulate and control external high heat and other factors, and heat stroke will easily occur.
05
Work intensity factor
In the state of overwork, in order to meet the needs of work and study, the body needs to increase the blood circulation speed to provide more oxygen and nutrients to reach various tissues and organs, and in a high-temperature environment for a long time, it may lead to a sharp increase in the heat in the body, and if the heat in the body is not dissipated in time, it will cause heat stroke; In order to meet the requirements of simulated actual combat, troop training and exercises need to carry out a series of high-intensity military training tasks, and the intense physical activity in a short period of time has caused the body to produce heat sharply, and a large amount of heat energy has been accumulated, which exceeds the body's ability to dissipate heat, and can easily lead to heat stroke.
"Department Style-Emergency Department Heat Stroke Treatment Skills Training"
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Editor in charge: Lu Zhangliang Duty Editor: Li Ka-shing
Submission email: [email protected]