Heat Stroke

Overview

Heatstroke is a condition that occurs when your body overheats, usually as a result of prolonged exposure to high temperatures or strenuous physical activity in hot weather. It is a serious form of heat injury, and if left untreated, it can cause damage to your brain, heart, kidneys, and muscles. Heatstroke can be classified into two main types: nonexertional (classic) heatstroke, which occurs in a hot environment, and exertional heatstroke, which results from intense physical activity in hot weather. Symptoms of heatstroke include a high body temperature, altered mental state or behavior, alteration in sweating, nausea and vomiting, flushed skin, rapid breathing, racing heart rate, and headache. If you suspect someone is experiencing heatstroke, it's essential to seek immediate medical help and take immediate action to cool the person while waiting for emergency treatment.

Understanding the disease

Symptoms

The symptoms of heat stroke are: high body temperature (core body temperature of 104 F or higher), altered mental state or behavior (confusion, agitation, slurred speech, irritability, delirium, seizures, or coma), alteration in sweating (dry or slightly moist skin), nausea and vomiting, flushed skin, rapid breathing, racing heart rate, headache. If you think a person may be experiencing heatstroke, seek immediate medical help.

Risk Factors

Heatstroke risk factors include:

1. Age - Both very young children and adults over 65 may have difficulty coping with extreme heat due to underdeveloped or deteriorating central nervous systems, leading to difficulty maintaining hydration and coping with changes in body temperature.
2. Exertion in hot weather - Engaging in strenuous physical activities, such as military training, sports events, or heavy labor, in hot conditions increases the risk of heatstroke.
3. Sudden exposure to hot weather - If you're suddenly exposed to a significant increase in temperature, such as during a heat wave or travel to a hotter climate, you may be more susceptible to heat-related illnesses.
4. Certain health conditions - Chronic illnesses like heart or lung disease, obesity, and a history of previous heatstroke can increase the risk of heatstroke.
5. Lifestyle factors - Being overweight or obese, engaging in heavy or binge drinking, and using illegal drugs such as cocaine or methamphetamines can raise the risk of heatstroke.
6. Medical risk factors - High blood pressure, cigarette smoking, high cholesterol, diabetes, obstructive sleep apnea, and cardiovascular disease can also contribute to an increased risk of heatstroke. It is important to take preventative measures during hot weather, such as staying hydrated, wearing appropriate clothing, and avoiding excessive alcohol consumption or strenuous activities in high temperatures.

Development

Heatstroke can develop in two main types: nonexertional (classic) heatstroke and exertional heatstroke.

1. Nonexertional (classic) heatstroke: This type of heatstroke occurs when you are in a hot environment for an extended period, leading to an increase in core body temperature. It typically happens in hot, humid weather and is more likely to affect older adults and people with chronic illnesses.
2. Exertional heatstroke: This type of heatstroke occurs as a result of intense physical activity in hot weather. It can happen to anyone exercising or working in high temperatures, but is more likely to occur in individuals who are not acclimated to the heat. In both types of heatstroke, certain factors can increase the risk, such as wearing excessive clothing, drinking alcohol, and becoming dehydrated.

Assessment and Diagnosis

Triage

You should seek immediate medical attention if you or someone else experiences symptoms of heatstroke, which include a high body temperature of 104 F (40 C) or higher, altered mental state or behavior, confusion, agitation, slurred speech, irritability, delirium, seizures, or coma. In adults, a temperature of 103 F (39.4 C) or higher also warrants a call to a healthcare provider. If someone is showing signs of heatstroke, it's crucial to cool the person down using whatever means available, such as immersing them in a cool tub or shower, spraying with a garden hose, or placing ice packs on the person's head, neck, armpits, and groin, while waiting for emergency medical assistance.

Diagnosis

To diagnose heat stroke, doctors usually rely on a combination of physical examination and laboratory tests. Laboratory tests can confirm the diagnosis, rule out other causes for the patient's symptoms, and assess organ damage. Some of the tests that may be performed to diagnose heat stroke include:

1. Rectal temperature: This is considered the most accurate way to measure a person's core body temperature.
2. Blood tests: These may be used to check blood sodium or potassium levels, as well as the content of gases in the blood to assess damage to the central nervous system.
3. Urine test: This can help determine if there's been damage to the kidneys, which can occur as a result of heat stroke.
4. Muscle function tests: These can help check for serious damage to muscle tissue (rhabdomyolysis). It's important to seek immediate medical attention if you suspect someone is experiencing heat stroke, as prompt treatment can help prevent or reduce the risk of serious complications.

Management and Treatment

Complications

Heatstroke can result in a number of complications, depending on how long the body temperature is high. Severe complications include:

1. Vital organ damage: Without a quick response to lower body temperature, heatstroke can cause your brain or other vital organs to swell, possibly resulting in permanent damage.
2. Death: Without prompt and adequate treatment, heatstroke can be fatal. Prompt medical treatment is crucial to minimize these complications and prevent long-term damage or loss of life.

Prevention

Heatstroke can be prevented by taking certain steps during hot weather. Preventive measures include wearing loose, lightweight clothing, protecting against sunburn with a wide-brimmed hat, sunglasses, and sunscreen, staying hydrated by drinking plenty of fluids, and being cautious with certain medications, such as stimulants for ADHD and illegal stimulants. Certain health conditions and factors like obesity, sedentary lifestyle, and a history of previous heatstroke can also increase the risk of heatstroke.

Preparing for medical consultation

To prepare for an appointment for heatstroke, you may want to consider the following steps:

1. Be aware of any pre-appointment restrictions: When you make the appointment, ask if there's anything you need to do in advance, such as fasting for certain tests or avoiding certain medications.
2. Write down any symptoms: Make a note of any symptoms you've experienced, including when they started and how severe they were.
3. Write down key personal information: Prepare a list of any known medical conditions, allergies, and current medications you're taking.
4. Prepare a list of questions: Compile a list of questions to ask your doctor during the appointment, such as what caused your heatstroke, how it will be treated, and what steps you can take to prevent it from happening again.
5. Gather relevant medical records: Bring any relevant medical records, test results, or imaging studies to the appointment. This can help your doctor better understand your medical history and current condition. Remember to prioritize rest, hydration, and staying cool in the meantime. These measures can help you recover from heatstroke and prevent further complications.