Home › Forums › General Medicine › HEAT STROKE
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December 21, 2023 at 1:44 pm #2204
Anonymous
InactiveHeat stroke is a serious condition that occurs when the body gets overheated (40o C or 140o F) due to prolonged exposure to high temperatures. The normal temperature regulatory mechanisms are unable to cool the body and if left untreated can result in damage to brain, heart, kidney and muscles and eventually death
TYPES OF HEAT STROKE
There are two types of heat stroke.
• Classical heat stroke (CHS) is generally seen in older patients during heat waves.
• Exertional heat stroke (EHS) occurs in younger people who exert themselves in a hot, humid weather conditionsSIGNS AND SYMPTOMS OF HEAT STROKE
Clinical features of heat stroke include the following• Increased body temperature – A core body temperature of 104 F (40 C) or higher, measured with a rectal thermometer, is the most important sign of heatstroke.
• Rapid and shallow breathing
• Increased heart rate (tachycardia)
• Headache
• Altered mental state or behavior – Confusion, irritability, agitation, slurred speech, delirium, seizures and eventually coma
• Alteration in sweating – In heatstroke triggered by hot weather, the skin will feel hot and dry to touch. However, in heatstroke brought on by rigorous physical exercise, skin may feel dry or slightly moist.
• Nausea and vomiting
• Flushed skin – Skin may turn red as the body temperature risesCAUSES/RISK FACTORS OF HEAT STROKE
Although heat stroke can affect anyone, the following persons are at an increased risk• Elderly and frail persons over 65 years
• Very young children
• Brain disease that affects normal temperature regulatory mechanisms
• Persons who do not drink adequate amounts of water/fluids especially in hot humid weather
• Medications – Diuretics, vasoconstrictors, beta blockers. antipsychotic drugs, antidepressants
• Alcohol consumption – affects body’s temperature regulatory mechanisms
• Sudden exposure to much hotter climate due to travel and lack of air conditioning
• Chronic medical conditions
• Sedentary lifestyle and obesity
• Previous history of heat strokeCOMPLICATIONS OF HEAT STROKE
Depending on the external temperature and duration of exposure, complications may occur if not recognised promptly and treated such asSwelling of organs including brain with permanent damage
Seizures
Coma and death
Fetal damage or death in pregnant womenDIAGNOSIS OF HEAT STROKE
Diagnosis of heatstroke is usually evident on history including drug history and physical examination. Nevertheless, certain tests can confirm the diagnosis, rule out other causes for the symptoms and assess organ damage.• Rectal temperature – A rectal temperature is the most accurate way of determining your core body temperature compared to oral or forehead temperatures.
• Blood tests – Tests to measure blood sodium or potassium and blood gas levels, liver and renal function tests and to identify underlying medical conditions such as diabetes and anaemia
• Urine test – Urine may be darker during heat exhaustion or heat stroke, urine test to look for evidence of renal damage and muscle breakdown (rhabdomyolysis)
• ECG – to assess heart function
• Chest x-ray – to look for lung swelling or evidence of aspiration
• CT and MRI scan – to check for damage to other internal organsTREATMENT OF HEAT STROKE
Treatment of heat stroke aims at cooling the person to normal temperature and to reduce organ damage• If the patient is conscious give him cool drinks such as sports drink/tender coconut water to rehydrate. Avoid alcohol or caffeine containing beverages
• Loosen tight clothing or remove excess clothing. Fanning may be useful
• Gently application of a wet towel cloth that has been dipped in cool water over the skin
• Immersion in cold water – A bath of cool water has been shown to be the most effective way of quickly bringing down core body temperature. The faster this is done, the less risk of death and organ damage.
• Evaporation cooling techniques – If cold water immersion is unavailable, body temperature can be lowered using an evaporation method. Cool water is sprayed on the body while warm air is fanned over the person, causing the water to evaporate and cool the skin
• If patient is having seizures gently shift away from objects that might cause injury
• If patient is unconscious or vomiting shifting to hospital for intravenous fluids and treatment of any medical condition and complications is advisable
• Muscle relaxant such as benzodiazepine prevents shivering
• Urinary catheter may be inserted to measure urine output
PREVENTION OF HEAT STROKE
Heatstroke can be prevented by taking these simple precautionary measures
• Wear loose fitting, lightweight and light coloured clothing – Wearing excess clothing or inappropriate clothing that fits tightly will not help in cooling of body• Protect against sunburn – Sunburn affects your body’s ability to cool itself, so protect yourself outdoors with a wide-brimmed hat and sunglasses and use a broad-spectrum sunscreen with an SPF of at least 15. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or sweating
• Stay hydrated – Drink plenty of fluids; this will help your body sweat and cool down rising body temperature
• Be cautious if you’re at increased risk – If you regularly take certain medications or have a chronic underlying condition that increases your risk of heat exhaustion or heat stroke, do not go out when it is hot. If you are taking part in a strenuous sporting event or physical activity in hot weather, take necessary precautions and ensure medical services are accessible nearby
• Take it easy during the hottest parts of the day – Drink plenty of fluids and rest frequently in the shade if you have to work or exercise in the hot weather. See if it is possible to time exercise or physical labor during relatively cooler parts of the day, such as early morning or evening.
• Never leave anyone in a parked car – This is a commonly reported cause of heat-related deaths in children. When parked in the sun, the temperature inside the vehicle can increase by 20 degrees F (more than 6.7 C) in less than 10 minutes. Lock a car which is parked in the sun to ensure children do not enter the car
• Get acclimatised – Restrict the time spent working or exercising in hot weather until you become used to it. It may take several weeks for the body to acclimatise to hot weather.
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