Thanks to Dr. Semenovskaya for today’s Morning Report!
Heat Illness
Heat Illness comprises a spectrum of disorders caused by environmental heat exposure. Can be subdivided into three relative stages:
1) Heat Cramps: Heavy sweating; muscle cramps and spasms
2) Heat Exhaustion: Weakness; cool, pale, clammy skin; may be normotensive
3) Heat Stroke: Temperature > 105°C; Altered mental status; headache; confusion, nausea, dizziness.
Treatment:
1) Evaporative cooling: Remove patient’s clothing and wet them with cool water or a wet sheet while directing a large fan directly at the patient
2) Strategic ice packing: Place ice packs on patients’ groin, axillae, anterior and posterior neck
3) Ice water immersion: Place patient in a large tub of ice water; Alternatively, place a patient on a stretcher and cover them with ice and sheet drenched in ice water
4) Cold Water Irrigation:
- Cold IV fluids (NS)
- Gastric and Bladder lavage
- Chest tubes
5) Advanced Cooling: Can consider hemodialysis, cardiopulmonary bypass, intravascular cooling.
Severe Side Effects: May include rhabdomyolysis, renal failure, seizures, DIC, and death; Aggressive cooling can also result in pulmonary edema, arrhythmias, shock, so cool cautiously!
Disposition: Patients with heat stroke may require ICU admission for intensive cooling and management of subsequent complications.
Reference:
“Heat Illness: How To Cool Down Hyperthermic Patients”. Semenovskaya Z, Weiner S. Medscape. http://reference.medscape.com/features/slideshow/heat-illness
Jay Khadpe MD
Latest posts by Jay Khadpe MD (see all)
- Morning Report: 7/30/2015 - July 30, 2015
- Morning Report: 7/28/2015 - July 28, 2015
- IN THE STRETCHER INSTEAD OF BESIDE IT - July 22, 2015
- Morning Report: 7/14/2015 - July 14, 2015
- Morning Report: 7/10/2015 - July 10, 2015