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Heat Stroke (cont.)

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Heat Stroke Diagnosis

The diagnosis of heat stroke is almost always made by the patient's symptoms, exposure to hot surroundings, and taking the core body temperature (rectal temperature). Other tests are usually done to check electrolyte levels, urine studies for renal damage, liver damage, and rhabdomyolysis (muscle breakdown). Tests such as chest X-ray, CT, or MRI may be ordered to search for additional organ damage.

Heat Stroke Treatment

Patient Comments

Immediate treatment of heat stroke is body cooling; currently the preferred method of cooling is evaporation cooling by spraying the patient with cold water or covering them with cold water soaked sheets, and using fans to augment evaporative cooling. Others recommend additional cooling by placing ice packs on the head, neck, armpits, and groin.

In addition, benzodiazepines can be administered to prevent shivering. Often the patient is dehydrated so IV fluids are given. The goal is to reach a core temperature (rectal probe reading with a constant readout) of below 102.2 F or 39 C. The ideal time frame for reaching this temperature is controversial but this should in general be achieved in the fastest possible time frame, ideally over the first 60 minutes. In addition, other supportive measures for breathing, hypotension, and seizures may be required.

Heat Stroke Prevention

Heat strokes can be prevented; simple precautions can be very effective. Such precautions include:

  • Wear loose-fitting, light colored clothing
  • Stay well hydrated; drink Gatorade or similar sports drinks - if you have infrequent urination or the urine is concentrated, you need more fluid intake (avoid alcohol)
  • Avoid hot sunlit areas and do not sit in a parked car (a common cause of heat stroke in children)
  • Avoid strenuous activity in the warmest part of the day
  • Some medications (diuretics, stimulants, sedatives, for example) can increase the risk of heat stroke; check with your pharmacist or doctor to see if you have increased risk because of your medications.
  • If you feel muscle cramps or feel weak, immediately stop the activity and cool down.
  • Acclimatize if you are traveling or moving to a hot climate by limiting outdoor activities for a few days or more if you have increased risk factors for heat-related illness.

Heat Stroke Prognosis and Long Term Effects

With quick and effective treatment, many people will recover with little or no problems, although some may become more sensitive to hot weather. Initial recovery takes about 1-2 days in the hospital; longer if organ damage is detected. Experts suggest that complete recovery from heat stroke and its effects on the internal organs may take 2 months to a year. However, the prognosis rapidly declines as complications increase. The brain and other organs (lungs, liver, kidneys) can be permanently damaged, thus causing long term effects on the person's health. Damage is caused by swelling due to heating and other mechanisms, so the prognosis in these patients may range from fair to poor.

Heat stroke outcomes in animals (for example, dogs and cats) are similar to that in humans; contact your animal's Vet for emergency medical care and for other details specific for your pet.

REFERENCES:

American Family Physician. Evaluation and Treatment of Heat-Related Illnesses.
<http://www.aafp.org/afp/2002/0601/p2307.htmlhttp://www.aafp.org/afp/2002/0601/p2307.html>

Humane Society. Keep Pets Safe in the Heat.
<http://www.humanesociety.org/animals/resources/tips/pets_safe_heat_wave.html>

noheatstroke.org. Heatstroke Deaths of Children in Vehicles.
<http://noheatstroke.org/>

UpToDate. Heatstroke.
<http://emedicine.medscape.com/article/166320-overview>


Medically Reviewed by a Doctor on 6/19/2015

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