Heat stroke

Anyone can experience heat stroke, but certain groups are more vulnerable, including infants and older adults, due to challenges in regulating body temperature.

Factors that can increase the risk include:

1. Hot Weather: Exposure to extremely hot and humid conditions.
2. Physical Activity: Engaging in intense exercise, especially in hot environments.
3. Dehydration: Not consuming enough fluids or excessive sweating without replenishment.
4. Age: Infants, young children, and the elderly are particularly susceptible. Children have a higher metabolic rate, and older adults often face health issues that impair temperature regulation.
5. Inability to Adapt: Individuals who are not accustomed to hot climates or have recently moved to warmer areas.
6. Lack of Cooling Resources: Inability to access air conditioning, fans, or cool water, especially during heatwaves.
7. Occupational or Physical Exertion: Jobs like construction work, firefighting, or intense athletic training often involve prolonged exposure to heat and strenuous activity.
8. Alcohol Consumption: Excessive alcohol intake can impair the body’s ability to regulate heat and increase the likelihood of heat stroke.
9. Pre-existing Health Conditions: People with chronic diseases like heart disease, lung disease, obesity, diabetes, certain immune disorders, or those experiencing high fever are at greater risk. Pregnant women and breastfeeding mothers are also more vulnerable.
10. Medications: Certain drugs, such as antipsychotics, antihistamines, diuretics, beta-blockers, and stimulants, can affect the body’s temperature regulation.
11. History of Heat-Related Illness: Past experiences with heat-related conditions increase the risk of future occurrences.

The diagnosis of heat stroke typically involves several steps:

1. Physical Examination: A healthcare provider will assess the person’s symptoms, paying attention to their body temperature, skin condition, and overall appearance.
2. Medical History Review: The doctor may inquire about the person’s recent exposure to heat, physical activity, and any underlying health conditions.
3. Rectal Temperature Measurement: A rectal temperature is the most accurate method to assess core body temperature, which is crucial in diagnosing heat stroke.
4. Blood Tests: Blood tests may be conducted to evaluate electrolyte levels, kidney function, and liver function. These tests help identify any complications related to heat stroke.
5. Urine Test: Urinalysis can reveal darker urine, which may indicate dehydration or kidney strain caused by heat stroke.
6. Imaging Studies: If the condition is severe or complications are suspected, imaging tests like a CT scan, MRI, chest X-ray, or ECG may be used to rule out other potential causes of the symptoms.
7. Muscle Function Tests: These tests assess muscle damage, which is more common in exertional heat stroke than in classic heat stroke.

To reduce the risk of heat stroke or sunstroke, take the following precautions:

Stay Hydrated

Ensure adequate hydration by drinking plenty of water throughout the day, even if you don’t feel thirsty. You can also consume alternatives like coconut water, buttermilk, fruit juices, lightly salted water, and broth. Avoid excessive alcohol and caffeinated drinks.

Wear Proper Clothing

In hot weather, opt for loose-fitting, lightweight, and light-colored clothing that helps your body regulate temperature and allows sweat to evaporate effectively.

Stay Updated

Monitor weather forecasts and heat warnings in your area. Pay attention to the heat index, which combines temperature and humidity, to gauge the level of heat-related risk.

Stay Cool and Safe

Avoid being outside during the peak heat hours of 10 a.m. to 4 p.m. If you must be outdoors, take frequent breaks in cooler areas. Stay indoors during extremely hot and humid days whenever possible.

Protect Yourself from the Sun

Seek shade or use an umbrella or canopy when outdoors. Wear a wide-brimmed, tightly woven hat and UV-protective sunglasses. Apply sunscreen with at least SPF 30, broad-spectrum protection, and water resistance.

Cool Your Body

Take regular cool baths or showers to help regulate body temperature. Stay in air-conditioned spaces when possible, such as malls or public buildings equipped with cooling systems.

Avoid Overexertion

Limit strenuous activities, especially in hot and humid conditions. If engaging in physical tasks, schedule them during the cooler hours of the day and take breaks in shaded or cool environments.

Acclimatize Gradually

Increase time spent outdoors slowly to allow your body to adjust to the heat.

Be Aware of Medications

Consult your doctor if you're taking any medications, as some may affect your body's ability to cope with heat.

