Heat stroke history and symptoms: Difference between revisions
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High body temperature ([[hyperthermia]]) and dysfunction of the [[CNS]] must coexist for the confirmation of the diagnosis of heat stroke. A history of an existing disease, outdoor activity, exposure to heat, extensive exertion and improper hydration may be observed.<ref name="pmid7914522">{{cite journal| author=Simon HB| title=Hyperthermia and heatstroke. | journal=Hosp Pract (Off Ed) | year= 1994 | volume= 29 | issue= 8 | pages= 65-8, 73, 78-80 | pmid=7914522 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7914522 }} </ref><ref name="pmid8907832">{{cite journal| author=Bricknell MC| title=Heat illness in Cyprus. | journal=J R Army Med Corps | year= 1994 | volume= 140 | issue= 2 | pages= 67-9 | pmid=8907832 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8907832 }} </ref><ref name="pmid25880507">{{cite journal| author=Leon LR, Bouchama A| title=Heat stroke. | journal=Compr Physiol | year= 2015 | volume= 5 | issue= 2 | pages= 611-47 | pmid=25880507 | doi=10.1002/cphy.c140017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25880507 }} </ref> | High body temperature ([[hyperthermia]]) and dysfunction of the [[CNS]] must coexist for the confirmation of the diagnosis of heat stroke. A history of an existing disease, outdoor activity, exposure to heat, extensive exertion and improper hydration may be observed.<ref name="pmid7914522">{{cite journal| author=Simon HB| title=Hyperthermia and heatstroke. | journal=Hosp Pract (Off Ed) | year= 1994 | volume= 29 | issue= 8 | pages= 65-8, 73, 78-80 | pmid=7914522 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7914522 }} </ref><ref name="pmid8907832">{{cite journal| author=Bricknell MC| title=Heat illness in Cyprus. | journal=J R Army Med Corps | year= 1994 | volume= 140 | issue= 2 | pages= 67-9 | pmid=8907832 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8907832 }} </ref><ref name="pmid25880507">{{cite journal| author=Leon LR, Bouchama A| title=Heat stroke. | journal=Compr Physiol | year= 2015 | volume= 5 | issue= 2 | pages= 611-47 | pmid=25880507 | doi=10.1002/cphy.c140017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25880507 }} </ref> | ||
==History | ==History== | ||
<ref name="pmid25880507">{{cite journal| author=Leon LR, Bouchama A| title=Heat stroke. | journal=Compr Physiol | year= 2015 | volume= 5 | issue= 2 | pages= 611-47 | pmid=25880507 | doi=10.1002/cphy.c140017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25880507 }} </ref> | A detailed history is necessary for the prompt diagnosis of heat stroke. The patient with heat stroke may hav ethe following salient features in the history:<ref name="pmid25880507">{{cite journal| author=Leon LR, Bouchama A| title=Heat stroke. | journal=Compr Physiol | year= 2015 | volume= 5 | issue= 2 | pages= 611-47 | pmid=25880507 | doi=10.1002/cphy.c140017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25880507 }} </ref><ref name="pmid1989755">{{cite journal| author=Bouchama A, Cafege A, Devol EB, Labdi O, el-Assil K, Seraj M| title=Ineffectiveness of dantrolene sodium in the treatment of heatstroke. | journal=Crit Care Med | year= 1991 | volume= 19 | issue= 2 | pages= 176-80 | pmid=1989755 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1989755 }} </ref><ref name="pmid20093248">{{cite journal| author=Klenk J, Becker C, Rapp K| title=Heat-related mortality in residents of nursing homes. | journal=Age Ageing | year= 2010 | volume= 39 | issue= 2 | pages= 245-52 | pmid=20093248 | doi=10.1093/ageing/afp248 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20093248 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20584838 Review in: Evid Based Nurs. 2010 Jul;13(3):90-1] </ref> | ||
===Non-exertional or Classic Heat Stroke=== | |||
The history of a patient with classic heat stroke inludes:<ref name="pmid12075060">{{cite journal| author=Bouchama A, Knochel JP| title=Heat stroke. | journal=N Engl J Med | year= 2002 | volume= 346 | issue= 25 | pages= 1978-88 | pmid=12075060 | doi=10.1056/NEJMra011089 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12075060 }} </ref><ref name="pmid8168025">{{cite journal| author=Brody GM| title=Hyperthermia and hypothermia in the elderly. | journal=Clin Geriatr Med | year= 1994 | volume= 10 | issue= 1 | pages= 213-29 | pmid=8168025 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8168025 }} </ref><ref name="pmid1480539">{{cite journal| author=Dann EJ, Berkman N| title=Chronic idiopathic anhydrosis--a rare cause of heat stroke. | journal=Postgrad Med J | year= 1992 | volume= 68 | issue= 803 | pages= 750-2 | pmid=1480539 | doi= | pmc=2399451 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1480539 }} </ref><ref name="pmid15728404">{{cite journal| author=Flynn A, McGreevy C, Mulkerrin EC| title=Why do older patients die in a heatwave? | journal=QJM | year= 2005 | volume= 98 | issue= 3 | pages= 227-9 | pmid=15728404 | doi=10.1093/qjmed/hci025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15728404 }} </ref> | |||
*[[Old age]] | |||
