A sample climatic illness data collection report form is included in this appendix which can be used to record and analyze climatic illnesses. Enter the patient's name, SSN, unit, and installation at time of injury. Enter date and time of onset of symptoms and of initial medical evaluation. Rhabdomyolysis may occur with or without fever of heat exposure. Heat stroke means heat injury with delirium, obtundation, or coma.
Heat injury includes heat exhaustion with or without milder neurologic problems.
Heat exhaustion involves symptoms and signs of fluid and salt loss. For heat injury or rhabdomyclysis give maximum rectal temperature in first hour after injury, for cold injury give minimum. Enter earliest vital signs obtained at your facility. Enter height in inches and weight in pounds. Check state of sweating and circle MOPP gear level at time of injury.