Annex F - Heat-Related Illness Surveillance System

1. To prevent cases of heat-related illness (HRI) in CAF members, it is vital to have accurate knowledge of how often it occurs in the CAF population and the risk factors associated with it. The Heat-Related Illness Surveillance System (HRISS) is a tool that provides this crucial epidemiologic information. It helps inform and evaluate efforts to prevent cases of HRI and raises awareness of the problem within the CAF.
2. There are two components, or data sources, to the HRISS: CFHIS and a HeatRelated Illness Reporting Form.

CFHIS

3. Whenever a CAF member is assessed by a clinician for a suspected HRI, a clinical note is created in CFHIS that includes a coded ICD-10 diagnosis. It is this diagnostic code that permits epidemiology to count the number of HRI cases over a specified time period and determine the rate of HRI in CAF members.
4. To obtain valid results of the rate of HRI in CAF members, it is extremely important that clinicians code an HRI diagnosis as accurately as possible within the ICD-10 structure. To support this, Appendix 1 provides an aide-memoire of the most appropriate ICD-10 codes for clinicians to use when documenting an HRI in CFHIS.

Heat-Related Illness Reporting Form

5. To identify relevant risk factors for developing an HRI in the CAF population, it is important to capture information about the events surrounding the episode. This includes factors such as WBGT, activities performed, kit worn, event location, underlying health conditions, and medication or nutritional supplement use.
6. The HRI Reporting Form is a fillable PDF used to capture these details. It may be completed at the time of the patient visit or after. Each clinical site may determine which health team member actually fills in the form. It does not have to be the treating clinician who performs this task, but it must be completed by a knowledgeable individual with appropriate access permissions to CFHIS.
7. The HRI Reporting Form, DND 4514, is available in both French and English in the Defence Forms Catalogue. (accessible only on the National Defence network)
8. Once the reporting form is completed, the user clicks the validate button to ensure the required fields have been filled, and then clicks the submit by email button. This attaches the completed form to an email message in Outlook, already addressed to a DFHP positional mailbox.
9. Ensure the email is encrypted when sent as the form contains PROTECTED B information once completed.

Inquiries

10. Inquiries related to this policy are to be submitted to D FHP by e-mail at: +DFHP Inquiries@CMP DGHS@Ottawa-Hull (intranet/DWAN) or DFHP-DPSF@forces.gc.ca (internet).

Appendices

A. Appendix 1 - Heat-Related Illness Diagnostic Code Aide-Memoire

Heat-Related Illness Diagnostic Code Aide-Memoire

DFHP is attempting to more accurately track cases and identify risk factors of HRI in CAF members. Examples of HRI include heat rash, heat edema, heat cramps, heat syncope, heat exhaustion, heat injury and heat stroke. To assist DFHP in conducting surveillance of HRI.

Please note, for individuals diagnosed with heat injury (severe heat exhaustion with hyperthermia and end organ damage, but no significant neurological involvement), please code as Heatstroke and Sunstroke (T67.0).

Your assistance with this is greatly appreciated. More accurate data going into CFHIS allows for higher quality reporting out of it.