Heat stroke

Heat stroke is a condition in which the body's temperature rises to high levels. In extreme heat, your body’s ability to cool itself down can fail, causing your body temperature to increase to a dangerous level. The symptoms of heat stroke can differ from person to person but often include:

• Absence of sweating due to the body's inability to release heat and cool down
• Symptoms like confusion, convulsions, and dizziness
• Hot, dry skin
• Uncontrollable muscle twitching
• Slurred speech
• Rapid, weak pulse
• Throbbing headache
• Shallow breathing, seizures, and unconsciousness
• Body temperature spikes to 102°F - 104°F or higher rapidly

Note: If the muscles begin to twitch uncontrollably, keep the person from self-injury. Do not place any objects in the mouth. Also, monitor body temperature and continue cooling efforts until emergency medical treatment is provided to the victim. Shop our selection of body temperature monitoring devices and cooling aids to ensure you're ready to act until medical help arrives.

Heat stroke occurs when the body's heat-regulating system is overwhelmed by excessive heat. The skin may be dry if the ability to sweat has been lost. It is a life-threatening emergency that requires immediate medical care.

Heat stroke happens when the body's ability to regulate temperature fails. As the condition worsens, the body reaches a point where it can no longer keep up with the heat it is gaining. This occurs because the heart is unable to pump enough blood to meet the body's cooling needs. As a result, body temperature continues to rise, exceeding 104°F (40°C), causing damage to cells and triggering an inflammatory response. This initiates a dangerous cycle, leading to the failure of multiple organs.

Various risk factors associated with heat stroke are discussed below.

Heatstroke can affect anyone, but infants and the elderly face heightened risk due to potential difficulties in regulating body temperature. The following conditions can increase susceptibility to heat stroke:

• Hot weather: Exposure to scorching and humid weather conditions.
• Physical exertion: Engaging in vigorous physical activity, especially in hot weather.
• Dehydration: Insufficient fluid intake or excessive sweating without replenishing fluids.
• Age: Infants, young children, and older adults are at greater risk. Children have a higher metabolic rate, while older adults may have underlying health conditions that affect their ability to regulate body temperature effectively.
• Lack of acclimatization: Individuals not used to hot weather or those who have recently moved to a hotter climate.
• Lack of cooling mechanisms: Inability to access cooling mechanisms like air conditioning, fans, or cool water, especially during heat waves.
• Certain occupations and activities: Construction workers, firefighters, and athletes who train intensively face prolonged exposure to high temperatures and physical exertion.
• Alcohol abuse: Excessive alcohol consumption can interfere with the body's heat regulation mechanisms and increase the risk of heatstroke.
• Certain health conditions: Individuals with chronic illnesses such as heart disease, lung disease, obesity, diabetes, certain immune-related conditions, or those experiencing high fever.
• Pregnancy and breastfeeding: Pregnant women and breastfeeding mothers are more prone to heatstroke.
• Certain medications: Some medications, including certain antipsychotics, antihistamines, diuretics, beta-blockers, and stimulants, can interfere with the body's temperature regulation.
• History of heat-related illnesses: Previous episodes of heat-related problems indicate a higher risk in subsequent exposures.

Diagnosing sunstroke usually involves a combination of the following:

• Physical examination: A doctor will evaluate the individual's signs and symptoms, paying close attention to their body temperature, skin condition, and overall appearance.
• Medical history assessment: The doctor may inquire about the person's recent exposure to hot environments, physical exertion, and any underlying health conditions.
• Rectal temperature: A rectal temperature is more accurate than a mouth or forehead temperature in identifying core body temperature.
• Blood tests: In some cases, blood tests may be conducted to assess the individual's electrolyte levels, kidney function, or liver function tests. These tests can aid in identifying any abnormalities or complications associated with sunstroke.
• Urinalysis: A urine test may be performed to check the color of the urine, which can turn darker in heat-related conditions, and to evaluate kidney function, which can be affected by heat stroke.
• Imaging studies: In severe cases or when complications are suspected, imaging studies such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), chest X-ray, or electrocardiogram (ECG) may be ordered. These tests can help rule out other potential causes of symptoms and provide additional information about the person's condition.
• Muscle function tests: These assess potential severe muscle tissue damage, which is more prevalent in exertional heat stroke than in classical heat stroke.

