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Site Safety and Health Plan <br /> Table B-1 Heat Stress Symptoms, Treatment and Prevention <br /> Heatstroke and Heat Hyperpyrexia <br /> Symptoms Heatstroke: (1)hot dry skin; red, mottled, or cyanotic; (2)high and rising <br /> core temperature, 40.5°C or over; (3) brain disorders;mental confusion, loss <br /> of consciousness, convulsions, or coma, as core temperature continues to <br /> rise. <br /> Fatal if treatment delayed. <br /> Heat Hyperpyrexia:milder form; core temperature lower; less severe brain <br /> disorders; some sweating. <br /> Treatment Heatstroke: immediate and rapid cooling by immersion in chilled water <br /> with massage, or by wrapping in wet sheet with vigorous fanning with cool <br /> dry air. <br /> Avoid overcooling. Treat shock if present. <br /> Heat hyperpyrexia: less drastic cooling required if sweating still present <br /> and core temperature <40.5°C. <br /> Prevention Medical screening of workers. Selection based on health and physical <br /> fitness. Acclimatization for 8 to 14 days by graded work and heat exposure. <br /> Monitoring workers during sustained work in severe heat. <br /> Heat Syncope <br /> Symptoms Fainting while standing erect and immobile in heat. <br /> Treatment Remove to cooler area. Recovery prompt and complete. <br /> Prevention Acclimatization. Intermittent activity to assist venous return to heart.. <br /> Heat Exhaustion <br /> Symptoms (1)Fatigue, nausea,headache, giddiness; (2) skin clammy and moist, <br /> complexion pale, muddy, or with hectic flush; (3) may faint on standing, <br /> with rapid thready pulse and low blood pressure; (4) oral temperature <br /> normal or low but rectal temperature usually elevated (37.5 to 38.5°C). <br /> Water-restriction type: urine volume small,highly concentrated. Salt- <br /> restriction type: urine less concentrated, chlorides less than 3 gfliter. <br /> Treatment Remove to cooler environment. Administer salted fluids by mouth or give <br /> intravenous infusions of normal saline (0.9 percent) if patient is unconscious <br /> or vomiting. Deep at rest until urine volume and salt content indicate that <br /> salt and water balances have been restored. <br /> Prevention Acclimatize workers using a breaking-in schedule;for 1 or 2 weeks. <br /> Supplement dietary salt only during acclimatization. Ample drinking water <br /> to be available at all times and to be taken frequently during workday. <br /> Heat Cramps <br /> Symptoms Painful spasms of muscles used during work (arms, legs, or abdominal). <br /> Onset during or after work hours. <br /> Treatment Salted liquids by mouth, or more prompt relief by intravenous infusion. <br /> Incident Free Operation Page 40 of 68 <br />