KYJ- 30- Heat Stroke v Heat Exhaustion
With Australian temps this week going crazy, it is timely that we review the real possibility that people will die from dehydration and heat stress related conditions.
Young children, pets and elderly are at increased risk as their thermoregulation is unable to
maintain adequate intrinsic cooling with air temperatures in the low to mid 40s.
The symptoms of heat stroke are rapid, and occur as the body's ability to keep cool is overloaded by high air temp, humidity and exercise. Dehydration is rapid .
Early heat exhaustion symptoms include headache, lethargy, dizziness, and muscle weakness and cramps.
Tachycardia (>120 in kids, >140 in babies, > 110 in adults).
And rapid breathing without exertion. This is especially diagnostic in kids, and a symptom of dehydration.
Nausea with vomiting compounds dehydration by eliminating a will to drink.
Heat stroke,
This morph or deterioration of heat exhaustion can be life-threatening.
In heat stroke the body’s temperature mechanism fails.
The skin is usually hot and dry .
The person is febrile- often above 41.
Collapse and fitting may occur in small children
Pyrexia (high fever) is the diagnostic feature that separates heat exhaustion from heat stroke.
Treatment
Step 1- Cooling
Remove unnecessary clothing, shade, swimming, cool showers, shopping centres and cinema can be life saving as a prevention agent.
Limit exercise.
Step 2 -Hydrate!!!
At least
1500ml non sugary fluids PLUS 20 -30 ml / kg body weight
Avoid energy drinks, caffeinated beverage and alcohol.
If symptoms of heat stroke are apparent, IV fluids and active cooling using cool mats may be needed.
Panadol, nurofen and aspirin DO nothing for this type of fever. !!! So don't use them . The patients care centres on hydration and active cooling.
Elderly patients may suffer electrolyte shifts causing muscle twitching and cramps, and cardiac failure. Arrest.
Baseline ECG and monitor blood Biochem, urine output and specific gravity.
Stay cool.
Rob Timmings
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