Heat Exhaustion:
Early Recognition Important...may lead to heat stroke.
Clinical
Picture:
Core
temp
38-40*C
[100.4-104*F]
Malaise, weakness, headache, anorexia, nausea, vomiting,
tachycardia,
hypotension,
profuse
sweating.
Treatment:
Most respond to PO/IV hydration and eliminating heat stress
Heat Stroke:
Classic vs.
Extertional
Affects elderly/debilitated
Young, healthy, unacclimatized
Minimal physical activity
Usually strenuous activity
Perspiration minimal to absent
> 50% sweating present
Sets in slowly
Develops rapidly
Clinical Picture:
Temp > 40*C [104*F]
Mental status changes: irritability, confusion, ataxia,
Seizures, coma
Tachycardia, tachypnea with resultant respiratory alkalosis
Ecchymosis,
hematuria,
hemetemesis clotting disorder--DIC
Lab/Diagnostic
Studies:
-
complete lab include LFT's and clotting studies
-
CXR
-
ECG and enzymes
-
ABG's
-
UA
-
Lactic acid [significant elevation indicates poor prognosis in classic HS]
Treatment:
HEAT STROKE:
**** First priority is to start lowering core temperature***
(
The best method is controversial
)
Rapid Cooling associated with improved survival.
Pre-Hospital:
-
Assess environment
-
ABCDE's...
-
Remove unnecessary clothing
-
Try cooling methods: mist body with lukewarm water
Augment airflow over patient
Cover with cool, wet sheets
-
Establish IV...fluid challenge
