Heat stroke can happen to anyone exposed to high temperatures or who are overexerting themselves over a period of time. The hotter the temperature the quicker heat stroke can set in. Knowing how to treat heat stroke can save your life. This condition needs to be taken seriously and treated as a medical emergency.
Heat stroke is one of the most preventable illnesses, and death can be avoided by seeking prompt medical attention. A person displaying symptoms of heat stroke needs to get to a hospital where they will probably admit you for a period of 48 hours. The first thing a medial team will do is reduce the body’s core temperature, and this usually happens at the scene if an ambulance is called. Delays in cooling can cause major complications.
Symptoms Of Heat Stroke
- Lightheadedness
- Dizziness
- Throbbing headache
- Hot and dry skin
- Red skin
- Lack of sweat in the heat
- Muscle weakness
- Muscle cramps
- Nausea
- Vomiting
- Rapid heartbeat
- Shallow breathing that is rapid
- High body temperature – sometimes as high as 104 degrees Fahrenheit
- Altered mental state
Non-Exertional Heat Stroke Vs. Exertional Heat Stoke
There are two types of heat stroke; EHS, which stands for exertional heat stroke and NEHS, which stands for non-exertional heat stoke. Both result in a raise in core body temperature that puts the body into a state of hyperthermia, the opposite of hypothermia, but just as dangerous. When it comes to EHS, more athletes suffer complications due to delay in getting treatment when they try to brush it off, or their trainers push them to keep going.
- NEHS
The elderly and young children are more susceptible to heat stroke caused by hot external temperatures, but it can happen to anyone. Prolonged periods of exposure to this type of environment over a period of time can increase chances of heat stroke. - EHS
Exertional heat stroke most often happens to athletes, or people who exercise in hot weather. Dehydration and excessive clothing play a big part in this type of heat stroke.
Who Is At Risk?
- Elderly
In people over 65 years old, the deterioration of the central nervous system makes it hard for the body to deal with sudden high temperatures, such as those that occur in a sudden heatwave or when taking a winter vacation to a warm climate.
- Young Children
The central nervous system of young children is not developed enough to cope with sudden high temperatures as a result of heatwave or a vacation that takes the child from a cold climate to a hot climate.
- Hot Weather Exertion
Those who exercise or work outdoors in hot weather are at a high risk for heat stroke.
- Medications
Certain medications affect how the body responds to heat and its ability to stay hydrated.
- Health Conditions
Anyone with a chronic illness, such as lung disease or heart disease, or those who are obese or lead a sedentary lifestyle are at a higher risk of heat stroke in hot weather.
Lowering Core Body Temperature
The first thing that needs to be done with a heat stroke patient is to lower their core body temperature. Determining the core body temperature is essential in treatment, making rectal thermometers the preferred choice due to its accuracy over oral thermometers. Positive outcomes and decreasing irreversible injury rely on reducing exposure to heat and dropping core body temperature aggressively and promptly. Multisystem organ failure can occur quickly if treatment is delayed.
Treatment
- Remove restrictive clothing
- Spray body with cool water
- Cover patient with sheets soaked in ice water
- Place ice packs in the groin and axillae
- Oxygen should be started on conscious patients
- Those who are unconscious may need to be intubated
- Intravenous with thiamine and dextrose should be administered
Intensive Care
If the patient is in serious shape, they will be placed in intensive care where staff monitors them closely to optimize circulation and treat any complications. The patient will be monitored with …
- A nasogastric tube which monitors gastrointenstinal bleed and fluid loss
- A thermistor probe to provide continuous body temperature readings
- A Foley catheter which monitors the output of urine
Treatment Goals
Reduce body temperature by 32 degrees Fahrenheit per minute until the body returns to 102 degrees Fahrenheit. Cooling is stopped at that point to prevent iatrogenic hypothermia
Cooling Methods
Each cooling method has its pros and cons
- Ice Water Immersion
This has been named the superior method of cooling since 2013 in heat stroke patients
–Pros
Rapid reduction in body core temperature taking less less than 20 to 40 minutes
-Cons
*Extremely uncomfortable
*Can be the cause of subcutaneous vasoconstriction
*Causes shivering, which raises core temperature
*Difficult to monitor core body temperature
*Difficult to resuscitate patients
- Evaporative Heat Loss
Less effective than ice water immersion but with fewer difficulties. It is done by spraying the nude victim’s body with cool water with a fan blowing across the body. This evaporate the water, taking the heat with it.
- Other Methods
Ice water immersion and evaporate heat loss are the two main methods of bringing down the core temperature of a patients. Other methods include …
- Gastric, Rectal, Peritoneal, and Thoracic Levage Using Cold Water
- Cold Humidified Oxygen
- Intravenous Fluids
- Wet Towels
- Cooling Blankets
- Cardiopulmonary Bypass (severe cases)
Pharmacologic Treatments
- Benxodiazepines
For patients whoa re shivering and are experiencing agitation
Acts as a sedative
Stops excessive heat production
- Dantrolene
Possibly good or treating hyperthermia as a result of heat stroke, but has not yet been 100% proven in clinical trials.
- Acetaminophen or aspirin
Not good for heat stroke, and can be harmful in those patients who have developed hematologic, hepatic, and renal problems. Aceteminophen or aspirin may cause or increase bleeding.
- Neuroleptics
Should be avoided as they can interfere with hepatotoxicity, hypotension, anticholinergic properties, thermoregulation, as well as lowering the seizure threshold and more adverse effects.
Complications From Heat Stroke
- Renal failure
- Muscle necrosis
- Pumonary injury
- Rhabdomyolysis
- Heptatic injury