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To prevent heat stroke or sunstroke, you can take the following measures:

1. Stay hydrated
   • Keep yourself well-hydrated by drinking ample water throughout the day, regardless of thirst.
   • Consider alternatives such as coconut water, buttermilk, juices, lightly salted water, and broth.
   • Avoid excessive alcohol and caffeinated beverages.
2. Dress appropriately
   • Wear loose-fitting, lightweight, light-colored clothing in hot weather to facilitate effective temperature regulation and sweat evaporation.
3. Stay informed
   • Watch for weather forecasts and heat advisories in your area.
   • Keep an eye on the heat index, which combines temperature and humidity, to determine the severity of heat-related risk.
4. Stay cool and safe
   • Avoid peak heat hours from 10 a.m. to 4 p.m. and take breaks in cool areas if outdoors.
   • Minimize outdoor time on hot, humid days by staying indoors when possible.
5. Stay sun-safe
   • Seek shade or use an umbrella/canopy when outdoors.
   • Wear a tightly woven, wide-brimmed hat and sunglasses with UV protection.
   • Apply sunscreen with SPF 30 or higher, broad-spectrum protection, and water resistance.
6. Cool your body
   • Take cool baths regularly to regulate body temperature and prevent overheating.
   • Stay in air-conditioned environments when possible, such as shopping malls with cooling facilities.
7. Avoid strenuous activities
   • Minimize physical exertion in hot and humid conditions.
   • Schedule activities for cooler parts of the day and take regular breaks in shaded or cool areas.
8. Acclimatize gradually
   • Increase outdoor time gradually to allow the body to acclimatize to the heat.
9. Be mindful of certain medications
   • Check with your doctor about any potential side effects of your medications in hot conditions.
10. Medical considerations
    • If your child has a medical condition or takes medication, consult their doctor for personalized advice on preventing heat-related illnesses.

First-Aid Tips

1. Call for emergency help: Contact a nearby hospital for immediate medical assistance.
2. Stay with the person: Check the individual’s airway, breathing, and pulse. If unconscious, position them on their side and commence CPR if required. Seek urgent medical advice if the ambulance is delayed. Remain with the affected individual until emergency services arrive.
3. Move to a shaded area: Transfer the person to a cool, shaded spot and remove any excess clothing.
4. Prioritize airway protection, breathing support, and circulation (ABC): Ensure the protection of the airway, provide adequate breathing assistance, and maintain circulation—this critical sequence is essential in managing heat stroke effectively.
5. Cool the person quickly: Swiftly initiate cooling procedures after ensuring basic care (ABCs). Utilize various cooling methods:
   • Submerge in a cold water or ice bath, if possible.
   • Wet the skin and apply cold wet cloths.
   • Soak clothing with cool water.
   • Enhance air circulation around the person for faster cooling.
   • Apply cold wet cloths or ice packs to the head, neck, armpits, and groin.
6. Encourage fluid intake: Offer cool fluids if the person is alert and able to drink. Provide a sports drink, rehydration solution, or cool water. Intravenous (IV) fluids will be administered in the emergency room upon arrival.

Medications

1. Benzodiazepines: Administered immediately in cases of agitation and shivering to halt excessive heat production.
2. Anticonvulsants: Benzodiazepines and barbiturates are recommended for convulsions. Barbiturates can be used despite potential impairment in sweat production.
3. Refractory convulsions: Patients with convulsions unresponsive to benzodiazepines and barbiturates may require paralysis and mechanical ventilation. Electroencephalographic monitoring and adjustment of anticonvulsant medications are essential in such cases.

Note: Antipyretics (fever-reducing medications) and other nonsteroidal anti-inflammatory drugs are not recommended and may harm the liver.

If not treated timely, heat stroke can give rise to a myriad of complications, each of which poses a severe threat to the individual's life. Its complications include:

• Low blood sugar level: A condition characterized by low blood sugar levels, which can occur as heat stroke impairs the body's ability to regulate glucose. This can lead to weakness, confusion, and even loss of consciousness.
• Rhabdomyolysis: This condition occurs when muscle tissue breaks down rapidly, releasing a large amount of myoglobin (a protein) into the bloodstream. Myoglobin can cause acute kidney injury.
• Disseminated intravascular coagulation (DIC): Heat stroke may trigger a complex and serious clotting disorder in the body, leading to excessive bleeding and clot formation.
• Acute respiratory distress syndrome (ARDS): High body temperatures can damage the delicate lung tissues, leading to inflammation and fluid accumulation, making it difficult for the individual to breathe.
• Heart damage: Heat stroke can disrupt the heart's electrical activity, leading to abnormal heart rhythms (arrhythmias) or even cardiac arrest in severe cases.
• Brain damage: Heat stroke can cause swelling and inflammation of the brain, leading to neurological complications, including seizures, confusion, memory problems, and even coma.
• Kidney failure: Heat stroke can affect the kidneys, leading to acute kidney injury or failure. Dehydration reduces blood flow to the kidneys, and direct damage from heat can contribute to kidney problems.
• Multi-organ failure: Prolonged exposure to high temperatures can cause damage to various organs, such as the brain, heart, liver, and kidneys.