Heat stroke
| Heat stroke | |
|---|---|
| Other names | Sun-stroke, siriasis[1] |
| A person being cooled down with water spray, one of the treatments for heat stroke, in Iraq in 1943 | |
| Specialty | Emergency medicine |
| Symptoms | High body temperature, red, dry or damp skin, headache, dizziness, confusion, nausea[2] |
| Complications | Seizures, rhabdomyolysis, kidney failure[3] |
| Duration | 1-2 days in the hospital (typical recovery period) 2 months to a year (complete recovery period range) |
| Types | Classic, exertional[3] |
| Causes | High external temperatures, physical exertion[3][4] |
| Risk factors | Extremes of age, heat waves, high humidity, certain drugs, heart disease, skin disorders[3] |
| Diagnostic method | Based on symptoms[3] |
| Differential diagnosis | Neuroleptic malignant syndrome, malaria, meningitis[3] |
| Treatment | Rapid cooling, supportive care[4] |
| Prognosis | Risk of death <5% (exercise induced), up to 65% (non-exercise induced)[3] |
| Deaths | > 600 per year (US)[4] |
Heat stroke or heatstroke, also known as sun-stroke, is a severe heat illness that results in a body temperature greater than 40.0 °C (104.0 °F),[4] along with red skin, headache, dizziness, and confusion.[2] Sweating is generally present in exertional heatstroke, but not in classic heatstroke.[5] The start of heat stroke can be sudden or gradual.[3] Heatstroke is a life-threatening condition due to the potential for multi-organ dysfunction,[6] with typical complications including seizures, rhabdomyolysis, or kidney failure.[3]
Heat stroke occurs because of high external temperatures and/or physical exertion.[3][4] It usually occurs under preventable prolonged exposure to extreme environmental or exertional heat.[6] However, certain health conditions can increase the risk of heat stroke, and patients, especially children, with certain genetic predispositions are vulnerable to heatstroke under relatively mild conditions.[7]
Preventive measures include drinking sufficient fluids and avoiding excessive heat.[8] Treatment is by rapid physical cooling of the body and supportive care.[4] Recommended methods include spraying the person with water and using a fan, putting the person in ice water, or giving cold intravenous fluids.[4] Adding ice packs around a person is beneficial but does not by itself achieve the fastest possible cooling.[4]
Heat stroke results in more than 600 deaths a year in the United States.[4] Rates increased between 1995 and 2015.[3] Purely exercise-induced heat stroke, though a medical emergency, tends to be self-limiting (the patient stops exercising from cramp or exhaustion) and fewer than 5% of cases are fatal. Non-exertional heatstroke is a much greater danger: even the healthiest person, if left in a heatstroke-inducing environment without medical attention, will continue to deteriorate to the point of death, and 65% of the most severe cases are fatal even with treatment.[3]
- ^ Herrick RT (April 1986). "Heat illness in the athlete: siriasis is serious". Alabama Medicine. 55 (10): 28, 33–28, 37. PMID 3706086.
- ^ a b "Warning Signs and Symptoms of Heat-Related Illness". www.cdc.gov. Archived from the original on July 13, 2017. Retrieved July 17, 2017.
- ^ a b c d e f g h i j k l Leon LR, Bouchama A (April 2015). "Heat stroke". Comprehensive Physiology. 5 (2): 611–647. doi:10.1002/cphy.c140017. ISBN 9780470650714. PMID 25880507.
- ^ a b c d e f g h i Gaudio FG, Grissom CK (April 2016). "Cooling Methods in Heat Stroke". The Journal of Emergency Medicine. 50 (4): 607–616. doi:10.1016/j.jemermed.2015.09.014. PMID 26525947.
- ^ Cite error: The named reference
NEJM2019was invoked but never defined (see the help page). - ^ a b Bouchama A, Knochel JP (June 2002). "Heat stroke". The New England Journal of Medicine. 346 (25): 1978–1988. doi:10.1056/nejmra011089. PMID 12075060.
- ^ Wang HJ, Lee CS, Yee RS, Groom L, Friedman I, Babcock L, et al. (October 2020). "Adaptive thermogenesis enhances the life-threatening response to heat in mice with an Ryr1 mutation". Nature Communications. 11 (1) 5099. Bibcode:2020NatCo..11.5099W. doi:10.1038/s41467-020-18865-z. PMC 7547078. PMID 33037202.
- ^ "Tips for Preventing Heat-Related Illness|Extreme Heat". www.cdc.gov. June 19, 2017. Archived from the original on July 29, 2017. Retrieved July 17, 2017.