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' 3.2 Heat Stress ' Provisions for monitoring Heat Stress will be determined by the site HSO, using the guidelines described below: ' For personnel wearing semipermeable protective outer wear when there is an ambient air temperature greater than 70 degrees F, heat stress monitoring is required and the following procedures will be implemented: ' 1. Increased awareness of heat stress symptoms and "buddy" monitoring. ' 2. Fluid intake discipline. 3. Work-rest intervals. ' The following heat stress causes and symptoms are provided for "buddy" monitoring purposes. Site personnel must realize that monitoring the physical condition of fellow personnel in Level B and C protective ensembles will be difficult. ' 1. Heat rash results from continuous exposure to heat or humid air. 2. Heat cramps are caused by heavy sweating and inadequate fluid intake. Symptoms include muscle spasms and pain in the hands, feet and abdomen. 3. Heat exhaustion occurs when body organs attempt to keep the body cool, due to inadequate fluid intake and affects personnel not acclimated to the ' environment. Symptoms include pale, cool, moist skin, heavy sweating and dizziness. 4. Heat stroke is the most serious form of heat stress. It is a MEDICAL ' EMERGENCY. Symptoms are red,hot, dry skin, lack of perspiration, nausea, dizziness and confusion, strong, rapid pulse rate and coma. ' The need to seek medical attention and the urgency in seeking medical attention depends on the symptoms and the severity of the symptoms displayed by the affected individual. If ' heat stroke is noted or suspected, medical attention must be sought IMMEDIATELY. Efforts should be taken to cool the body to prevent serious injury or death. Excessive cooling can cause hypothermia and should be avoided. ' Fluid intake should be increased during rest schedules to prevent dehydration. Drinking cool water is best; however, diluted electrolyte solutions (i.e., Gatorade)can be substituted for water. A more detailed examination of heat stress monitoring is provided in Section D. First ' Aid and Emergency Treatments, including heat exposure, are found in Attachment E. 8