*Chronic condition effecting [[thermoregulation]] | |||
*[[Cardiovascular]] illness | |||
*[[Alcohol]] use | |||
*Drugs | |||
**[[Cocaine]] | |||
**[[Ecstasy]] | |||
*Prescription drugs | |||
**[[Beta blockers]] | |||
**[[Diuretics]] | |||
**[[Anticholinergics]] | |||
*[[Anhidrosis]] | |||
*[[Disability]] | |||
*[[Obesity]] | |||
*Job in hot surroundings | |||
**[[Cooking]] | |||
**Iron molding | |||
**Thermal plants | |||
===Exertional Heat Stroke=== | |||
A patient with exertional heat stroke may have the following salient features in the history:<ref name="pmid11524341">{{cite journal| author=Bendahan D, Kozak-Ribbens G, Confort-Gouny S, Ghattas B, Figarella-Branger D, Aubert M et al.| title=A noninvasive investigation of muscle energetics supports similarities between exertional heat stroke and malignant hyperthermia. | journal=Anesth Analg | year= 2001 | volume= 93 | issue= 3 | pages= 683-9 | pmid=11524341 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11524341 }} </ref><ref name="pmid21709147">{{cite journal| author=Hirshey Dirksen SJ, Larach MG, Rosenberg H, Brandom BW, Parness J, Lang RS et al.| title=Special article: Future directions in malignant hyperthermia research and patient care. | journal=Anesth Analg | year= 2011 | volume= 113 | issue= 5 | pages= 1108-19 | pmid=21709147 | doi=10.1213/ANE.0b013e318222af2e | pmc=3184381 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21709147 }} </ref> | |||
*Young age | |||
*Heavy [[exercise]] | |||
*Humid weather | |||
*Otherwise helathy individuals | |||
*Military personnel | |||
*[[Athletes]] | |||
*Construction workers | |||
==Symptoms== | |||
The symptoms of a heat stroke include: | |||
*[[Hyperthermia]] (40-47C) | |||
*[[CNS]] dysfunction | |||
**[[Disorientation]] | |||
**[[Irritability]] | |||
**[[Dizziness]] | |||
*Red [[dry skin]] | |||
*[[Nausea and vomiting|Nausea]] | |||
*[[Muscle soreness]] | |||
*[[Seizure|Seizures]] may be rarely seen | |||
==References== | ==References== |
Latest revision as of 22:27, 30 May 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Overview
High body temperature (hyperthermia) and dysfunction of the CNS must coexist for the confirmation of the diagnosis of heat stroke. A history of an existing disease, outdoor activity, exposure to heat, extensive exertion and improper hydration may be observed.[1][2][3]
History
A detailed history is necessary for the prompt diagnosis of heat stroke. The patient with heat stroke may hav ethe following salient features in the history:[3][4][5]
Non-exertional or Classic Heat Stroke
The history of a patient with classic heat stroke inludes:[6][7][8][9]
- Old age
- Chronic condition effecting thermoregulation
- Cardiovascular illness
- Alcohol use
- Drugs
- Prescription drugs
- Anhidrosis
- Disability
- Obesity
- Job in hot surroundings
- Cooking
- Iron molding
- Thermal plants
Exertional Heat Stroke
A patient with exertional heat stroke may have the following salient features in the history:[10][11]
- Young age
- Heavy exercise
- Humid weather
- Otherwise helathy individuals
- Military personnel
- Athletes
- Construction workers
Symptoms
The symptoms of a heat stroke include:
- Hyperthermia (40-47C)
- CNS dysfunction
- Red dry skin
- Nausea
- Muscle soreness
- Seizures may be rarely seen
References
- ↑ Simon HB (1994). "Hyperthermia and heatstroke". Hosp Pract (Off Ed). 29 (8): 65–8, 73, 78–80. PMID 7914522.
- ↑ Bricknell MC (1994). "Heat illness in Cyprus". J R Army Med Corps. 140 (2): 67–9. PMID 8907832.
- ↑ 3.0 3.1 Leon LR, Bouchama A (2015). "Heat stroke". Compr Physiol. 5 (2): 611–47. doi:10.1002/cphy.c140017. PMID 25880507.
- ↑ Bouchama A, Cafege A, Devol EB, Labdi O, el-Assil K, Seraj M (1991). "Ineffectiveness of dantrolene sodium in the treatment of heatstroke". Crit Care Med. 19 (2): 176–80. PMID 1989755.
- ↑ Klenk J, Becker C, Rapp K (2010). "Heat-related mortality in residents of nursing homes". Age Ageing. 39 (2): 245–52. doi:10.1093/ageing/afp248. PMID 20093248. Review in: Evid Based Nurs. 2010 Jul;13(3):90-1
- ↑ Bouchama A, Knochel JP (2002). "Heat stroke". N Engl J Med. 346 (25): 1978–88. doi:10.1056/NEJMra011089. PMID 12075060.
- ↑ Brody GM (1994). "Hyperthermia and hypothermia in the elderly". Clin Geriatr Med. 10 (1): 213–29. PMID 8168025.
- ↑ Dann EJ, Berkman N (1992). "Chronic idiopathic anhydrosis--a rare cause of heat stroke". Postgrad Med J. 68 (803): 750–2. PMC 2399451. PMID 1480539.
- ↑ Flynn A, McGreevy C, Mulkerrin EC (2005). "Why do older patients die in a heatwave?". QJM. 98 (3): 227–9. doi:10.1093/qjmed/hci025. PMID 15728404.
- ↑ Bendahan D, Kozak-Ribbens G, Confort-Gouny S, Ghattas B, Figarella-Branger D, Aubert M; et al. (2001). "A noninvasive investigation of muscle energetics supports similarities between exertional heat stroke and malignant hyperthermia". Anesth Analg. 93 (3): 683–9. PMID 11524341.
- ↑ Hirshey Dirksen SJ, Larach MG, Rosenberg H, Brandom BW, Parness J, Lang RS; et al. (2011). "Special article: Future directions in malignant hyperthermia research and patient care". Anesth Analg. 113 (5): 1108–19. doi:10.1213/ANE.0b013e318222af2e. PMC 3184381. PMID 21709147.