I don't think I will ever forget it as long as I live.

This particular incident happened two years ago.  It was a busy Friday in the ER department, where I was scheduled to work.  It was during a brutal summer heat wave, where the temperatures topped out over 100 degrees in a week's period.  Many people were coming in for heat-related illnesses, most of them minor, but not making things any easier for the ER staff.

We got a call for a man down around three in the afternoon, the hottest part of the day.  A man had been found lying in his yard, unconscious and not moving.  An ambulance was called (probably the man's wife or some concerned neighbors were the ones who summoned the paramedics).

When the paramedics got on the scene, the man was found to be severely sunburnt, hot, and dry.  When paramedics touched his body, they drew their hands back in surprise: the man was as hot as a live coal, I remember one of them saying during their report back to us here at the hospital.

Doctors instructed the paramedics to start IV's of Ringer's and other life-saving fluids and to quickly cool the man's temperature, and most importantly, get him out of the sun.  In the background, you could hear people gobbling hysterically as the paramedics tended to their loved one/neighbor.

The ambulance arrived at the ER department within minutes.  The man was still unconscious; he reminded me of a boiled crawfish.  Bright red skin.  It was hard not to laugh, given the seriousness of the situation.

The man was placed upon a treatment table, where doctors and nurses soon took over, like a swarm of mad hornets.  Lines and IVs were inserted, vitals were taken, oxygen was administered, and we had him on a heart monitor in all one smooth motion, at the insistance of the head ER doctor who was in charge.

At the sight of the thermometer reading, there was a collective gasp.  We thought there was an error; there was no way anyone could have a temperature reading of 108 degrees and survive without lethal damage to their brain.  Yet that is exactly what the thermoneter registered:  One-hundred-and-eight degrees.  We knew we had to act fast, or the man was doomed to die within a relatively short period of time.

We covered the man in ice, as a way to quickly try to lower his elevated temperature.  The man was seizing uncontrollably.  We had to keep reinserting his IVs after he'd pop 'em out or to keep hooking him back up to the heart monitor after leads loosened and fell off, thus, sending a high, squealing, piercing alarm around the ER department.

We didn't want to alarm the people who were waiting in the ER; however, I had a feeling they could hear the whine of the monitors and calls going out over the PA system for "added assistance in treatment room #17".

It was a nightmare.

Eventually, the man's temp fell to a safe level:  104 degrees.  Still alarmingly high, but as long as we kept feeding him fluids through IV's and other lines and kept him "in ice", he would (hopefully) recover without any lasting damage to his brain.  At least the seizures stopped; for that, we all breathed one collected sigh of relief.

The diagnosis:  heatstroke.  A rather severe case of heatstroke.

It was fortunate the man got to the hospital when he did or else he might not be here.  It was a miracle he survived at all.

The man ended up staying in the hospital for a week, so we could keep a close eye on him as he recovered.  He also got a tongue-lashing from both the doctors and his wife for being out in the hottest part of the day.

Last time I saw him, he came to the hospital for his "post-treatment" check-up.  He looked a little embarrassed at what he caused; he was very apologetic.  I told him, "no worries, but just watch his step next time; we didn't want a repeat performance because the next time he might not be so lucky".

He didn't look so much like a boiled crawfish: he was his normal pink color.  :)

Surprisingly he didn't suffer from any ill effects as a result.

*written by Louisiana M. Sandusky, RN, Nashville, Tennessee.