HEAT STROKE

HEAT STROKE
An acute medical emergency caused by failure of the heartregulating mechanism of the body. Heat stroke is a form of hyperthermia in which the body temperature is elevated dramatically. Usually occurs during extended heat waves, especially when they are accompanied by high humidity.

o Heat stroke is a medical emergency and can be fatal if not promptly and properly treated. o The most important measures to prevent heat strokes are to avoid becoming dehydrated and to avoid vigorous physical activities in hot and humid weather.

CAUSES:
o Most common cause of heat stroke is prolonged exposure to an environment temperature of greater than 39.2 C . o Strenuous activity in hot weather.

RISK FACTORS:
o People that does not acclimated to heat. o Elderly (often with associated heart diseases, lung diseases, kidney diseases, or who are taking medications that make them vulnerable to dehydration and heat strokes),or very young. o Unable to care for themselves (because of their inability to control their environment). o People with chronic and debilitating diseases. o Those people that taking certain medications. o Athlete o Individual who work outside and physically exert themselves under the sun.

TWO FORM OF HEAT STROKE Exertional Heat Stroke Heat Exhaustion

EXERTIONAL HEAT STROKE

o Occurs in healthy individuals during sports or work activities. o Hyperthermia results because of inadequate heat loss. o This type of heat stroke can also cause DEATH.

HEAT EXHAUSTION
o The patients temperature may be normal to 40 C. o The patient demonstrate weakness, hypotension, increased heart rate, and increased thirst.

Heat stroke causes thermal injury at the cellular level, resulting in coagulopathies and wide spread damage to the heart, liver, and kidneys.

SIGNS AND SYMPTOMS

Profound CNS dysfunction manifested by confusion, delirium, bizarre behavior, and coma. Elevated body temperature (40.6 C or higher). Hot and dry skin. Usually anhidrosis (absence of sweating). Tachypnea. Hypotension. Tachycardia.

 Chills. Loss of consciousness. Dizziness. Fatigue. Muscle cramps. Vomiting. Nausea

MANAGEMENT

o Remove the clothing of the patient. o Apply cool sheets and towels or continuous sponging with cool water. o Apply ice to the neck, groin, chest, and axillae while spraying with tepid water. o Provide cooling blankets. o Immersion of the patient in a cold water bath (if possible).

o During cooling procedures, an electric fan is positioned so that it blows on the patient to augment heat dissipation by convection and evaporation. o Monitor patient temperature constantly. o The cooling process should stop at 38.8 C in order to avoid aitrogenic hypothermia. o Monitor patient status including vital signs, ECG for possible myocardial ischemia, MI, and dysrhythmias, CVP, and level of responsiveness.

o IV infusion of normal saline, or lactated Ringers solution is initiated as directed to replace fluid losses and maintain adequate circulation. o Urine output is also measured frequently, because acute tubular necrosis may occur as a complication of heat stroke from rhabdomyolysis (myoglobin in the urine). o Rehydrate.

PREVENTION

o Advise the patient treated for heat stroke to avoid immediate reexposure to high temperature; hypersensitivity to high temperature may remain for a considerable time. o Emphasize the importance of maintaining adequate fluid intake, wearing loose clothing, reducing activity in hot weather. o Advice athlete to monitor fluid losses and weight loss during workout activities or exercise to replace fluids and electrolytes.

o Advice the patient to use a gradual approach to physical conditioning, allowing sufficient time for return to baseline temperature. o Direct frail elderly patients living in urban settings with high environmental temperature to places where air conditioning is available. o Advice patient to plan outdoor activities to avoid the hottest part of the day (between 10 AM and 2 PM).

o If you have to perform physical activities in hot weather, drink plenty of fluids (such as water and sports drinks), but avoid alcohol, caffeine (including soft drinks and tea), and tea which may lead to dehydration. o Your body will need replenishment of electrolytes (such as sodium) as well as fluids if you sweat excessively or perform vigorous activity in the sunlight for prolonged periods. o Wear light-colored clothing if you're in the sun. Dark clothing absorbs heat. Light-colored clothing can help keep you cool by reflecting the sun's rays.

o Get acclimatized. Limit the amount you spend working or exercising in the heat until you're conditioned to it. People who are not used to hot weather are especially susceptible to heat-related illness, including heatstroke. It can take several weeks for your body to adjust to hot weather. o Be cautious if you're at increased risk. If you take medications or have a physical condition that increases your risk of heat-related problems, avoid the heat and act quickly if you notice symptoms of overheating. If you participate in a strenuous sporting event or activity in hot weather, make sure there are medical services at the event in case a heat emergency arises.