EMS Corner: Acclimatization and Heat Emergencies pt. I

With summer upon us, we would like to take a moment to think about how warmer temperatures will begin to affect workers who must be outside.  In this two part series we will examine how to prepare for warm weather work and how to avoid environmental emergencies.

What is Heat acclimatization?

Heat Acclimatization refers to biological adaptations the body undergoes that reduce physiologic strain, improve physical work capabilities, improve comfort and protects vital organs from heat injury. The most important biological adaptation from heat acclimatization is an earlier and greater sweating response, and for this response to improve it needs to be invoked.

Heat acclimatization occurs when repeated heat exposures are sufficiently stressful to elevate body temperature and provoke profuse sweating. Resting in the heat, with limited physical activity to that required for existence, results in only partial acclimatization. Physical exertion in the heat is required to achieve optimal heat acclimatization for that exercise intensity in a given hot environment.

Generally, about two weeks of daily increased heat exposure is needed to induce heat acclimatization.  In this time the bodies physiological response to elevated temperatures will become more efficient. Sweating will gradually become less profuse, resulting in a lesser chance of rapid dehydration.  Blood flow to the skin will be tempered to not deplete circulation to other vital organs and muscle systems.  Also a well acclimatized worker will maintain a more stable, predictable heart rhythm as their circulatory response is also better regulated.

Although a well acclimatized worker can thrive in warmer environments, should the worker become dehydrated these protections will soon be lost.  Dehydration is a typical reason that workers suffer from heat injury.  Note the chart below from the National Institute of Health detailing how fluid loss causes a downturn in physical condition.

% Weight loss Fluid loss Time* Effect & Symptoms

(* timing may vary based on intensity of work and heat/humidity)

1% 0.75 L 1 hr Unnoticed (at 1.5% weight loss you are considered dehydrated)
2% 1.5 L 2-3 hrs Loss of endurance, start to feel thirsty, feel hot, uncomfortable
3% 2.25 L 3-4 hrs Loss of strength, loss of energy, moderate discomfort
4% 3 L 4-5 hrs Cramps, headaches, extreme discomfort
5-6% 3.5-4 L 5-6 hrs Heat exhaustion, nausea, fainting
7+% 5+ L 7+ hrs Heat stroke, collapse, unconsciousness

It is for this reason, maintaining good hydration is key for workers in warm environments. The NIH provides guidelines for water intake based on Wet Bulb Globe Thermometer temperature , which takes into account ambient temperature, humidity, solar radiation, and wind.

Dehydrated workers will experience thirst, cramps, dry eyes, dark colored urine, and eventually confusion and organ failure.  Actively monitoring personal hydration through urine output and color tends to be a most effective way to determine if you’re falling behind in your water intake.

courtesy of Maryland Public Secondary School Athletic Association

 

To be continued…

In Part II we will examine the symptoms and courses of action for escalating heat emergencies.

EMS Corner: Diabetic Emergencies

What Is the Difference Between Insulin Shock vs. Diabetic Coma?

Diabetic emergencies are common calls for first aid providers and industrial response teams.  Although the symptoms may seem similar, there are vastly different reasons for various diabetic conditions.

Insulin Reaction (or Insulin Shock) is a condition that occurs when there is TOO MUCH INSULIN in the body. This condition rapidly reduces the level of sugar in the blood and brain cells suffer. Insulin reaction can be caused by taking too much medication, by failing to eat, by heavy exercise and by emotional factors. Signs and symptoms of Insulin Shock include; fast breathing, fast pulse, dizziness, weakness, change in the level of consciousness, vision difficulties, sweating, headache, numb hands or feet, hunger.

Diabetic Coma is a condition that occurs when there is TOO MUCH SUGAR and too little INSULIN in the blood and body cells do not get enough nourishment. Diabetic coma can be caused by eating too much sugar, by not taking prescribed medications, by stress and by infection. Diabetic coma develops slowly, sometimes over days, with signs and symptoms including; drowsiness, confusion, deep and fast breathing, thirst, dehydration, fever, a change in the level of consciousness and a peculiar sweet or fruity-smelling breath.

If the patient is conscious, you can ask two very important questions which will help determine the nature of the problem:

– Ask “HAVE YOU EATEN TODAY?” – Someone who has eaten, but has not taken prescribed medication may be in a diabetic coma.

– Ask “HAVE YOU TAKEN YOUR MEDICATION TODAY?” – Someone who has not eaten, but did take their medication, may be having an Insulin reaction.

NOTE: Distinguishing between the two types of diabetic emergencies can be difficult

A person in Insulin Shock needs sugar quickly. If the person is conscious, give sugar in any form such as juice, candy, or a soft drink. If the person is suffering from Diabetic Coma, the sugar is not required but will not cause them harm.

Safety Compliance Services provides National Safety Council First Aid in which diabetic emergencies are covered.  This can be an important skill to help a friend, family member or coworker.

Mixing and Matching Fall Protection: Can I do that?

Can I mix Fall Protection Equipment from different manufacturers?

