Law Department notice on WTC document preservation, Oct 2001

NYC 9/11 Public Portal Document

WRS Heta Stress Management Standard Operating Procedure

5.1 Symptom Recognition and Treatment

A large portion of heat stress control lies in the ability of an individual to recognize heat stress symptoms in themselves and co-workers. Early recognition and treatment of heat stress symptoms can prevent the development of more serious, debilitating and even life threatening conditions.

5.1.1 Heat Stroke

Heat stroke is an acute and dangerous reaction to heat stress caused by a failure of the heat regulating mechanisms of the body. The individual's temperature control system that causes sweating stops working correctly. Body temperature rises so high that brain damage and death will result if the person is not cooled quickly. Heat stroke requires medical attention.

a. Symptoms - Red, hot dry skin, although person may have been sweating earlier. Nausea, dizziness, confusion, extremely high body temperature, rapid respiratory and pulse rate, convulsions, unconsciousness, or coma. b. Treatment - Cool the victim quickly. If the body temperature is not brought down fast, permanent brain damage or death will result. Soak the victim in cool, but not cold, water; sponge the body with cool water; or pour water on the body to reduce the temperature to a safe level (102°F). Observe the victim and obtain medical help. Do not give coffee, tea, or alcoholic beverages. Do give fluids by mouth if victim is in and out of consciousness

5.1.2 Heat Exhaustion

Heat exhaustion is a state of very definite weakness or exhaustion caused by the loss of fluids from the body. This condition is much less dangerous than heat stroke, but it nonetheless must be treated.

a. Symptoms - Pale, clammy moist skin, profuse perspiration and extreme weakness. Body temperature is normal, pulse is weak and rapid, breathing is shallow. The person may have a headache, may vomit, and may be dizzy.

b. Treatment - Remove the person to a cool, air-conditioned place, loosen clothing, place in a head- low position, and provide bed rest. Consult a physician, especially in severe cases. The normal thirst mechanism is not sensitive enough to ensure body fluid replacement. Have the patient drink one to two cups of water immediately and every 20 minutes thereafter until symptoms subside. Total water consumption should be about one to two gallons per day.

5.1.3 Heat Cramps

Heat cramps are caused by perspiration that is not balanced by adequate fluid intake. Heat cramps are often the first sign of a condition that can lead to heat stroke.

a. Symptoms - Acute painful spasms of voluntary muscles: e.g., abdomen and extremities.

b. Treatment - Remove the victim to a cool area and loosen clothing. Have the patient drink one to two cups of water immediately and every 20 minutes thereafter until the symptoms subside. Total water consumption should be one to two gallons per day. Consult your physician.

5.1.4 Heat Rash

Heat rash is caused by continuous exposure to heat and humid air and is aggravated by chafing cloths. The condition decreases the ability to tolerate heat.

WKS Infrastructure & Environment, Inc

NYC-WTC_000145118