Sunstroke is more accurately called heatstroke since it is not necessary to be exposed to the sun for this condition to develop. It is a less common but far more serious condition than heat exhaustion since it carries a 20-percent mortality rate. The most important feature of heatstroke is the extremely high body temperature (105F [41C] or higher) that accompanies it. In heatstroke, the victim has a breakdown of his sweating mechanism and is unable to eliminate excessive body heat. When the body temperature rises too high, the brain, kidneys, and liver may be permanently damaged. Sometimes the victim may have preliminary symptoms, such as headache, nausea, dizziness, or weakness. Breathing is deep and rapid at first; later, it is shallow and almost absent. Usually the victim is flushed, very dry, and very hot. His pupils are constricted (pinpointed) and the pulse is fast and strong. See figure 10-43 for a comparison of these symptoms with those of heat exhaustion.

TREATMENT. When providing first aid for heatstroke, keep in mind that this is a true life and death emergency. The longer the victim remains overheated, the more likely he is to suffer irreversible body damage

Figure 10-43.-Symptoms of heatstroke and heat exhaustion.

or death. The main objective of first aid is to get the body temperature down as quickly as possible.

Move the victim to the coolest possible place, and remove as much clothing as possible. Body heat can be reduced quickly by immersing the victim in a cold-water bath. When a cold-water bath is not possible, give the victim a sponge bath by applying wet, cold towels to the whole body. Exposing the victim to a fan or air conditioner also promotes body cooling. When cold packs are available, place them under his arms, around his neck at his ankles, and in his groin. When the victim is conscious, give him cool water to drink Do NOT give him hot drinks or stimulants.

Because of the seriousness of heatstroke, it is important to get the victim to a medical facility as soon as possible. Cooling measures must be continued during transportation.

COLD WEATHER INJURIES

When the body is subjected to severely cold temperatures, blood vessels constrict and body heat is gradually lost. As the body temperature drops, tissues are easily damaged or destroyed.

All cold injuries are similar, varying only in degree of tissue injury. The extent of injury depends on such factors as wind speep, temperature, type and duration of exposure, and humidity. Tissue freezing is accelerated by wind, humidity, or a combination of the two. Injury caused by cold, dry air is less than that caused by cold, moist air, or exposure to cold air while you are wearing wet clothing. Fatigue, smoking, drugs, alcoholic beverages, emotional stress, dehydration, and the presence of other injuries intensify the harmful effects of cold.

You should also know that in cold weather, wounds bleed easily because the low temperatures keep the blood from clotting and increased bleeding, of course, increases the likelihood of shock. Also, wounds that are open to the cold weather freeze quickly. The body loses heat in the areas around the injury, as blood soaks the skin around the wound, and clothing is usually torn. Therefore, early first-aid treatment becomes even more important during periods of low temperatures.