Although many published documents from manufacturers contain statements such as “Brand X harnesses are designed for use with Brand X components.  Substitution or replacement with non-approved components combinations or subsystems or both may affect or interfere with the safe function of each other and endanger the compatibility within the system”, it does NOT violate OSHA or ANSI to utilize components from different manufacturers in a fall protection system. Mixing manufacturer’s equipment is less about regulations or safety and more about potential litigation should equipment fail. Manufacturers know that mixed brand fall protection systems are used every day with no harmful outcome. However, these same groups must state that this practice is ill-advised due to legal liability.

Using components from different manufacturers in assembling a fall protection system is safe and acceptable to OSHA and ANSI provided the components are “compatible” as determined by a competent person. ANSI defines compatible as; “Capable of orderly, efficient integration and operation with other elements or components in a system, without the need of special modification or conversion, such that connection will not fail when used in the manner intended”. OSHA 1926, Subpart M, Appendix C states; “Ideally, a personal fall arrest system is designed, tested, and supplied as a complete system. However, it is common practice for lanyards, connectors, lifelines, deceleration devices, body belts and body harnesses to be interchanged since some components wear out before others. The employer and employee should realize that not all components are interchangeable. For instance, … . Any substitution or change to a personal fall arrest system should be fully evaluated or tested by a competent person to determine that it meets the standard, before the modified system is put in use”.

Bottom line is you should strive to purchase your fall protection equipment from the same manufacturer, but when inheriting a mix of equipment already present at your site, changing over to a new brand, or needing specific equipment not available from your “preferred” manufacturer, you can safely, and in full compliance with OSHA, assemble personal fall protection systems with components from differing manufacturers provided all equipment is compatible with each other for their intended uses.

SCS Welcomes Rescue 6 to the Syracuse Fleet

SCS recently welcomed Rescue 6 to our Syracuse based fleet of support vehicles. Rescue 6 is a 2016 Ford Transit 250 van capable of supporting a variety of rescue operations with a crew of two. Complete with storage areas for rope, rigging, EMS equipment, tools and a work station, Rescue 6 was custom designed to best serve our rescue clients.

This vehicle has already deployed twice since being put into service on 6 February 2016. If you see Rescue 6 and its crew out in the field, stop by to say hi and take a look. Have a safe weekend everyone!

Can the Local Fire Department be my Confined Space Rescue Team?

Our safety professionals often field questions regarding the legitimacy of relaying on 911 for rescue services when working in a permit required confined space. Since this topic has been especially popular the last few weeks, we dug up an OSHA Letter of Interpretation (below) from 2008 that shed a little light on the subject

 

From a “Letter of Interpretation” dated May 23, 2008

Scenario: An employer evaluates and selects a local fire department using the guidance provided in Appendix F of the PRCS standard, Rescue Team or Rescue Service Evaluation Criteria. The employer has determined that the local fire department is adequately trained and equipped to perform permit space rescues of the kind needed at the facility. The employer has also made a performance evaluation of the service in which the employer has measured the performance of the team or service during an actual or practice rescue. However, the local fire department cannot guarantee that the rescue team will not be sent on another call during the employer’s permit-space entry operations. In other words, they have the ability to respond in a timely basis, unless another call prevents them from doing so.

Question: If the employer selects this local fire department as its off-site rescue service, would the employer be in compliance with 29 CFR 1910.146(k)(1)?

 

Response: OSHA cited the requirements of 29 CFR 1910.146(k)(1) and stated the following:

The employer must evaluate and select an off-site rescue service that has the capability to respond in a timely manner to the particular hazards at issue and to the types of emergencies that may arise in the employer’s confined spaces. The criteria employers can use in evaluating and selecting a service include determining whether the service is unavailable at certain times of the day or in certain situations, the likelihood that key personnel of the rescue service might be unavailable at times, and, if the rescue service becomes unavailable while an entry is underway, whether the service has the capability of notifying the employer so that the employer can instruct the attendant to abort the entry immediately.

Compliance may require the employer to be in close communication with the off-site rescue service immediately prior to each permit space entry. In the scenario you describe, the employer must ensure close communication with the rescue service during entry operations so that if the rescue service becomes unavailable while an entry is underway, the employer can instruct the attendant to abort the entry immediately. Entry operations cannot resume until the entry supervisor verifies that rescue services are able to respond in a timely manner.

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New Website

Safety Compliance Services has switched to a brand new website to better serve both our customers and our employees. Over the next several months we will be working hard to to update and upgrade the public side of our website to provide more useful information both about our company and our services as well as to provide useful and important information for related to safety and rescue in the industrial environment. In the near future we will also be completing our ‘Resources’ section to our website that will provide clients and others information and resources to help them in maintaining a safe and healthful work environment for their employees. This new Resources page will also be replacing our company Newsletter that many loyal subscribers have come to rely on for its useful information.

We’re are also very excited about the platform’s private side capabilities Our new web platform’s private side gives us near limitless options to push information out to our staff, interact with our remote personnel, and to provide all of our staff with resources to aid in their professional development. This will help us to improve the quality of our services and the efficiency of our operations.