Heat Stroke

Summary Exposure to warm environments can cause a number of heat-related illnesses including muscle cramps, heat rash, edema, syncope, heat exhaustion, and heat stroke. All of these issues are preventable. Early recognition of heat stroke is paramount for improving survival. Cool patients with cold water immersion. Morbidity and Mortality Approximately 600 deaths occur every year in the United States related to heat. It is a leading cause of death in high school athletes. Mortality from heat stroke approaches 10% even in modern times. Story As many as 53 children die every year from heat related vehicle entrapment in the United States. Most of these cases are due to people forgetting the child was in the car. The second leading cause is children getting into unattended cars. Always know where your baby or child is and keep your unattended car locked. A record-breaking heat wave in Europe in 2003 killed at least 30,000 people, mostly elderly. Taking cool baths throughout the day could have prevented many of these deaths. Key Points 1. Risk factors for heat illness include older age, dehydration, impaired cooling capacity, lack of acclimatization, poor fitness, lack of sleep, chronic health issues, and obesity. 2. Temperature, wind, humidity, and solar radiation all effect the thermal strain felt by any individual. 3. Heat exhaustion is common and characterized by fatigue, thirst, weakness, anxiety, and dizziness. Heat stroke is much more severe and can be distinguished from exhaustion by the presence of altered coordination, balance, and/or mentation. 4. Rapid cooling is the most important treatment for heat stroke. Cold water emersion is the gold standard for lowering body temperature. References - Lipman et al. WMS Practice Guidelines for the Prevention and Treatment of Heat-Related Illness. Wild & Env Med. 2014. - O’Brien et al. Clinical Management of Heat-Related Illnesses. Ch. 13. Auerbachs, Wilderness Medicine. - Gaudio FG, Grissom CK. Cooling Methods in Heat Stroke. J Emerg Med. 2016 - Wikipedia – Heat Stroke - Personal experience as a physician and athlete