Revisiting exertional heat stress: A field-worker’s case study.
Objective. The case study reports an incident of heat stress occurring during an archeological dig, and discusses measures for the prevention and treatment of such incidents. Methods. The case is described by an exercise physiologist/nurse who attended the scene and followed the outcome. Results. On her third day at the site an 18-year-old Canadian university student (body mass index = 23 kg/m2) reported tremors, dizziness, headache, chills, and nausea following vomiting and diarrhoea. The initial assessment demonstrated a fever, and treatment included oral acetaminophen, an anti-emetic, pro-biotics, and Vitamin B and C supplements. Persistent chills and tremors necessitated a second opinion, leading to a diagnosis of heat exhaustion. The emergency department administered 1 L of cold IV fluid, and recommended return to work as tolerated, with a daily fluid-intake of at least 3 L. Subsequent prognosis was good. Conclusions. This case is a unique recorded example of heat exhaustion in archeological excavation, but emphasizes that heat stress can occur in many classes of outdoor workers, as well as in athletes and employees in hot indoor environments. Individuals who are un-acclimatized and dehydrated are particularly vulnerable. The use of tools to assess the severity of heat exposure and an awareness of risk factors and possible symptoms can help in flagging those at risk. Preventive measures (prior heat acclimation, precooling and adequate hydration and rest periods) can also help to decrease the risk and severity of heat-related incidents.
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