Heatstroke
Heatstroke is a life-threatening condition that results in
very high body temperature and malfunction of many organ systems.
Heatstroke can develop after hours of exertion in young
athletes or after days of hot weather in rooms without air-conditioning in very
old people.
Body temperature is higher than 104° F (40° C), and the
brain malfunctions.
People should be cooled immediately.
Heatstroke is the most severe form of heat-induced illness.
People with heatstroke are much sicker than people with other heat disorders.
The following features in particular distinguish heatstroke from other heat
disorders:
Body temperature is usually higher than 104° F (40° C)
Symptoms of brain malfunction develop
Heatstroke may occur fairly rapidly when people exert
themselves in extreme heat or are in a closed, hot environment. For example,
heatstroke can develop in young, healthy athletes and soldiers, particularly
those who are not acclimatized, after only hours of intense exertion in hot,
humid weather. Workers in hot environments, particularly those, such as
firefighters and foundry workers, who must wear heavy protective clothing are
at similar risk. Heatstroke is a common cause of death in athletes.
Heatstroke can also develop over days of hot weather when
people, particularly older sedentary people, stay in rooms that are poorly
ventilated and not air-conditioned. Older people, people who have certain
medical conditions (such as those that involve malfunction of the heart, lungs,
kidneys, or liver), and young children are most vulnerable to heatstroke. It
can occur rapidly in children left in a hot car.
Heatstroke occurs because the body cannot lose heat rapidly
enough in conditions of extreme heat. Because the body cannot cool itself, body
temperature continues to rise rapidly to dangerously high levels. Conditions
that interfere with heat loss, including certain skin disorders and drugs that
decrease sweating, increase the risk.
Heatstroke can temporarily or permanently damage vital
organs, such as the heart, lungs, kidneys, liver, and brain. The higher the
temperature, especially when higher than 106° F (41° C), the more rapidly
problems develop. Death may occur.
Symptoms of Heatstroke
Dizziness, light-headedness, weakness, clumsiness and poor
coordination, fatigue, headache, blurred vision, muscle aches, nausea, and
vomiting (which are also symptoms of heat exhaustion) are common warning symptoms
of heatstroke. Affected people do not sense that body temperature is greatly
elevated.
During heatstroke, the skin becomes hot, flushed, and
sometimes dry. Sweating may or may not occur, despite the heat.
Because of brain malfunction, people may become confused and
disoriented and may have seizures or go into a coma. The heart rate and
breathing rate increase. The pulse rate is usually rapid. The blood pressure
may be high or low.
Body temperature usually exceeds 104° F (40° C) and may be
so high that it exceeds the markings on a typical thermometer.
Diagnosis of Heatstroke
Symptoms and a history of exposure to high heat and humidity
The diagnosis of heatstroke is usually evident. People have
a high fever, symptoms of brain malfunction, and a history of being exposed to
high heat and humidity.
If the diagnosis is not evident, tests are done for other
disorders that can cause similar symptoms, such as infections, stroke, drug
use, and an overactive thyroid gland (hyperthyroidism).
Prognosis of Heatstroke
The risk of death from heatstroke depends on the following
factors:
How old adults are
How young children are
How severe any medical conditions (such as heart, lung,
kidney, or liver disorders) are
What the highest body temperature is
How long body temperature remains extremely high
Without prompt treatment, about 80% of people will die. In
about 20% of people who survive, the brain may not fully recover, leaving a
person with personality changes, clumsiness, or poor coordination. In some
people, the kidneys do not fully recover.
After recovery, body temperature may fluctuate abnormally
for weeks.
Treatment of Heatstroke
Cold water immersion
Evaporative cooling measures
Sometimes cooled fluids given intravenously
People with heatstroke must be cooled immediately, and an
ambulance should be called. While awaiting transportation to the hospital,
people should be immersed in cold water such as a lake, stream, or bathtub. If
immersion is not possible, people should be cooled by misting the body with
water and then blowing air across the body with a fan (evaporative cooling).
Slightly warm or tepid water is better than cold, for misting because people
are less likely to shiver, which generates more heat.
Using drugs designed
to treat a fever due to an infection is useless and should be avoided.
Did You Know...
If a person exposed to high heat and humidity develops
confusion or symptoms of brain malfunction, immediately call an ambulance and
begin cooling measures.
At the hospital, the body is usually cooled rapidly by
removing the clothes and covering the exposed skin with water or occasionally
ice. To speed evaporation and body cooling, a fan may be used to blow air on
the body. Body temperature is measured frequently, often continuously. Cooled
fluids may be given intravenously. To avoid overcooling, cooling is stopped
when the body temperature is reduced to about 102° F (about 39° C).
Seizures, coma, and malfunction of other organs may also
need treatment. Heatstroke is best treated in an intensive care unit of a
hospital.
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