Treatment Guide for Heat Stroke (Sun Stroke or Heat Hyperpyrexia)
Rapid cooling is the crucial element in the treatment of heat stroke. A delay in such treatment significantly increases the chances of death. Clothing should be removed and the victim cooled by any available means. The most effective method of reducing body temperature is by placing the victim in an ice bath. Vigorous massage promotes cooling by stimulating blood flow to and through the skin. Ice water baths do not cause shock nor do they constrict the blood vessels in the skin. The victim should be removed from the ice bath when his rectal temperature is 38.3°C (101 F). Otherwise, his body temperature may continue to drop until it is below normal.
Ice baths are not likely to be available in the field, but several alternate methods can be used with good results. The victim may be put in a shaded area and splashed or sponged with cold water or massaged with ice. Circulating air also increases the dissipation of heat. This can be accomplished by fanning by hand, the use of electric fans, or evacuating the victim in an open shaded vehicle. Transportation of the victim to a medical facility for further treatment and management of possible complications should be done as soon as possible.
Remember that if a healthy individual collapses with fever after exertion in the heat, heat stroke should be the foremost consideration. The first thing to do is take his rectal temperature to establish or rule out the diagnosis of heat stroke.
Virtually any form of chronic disabling disease increases the risk of heat stroke. People with heart or circulatory diseases, as well as diabetes, obesity, malnutrition, or alcoholism, are more likely to suffer heat stroke and tend to become more seriously ill. Acute illness with fever, nausea, vomiting, or diarrhea and subsequent dehydration make it more difficult for the individual to cope with heat stress. Several skin disorders that impair sweating have been associated with a higher rate of heat stroke, since physical exertion in any form generates body heat, thereby increasing the heat that must be dissipated by the skin.
A number of medications, many of them widely used, have been associated with the development of heat stroke. There are three types of medications that have been linked to heat stroke. Drugs that have anticholinergic properties inhibit sweating. Sympathomimetic drugs decrease blood flow to the skin and sweat glands, thus diminishing sweating. Finally, some drugs affect the heat and temperature controls centers in the brain directly.
Most cases of heat stroke associated with these drugs have been. in the elderly. Realistically, medications do not greatly increase the risk of heat stroke in normally healthy young people. This becomes apparent if one considers the huge number of individuals taking antihistamines, sympathomimetic agents, and drugs with anticholinergic properties.
It would seem prudent, however, to avoid such medications if one is exposed to prolonged extremes of heat and/or exercise, . e.g., distance running or long hikes. The illnesses for which some of these medications are used, such as acute viral illnesses with fever, or stomach upsets with vomiting and diarrhea, may predispose to heat stroke in and of themselves. Moreover, high body temperatures are commonly encountered during extreme heat and exercise stress. An additional factor inhibiting heat loss, such as one of these drugs, could mean the difference between mild or severe heat stroke.
Ice baths are not likely to be available in the field, but several alternate methods can be used with good results. The victim may be put in a shaded area and splashed or sponged with cold water or massaged with ice. Circulating air also increases the dissipation of heat. This can be accomplished by fanning by hand, the use of electric fans, or evacuating the victim in an open shaded vehicle. Transportation of the victim to a medical facility for further treatment and management of possible complications should be done as soon as possible.
Remember that if a healthy individual collapses with fever after exertion in the heat, heat stroke should be the foremost consideration. The first thing to do is take his rectal temperature to establish or rule out the diagnosis of heat stroke.
Virtually any form of chronic disabling disease increases the risk of heat stroke. People with heart or circulatory diseases, as well as diabetes, obesity, malnutrition, or alcoholism, are more likely to suffer heat stroke and tend to become more seriously ill. Acute illness with fever, nausea, vomiting, or diarrhea and subsequent dehydration make it more difficult for the individual to cope with heat stress. Several skin disorders that impair sweating have been associated with a higher rate of heat stroke, since physical exertion in any form generates body heat, thereby increasing the heat that must be dissipated by the skin.
A number of medications, many of them widely used, have been associated with the development of heat stroke. There are three types of medications that have been linked to heat stroke. Drugs that have anticholinergic properties inhibit sweating. Sympathomimetic drugs decrease blood flow to the skin and sweat glands, thus diminishing sweating. Finally, some drugs affect the heat and temperature controls centers in the brain directly.
Most cases of heat stroke associated with these drugs have been. in the elderly. Realistically, medications do not greatly increase the risk of heat stroke in normally healthy young people. This becomes apparent if one considers the huge number of individuals taking antihistamines, sympathomimetic agents, and drugs with anticholinergic properties.
It would seem prudent, however, to avoid such medications if one is exposed to prolonged extremes of heat and/or exercise, . e.g., distance running or long hikes. The illnesses for which some of these medications are used, such as acute viral illnesses with fever, or stomach upsets with vomiting and diarrhea, may predispose to heat stroke in and of themselves. Moreover, high body temperatures are commonly encountered during extreme heat and exercise stress. An additional factor inhibiting heat loss, such as one of these drugs, could mean the difference between mild or severe heat stroke.
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