Collapsed Mason in Extreme Heat
At 14:00 on a May afternoon, the temperature at the Nirman construction site near Durgapur is 42°C. You are the only security guard on duty. A 35-year-old mason, Bhola, collapses near the cement store. He is confused, has hot dry skin, no visible sweating, a weak rapid pulse around 120 beats per minute, and a temperature that feels very high to touch. He is breathing but cannot answer clearly. The site first-aid box has ORS packets, drinking water, bandages and a thermometer, but no ice packs. The nearest ambulance is 108, about 12 minutes away; the site is 2 km from the highway. A supervisor wants to pour water into his mouth and carry him to the office 300 metres away.
1. What is the likely condition, and what should you do in the first five minutes?
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These are classic heat stroke signs: hot dry skin, confusion, very high body temperature, and a rapid weak pulse after work in 42°C heat. Heat stroke is a medical emergency; cooling must start before transport.
- Call 108 immediately and give the site address, landmark near the highway, and the patient's condition.
- Move him to shade or create shade with a tarpaulin; do not carry him 300 metres to the office in the sun. Loosen clothing.
- Cool him actively: wet cloths to neck, armpits and groin; fan him; pour water over the body if available. The first-aid box has no ice packs, so use water and airflow.
- Check breathing and responsiveness. If he is breathing but unconscious, place him in the recovery position; if not breathing, start CPR if trained and call for help.
- Do not leave him alone; monitor breathing and pulse until the ambulance arrives. Record the time of collapse and what you did.
2. Should you give ORS or water by mouth? Explain your reasoning.
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No fluids by mouth while he is confused or unable to answer clearly. His swallow reflex may be impaired; pouring water into his mouth can cause choking and aspiration into the lungs, which can be fatal. The supervisor's plan to pour water into his mouth is unsafe.
If he becomes fully alert and can sit up and swallow, give small sips of ORS or water - not large gulps. Continue cooling. Do not give salt tablets, alcohol or stimulants. If he vomits, turn him to the recovery position and keep the airway clear. The priority is rapid cooling and ambulance transfer, not oral rehydration. Record that fluids were withheld because of altered consciousness.
3. What information should you hand over to the ambulance crew?
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Give the ambulance crew a short, structured handover:
- Who: Bhola, 35-year-old mason; site name and nearest landmark.
- What happened: collapsed at 14:00 after work in 42°C heat; confused, hot dry skin, no sweating, weak rapid pulse about 120.
- What you did: moved to shade, loosened clothes, applied wet cloths and fanning, called 108; no fluids by mouth because he was confused.
- Response: whether he is more alert, breathing normally, vomiting or unconscious.
- Contacts: supervisor's name and phone; your name and duty post.
Hand over any first-aid items used and note the ambulance arrival time. Do not speculate about causes beyond what you observed; say "suspected heat stroke".