Heat stroke

Definition:

Heat stroke is a severe and life-threatening type of heat illness that occurs when the core body temperature is more than 40°C.

Risk factors of heat stroke:

i) Environmental risk factors-

1. Core body temperature – more than 40°C
2. Short of wind and / or ventilation
3. Humid weather (Humidity – 75% or more).

ii) Endogenous risk factors-

1. Obesity
2. Decreased sweating

iii) Exogenous risk factors-

1. Dehydration
2. Exertion
3. Fever.

iv) Drugs-

1. Anti cholinergic drugs
2. Amphetamine
3. Phenothiazine.

Clinical features of heat stroke:

1. Very hot skin
2. Less or no sweating
3. Headache
4. Nausea
5. Vomiting
6. Muscle tremor
7.Confusion
8. Unconsciousness.

Complications of heat stroke:

1.Hypovolaemic shock
2. DIC (Disseminated Intravascular Coagulation)
3. Lactic acidosis
4.Rhabdomyolysis
5. Renal failure
6. Hepatic failure
7. Pulmonary edema
8. Cerebral edema.

Investigations:

A. For dehydration-

1. Blood Urea- Increased
2. Serum sodium- Increased
3. Haematocrit- Increased.

B. For DIC-

1. Total platelet count- Thrombocytopenia
2. Prothrombin time – Prolonged
3. APTT (Activated Partial Thromboplastin Time) – Prolonged
4. Fibrinogen concentration – Decreased
5. D-dimer – Increased.

C. For Rhabdomyolysis-

1. LDH- Increased
2.CPK – Increased.

Treatment of heat stroke:

I) Admission in ICU(intensive care unit)
II) Quick cooling of the body by water spraying
III) Keeping ice packs in both axillae and groins
IV) Fanning
V) Cold Intravenous fluid replacement with Normal Saline or 5% DNS
VI) Benzodiazepines – occasionally needed in treatment of heat strokeVII) Post recovery advices-

• Staying away from recurrence
• Escaping of heavy exercise during recovery.