Exertional Heat Stroke Knowledge and Management among Emergency Medical Service Providers
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Questionnaire
2.3. Procedures
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
References
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Variable | n (%) |
---|---|
Age (mean, SD, [range]) | 42.0 (13.0), [19–77] |
Gender | |
Male | 163 (75.5) |
Female | 53 (24.5) |
Non-binary | 0 (0.0) |
Prefer Not to Identify | 0 (0.0) |
Race/Ethnicity | |
White | 176 (81.5) |
Asian | 12 (5.6) |
Black or African American | 1 (0.5) |
Hispanic or Latino | 4 (1.9) |
American Indian or Alaskan Native | 1 (0.5) |
Native Hawaiian or Other Pacific Islander | 7 (3.2) |
More Than One Race/Ethnicity | 10 (4.6) |
Prefer Not to Identify | 5 (2.3) |
Highest Level of Education Completed | |
High School/GED | 6 (2.8) |
Some College | 60 (27.8) |
Associate Degree | 57 (26.4) |
Bachelor’s Degree | 63 (29.2) |
Master’s Degree | 25 (11.6) |
Doctorate Degree | 5 (2.3) |
State | n (%) | State | n (%) |
---|---|---|---|
Alabama | 41 (19.0) | Missouri | 1 (0.5) |
Alaska | 3 (1.4) | Montana | 3 (1.4) |
Arizona | 9 (4.2) | New Hampshire | 3 (1.4) |
Arkansas | 7 (3.2) | New Jersey | 4 (1.9) |
Colorado | 12 (5.6) | New Mexico | 1 (0.5) |
Connecticut | 1 (0.5) | New York | 1 (0.5) |
Florida | 1 (0.5) | Pennsylvania | 1 (0.5) |
Hawaii | 34 (15.7) | Rhode Island | 1 (0.5) |
Idaho | 1 (0.5) | South Carolina | 9 (4.2) |
Illinois | 6 (2.8) | South Dakota | 10 (4.6) |
Iowa | 1 (0.5) | Texas | 1 (0.5) |
Kentucky | 4 (1.8) | Vermont | 1 (0.5) |
Louisiana | 48 (22.2) | Virginia | 1 (0.5) |
Maryland | 10 (4.6) | Wisconsin | 1 (0.5) |
Variable | n (%) |
---|---|
State Certification Level (n = 216) | |
EMR | 3 (1.4) |
EMT | 77 (35.7) |
AEMT | 20 (9.3) |
Paramedic | 110 (50.9) |
Other | 6 (2.8) |
Years of EMS Experience (n = 214) | |
2 Years or Less | 18 (8.3) |
3–7 Years | 35 (16.4) |
8–15 Years | 52 (24.3) |
16 Years or More | 109 (50.9) |
Type of Position (n = 214) | |
Volunteer-Compensated | 5 (2.3) |
Volunteer- Non-compensated | 22 (10.3) |
Career-Part-time | 21 (9.8) |
Career-Full-time | 166 (77.6) |
Type of Agency (n = 214) | |
Fire Department | 104 (48.6) |
Private | 30 (14.0) |
Governmental Non-fire | 49 (22.9) |
Hospital | 11 (5.1) |
Volunteer/Rescue Squad | 7 (3.3) |
Other | 13 (6.1) |
Type of Agency Service (n = 214) | |
Primarily 9-1-1 | 153 (71.5) |
Combination 9-1-1 and Medical Transport | 46 (21.5) |
Primarily Medical Transport (Convalescent) | 3 (1.4) |
Clinical Services | 3 (1.4) |
Other | 9 (4.2) |
Question and Response Options | n (%) | Correct Responses (n, %) | Incorrect Responses (n, %) |
---|---|---|---|
True or False. Exertional heat stroke is considered a life-threatening medical emergency. | |||
True * | 181 (98.9) | 181 (98.9) | 2 (1.1) |
False | 2 (1.1) | ||
Please select the two primary signs and symptoms that characterize exertional heat stroke. | |||
Hot, dry skin | 103 (27.3) | 50 (27.3) | 133 (72.7) |
Cool, clammy skin | 11 (2.9) | ||
Unconsciousness | 19 (5.0) | ||
Elevated core body temperature (>40.5 °C or 105 °F) * | 102 (27.1) | ||
Profuse sweating | 5 (1.3) | ||
CNS dysfunction (e.g., confusion, altered mental status) * | 120 (31.8) | ||
Vomiting | 10 (2.7) | ||
Dehydration | 7 (1.9) | ||
What is the most acceptable method of temperature assessment for the diagnosis of exertional heat stroke in the prehospital setting? | |||
Aural | 4 (2.2) | 62 (33.9) | 121 (66.1) |
Oral | 43 (23.5) | ||
Tympanic | 31 (16.9) | ||
Axillary | 19 (10.4) | ||
Rectal * | 62 (33.9) | ||
Temporal | 22 (12.0) | ||
Gastrointestinal | 1 (0.6) | ||
Esophageal | 1 (0.6) | ||
Rapid cooling of a patient with exertional heat stroke should occur within ___ minutes from the time of collapse. | |||
15 min | 152 (83.1) | 30 (16.4) | 153 (83.6) |
30 min* | 30 (16.4) | ||
45 min | 0 (0.0) | ||
60 min | 1 (0.6) | ||
True or False. A patient with exertional heat stroke should be transported by EMS to the hospital immediately upon EMS arrival and assessment on scene, regardless of any treatments initiated and being provided on-scene. | |||
True | 118 (64.5) | 65 (35.5) | 118 (64.5) |
False * | 65 (35.5) | ||
Select all appropriate methods of cooling for the management of exertional heat stroke. | |||
Tarp-assisted cooling * | 33 (4.1) | 0 (0.0) | 183 (100.0) |
Cold-water immersion (from neck down) * | 62 (7.8) | ||
Ice packs on major arteries | 153 (19.1) | ||
Ice packs on whole body | 28 (3.5) | ||
Ice-water immersion * | 38 (4.8) | ||
Fanning the patient | 81 (10.1) | ||
Move the patient to an area with air conditioning | 142 (17.8) | ||
Cold-water dousing with ice massage | 21 (2.6) | ||
Intravenous cold saline infusion | 73 (9.1) | ||
Placing wet towels on the patient | 111 (13.9) | ||
Providing the patient with oral fluids for rehydration | 58 (7.3) |
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Hirschhorn, R.; DadeMatthews, O.; Sefton, J. Exertional Heat Stroke Knowledge and Management among Emergency Medical Service Providers. Int. J. Environ. Res. Public Health 2021, 18, 5016. https://doi.org/10.3390/ijerph18095016
Hirschhorn R, DadeMatthews O, Sefton J. Exertional Heat Stroke Knowledge and Management among Emergency Medical Service Providers. International Journal of Environmental Research and Public Health. 2021; 18(9):5016. https://doi.org/10.3390/ijerph18095016
Chicago/Turabian StyleHirschhorn, Rebecca, Oluwagbemiga DadeMatthews, and JoEllen Sefton. 2021. "Exertional Heat Stroke Knowledge and Management among Emergency Medical Service Providers" International Journal of Environmental Research and Public Health 18, no. 9: 5016. https://doi.org/10.3390/ijerph18095016