Medical Considerations

If a child has a medical condition or is on medication, seek advice from a healthcare provider to develop a tailored strategy for preventing heat-related illnesses.

Doctor to Visit

If symptoms of heat stroke persist for more than 30 minutes, it’s a critical emergency requiring immediate medical attention. If you're unsure about the severity of symptoms or suspect heat stroke, seek medical help right away.

Prompt medical intervention is vital to avoid severe complications and potentially fatal outcomes.

Consult the following healthcare professionals:

• General Physician: Can diagnose and treat heat stroke symptoms and provide immediate care and guidance on prevention.
• Internal Medicine Specialist: Handles systemic effects of heat stroke, coordinating comprehensive care and managing underlying conditions.
• Pediatrician: Plays an important role in preventing and managing heat stroke in children, educating parents on hydration and sun safety, and providing quick diagnosis and treatment for heat-related issues.

First-Aid Tips

Call for Emergency Help:

Dial emergency services for immediate assistance.

Stay with the Person:

Check the individual's airway, breathing, and pulse.

• If unconscious, position them on their side and start CPR if necessary. Seek urgent medical help if an ambulance is delayed.
• Remain with the individual until emergency services arrive.

Move to a Cool Area:

Relocate the person to a shaded or air-conditioned space and remove any excess clothing.

Prioritize ABC:

Focus on airway protection, ensuring proper breathing support, and maintaining circulation—an essential sequence in treating heat stroke.

Cool the Person Rapidly:

After ensuring basic care (ABCs), begin cooling procedures immediately.

• Submerge the individual in cold water or an ice bath if possible.
• Wet their skin and apply cold, damp cloths.
• Soak clothing in cool water.
• Improve air circulation around the person for faster cooling.
• Apply ice packs or cool cloths to their head, neck, armpits, and groin.

Offer Fluids:

If the person is alert and able to drink, offer cool fluids like water, sports drinks, or rehydration solutions.

• IV fluids will be provided upon arrival at the emergency room.

Medications

• Benzodiazepines: These are given immediately in cases of agitation or shivering to stop excessive heat production.
• Anticonvulsants: Benzodiazepines and barbiturates are typically used to manage convulsions. Barbiturates can still be utilized even if they inhibit sweating.
• Refractory Convulsions: For convulsions that do not respond to benzodiazepines and barbiturates, paralysis and mechanical ventilation may be needed. Electroencephalographic monitoring and adjustments to anticonvulsant medications are essential in such cases.

Note: Antipyretics (fever-reducing medications) and NSAIDs are not recommended, as they can damage the liver.

If heat stroke is not treated promptly, it can lead to numerous serious complications, each of which poses a major risk to the individual's life. Some potential complications include:

1. Low Blood Sugar: Heat stroke can impair the body's ability to regulate glucose levels, leading to hypoglycemia. This condition may result in weakness, confusion, and in extreme cases, loss of consciousness.
2. Rhabdomyolysis: This occurs when muscle tissue breaks down at an accelerated rate, releasing myoglobin—a protein—into the bloodstream. Myoglobin can cause severe damage to the kidneys, resulting in acute kidney injury.
3. Disseminated Intravascular Coagulation (DIC): Heat stroke may trigger a complex clotting disorder in the body, which results in excessive clot formation and bleeding. This is a life-threatening condition that requires immediate attention.
4. Acute Respiratory Distress Syndrome (ARDS): Elevated body temperatures can cause damage to lung tissues, leading to inflammation and fluid buildup. This can impair breathing and may require mechanical support.
5. Heart Damage: Heat stroke can disturb the heart’s electrical rhythms, leading to arrhythmias or even cardiac arrest in severe cases, which can be fatal.
6. Brain Damage: High body temperatures can cause the brain to swell and become inflamed, potentially leading to neurological problems like seizures, confusion, memory issues, or even coma.
7. Kidney Failure: Dehydration and direct heat damage can reduce blood flow to the kidneys, leading to acute kidney injury or failure.
8. Multi-Organ Failure: Prolonged heat exposure can cause widespread damage to vital organs, including the brain, heart, liver, and kidneys, which can result in multi-organ failure.