Heat Stroke: Teach the TACO Method

If cold water immersion is not an option, the Tarp-Assisted Cooling Oscillation method for treating heat stroke sufferers can save lives on remote jobsites.

• By John Heniff
• Jun 01, 2023

The summer heat that’s welcome to sun lovers and vacationers can be dangerous and even deadly to workers. The Environmental Protection Agency estimates that extreme heat is responsible for over 1,300 deaths every year in the United States. With global temperatures expected to continue rising, more and more workers will soon be at risk of heat stroke and other debilitating conditions caused by overheating and the loss of body fluids and salts.

Treatment for heat stroke is clear for facilities and jobsites with the right equipment like full-body immersion tubs, but it can be difficult or even impossible to lug a large tub along to every job location. So, what do remote teams need to know if someone on the jobsite falls victim to heat stroke? Teaching everyone the facts about heat stroke and equipping them with the right gear and knowledge to treat sufferers in any location can save a life.

You Need to Cool a Heat Stroke Sufferer—Fast

If a worker experiences heat stroke, they can develop serious injuries if they are not treated within 30 minutes of initial collapse. These injuries can include permanent damage to the brain, liver, kidneys and heart via hyperthermia, swelling or disintegrating damaged muscle tissue. These injuries can damage internal organs to the point of needing an organ transplant, regardless of whether the worker had any underlying medical conditions beforehand or not. Heat stroke overwhelms the body’s ability to regulate core temperature. In the worst cases, this can be fatal.

Even if a worker survives with organs and muscles intact, they can have a compromised heat tolerance, which means their body can no longer react to the heat as well as it did before. They may notice their body temperature increases faster, they don’t sweat as much and they start to exhibit signs and symptoms of heat illness more quickly than in the past.

What Are the Symptoms of Heat Stroke?

Heat stroke occurs when the body becomes so hot, it can no longer shed enough heat to prevent damage, which causes a range of symptoms, including:

• Dizziness
• Flushed skin
• Headache
• Confusion
• Staggering or physical collapse
• Strong and rapid pulse
• Rapid breathing
• Muscle cramps or weakness
• Irrational behavior
• Seizures
• Unconsciousness

How to Treat Heat Stroke in Remote Locations

Heat stroke is a medical emergency, so if you or your workers suspect someone is experiencing heat stroke, contact your nearest Emergency Medical Services (EMS) so the person can be treated by medical professionals as soon as possible. In the meantime, the victim should be cared for with a “cool first, transport second” protocol. Cooling the person before EMS arrives can greatly increase their chance of survival without developing long-lasting health conditions.

The preferred cooling method by heat safety experts at the Korey Stringer Institute and the Heat Safety & Performance Coalition (HSPC) is a process called cold water immersion. Ideally,

• Fill a tub halfway with cool water in a shaded area.
• Remove the sufferer’s excess clothing and equipment.
• Place them in the tub.
• Cover their body with water and ice up to the middle of their chest or neck to begin cooling.
• Continually add and circulate cool water and ice to maintain cooling.
• Monitor vital signs like heart rate and breathing rate.
• After approximately 15 to 20 minutes, check to see if the sufferer is exhibiting any signs of hypothermia. This indicates that heat stroke was misdiagnosed.

If a tub is not available or usable in your work environment, heat safety experts recommend an alternative cooling method known as Tarp-Assisted Cooling Oscillation (TACO).

• Remove the sufferer’s excess clothing and equipment.
• Place them in the middle of a tarp, which will serve as the makeshift tub.
• Have nearby workers pick-up each corner of the tarp to form a sling (or “taco shape”).
• Cover the sufferer with cool water and ice up to their chest.
• Slowly move the tarp back and forth to oscillate the mixture and initiate cooling.
• Monitor vital signs such as heart rate and breathing rate.

Before EMS transports the sufferer, their internal body temperature should fall below 102 degrees Fahrenheit to increase the likelihood of survival and recovery with no permanent injuries.

How to Prevent Heat Stroke

Building a comprehensive heat safety plan can help you address hot and humid conditions on your jobsite with a multi-faceted strategy. By approaching topics like body cooling, environmental monitoring, hydration and personal protective gear, you can protect your team while they work in hot environments. Heat safety experts from the HSPC recommend implementing eight simple steps as part of a comprehensive heat safety plan, including:

• Provide workers with information to recognize the risks of extreme heat and symptoms of heat illness. This can be done through safety training presentations, heat-specific toolbox talks, informing your crew about temperature changes before shifts or creating a “buddy system” to help workers keep an eye on each other throughout the day.
• Institute regular breaks in a cool area of the jobsite filled with cold towels and rehydrating beverages. These areas can take the form of shaded areas, cooling tents or indoor locations like air-conditioned lunchrooms or bathroom trailers.
• Track high temperatures, humidity and other weather factors that can increase heat on the jobsite so you know when to alter work schedules. The best way to accurately monitor these factors is by using a Wet Bulb Globe Temperature monitor, which tracks multiple weather elements while accounting for the specific microclimate on your jobsite.
• Prioritize access to clean and cool water and/or electrolyte-replacing beverages close to the jobsite. While hydrating alone will not prevent heat stroke, regular hydration before, during and after a shift can help workers be less susceptible to developing heat illnesses.
• Slowly introduce workers to the heat over a five- to seven-day period through the process of heat acclimatization. This process gradually familiarizes them to the heat stress of the jobsite and lets their bodies develop defenses to work better in the heat, such as sweating more and lowering their heart rate.
• Distribute physiological monitors like a body temperature tracker or heart rate monitor to help your workers track risk factors that can indicate heat illness.
• Teach workers what to do in the event of a heat-related medical emergency, such as initiating cold water immersion with a tub or tarp using the TACO method, if necessary.
• Provide your workers with quality body cooling PPE that activates fast, stays cool for hours and can be reactivated throughout the day.

Time is of the essence if you suspect one of your workers is experiencing heat stroke. But knowing the signs, symptoms, prevention measures and treatment options can help you and your team spring into action to keep everyone safe in the heat. For more information on heat stroke as well as free heat safety resources, visit Magid’s Heat Illness Prevention page at www.magidglove.com/safety-matters/heat-illness-prevention. 

This article originally appeared in the June 1, 2023 issue of Occupational Health & Safety.