59 There are jobs where the work is performed outdoors, such as construction workers, which raises the question about whether heat stroke should be classified as an occupational safety issue. Heat stroke can occur indoors, such as with occupants of flats with no air-conditioning. Heat stroke can occur in outdoor recreational activities, such as hiking and running. Another type of risk could be seen from the tragic death of a young child who died after being locked inside a car for some hours, with the engine off, but exposed to sunlight. 5 Preparedness and Resilience As heat stroke could kill rapidly, prompt treatment must be given on the scene to cool down the patient, preferably using ice water, before transfer to the hospital. Upon arrival at the hospital, it is important for the physician to maintain a high index of suspicion as the patient may appear to be relatively normal on the body surface but actually the core temperature may be very high internally. Monitoring of the core temperature, aggressive cooling, and supporting the end organ function are the subsequent steps to be applied. FIGURE 5.25 Heat related illnesses Source: Centers for Disease Control and Prevention, USA FIGURE 5.26 Heat stroke situations in Hong Kong Sources: Skypost, HK01, Oriental Daily News, ETtoday and Hong Kong Economic Times
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