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Heat exhaustion and heatstroke

AGE  May occur at any age but most common in babies and elderly peopleGENDER  Not significant factors
LIFESTYLE  Exertion in a hot environment is a risk factorGENETICS  Not significant factors

Heat exhaustion and heatstroke are conditions resulting from exposure to excessive heat, in which there is loss of fluids and a rise in body temperature.

Heat exhaustion and heatstroke
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In a hot environment, the body loses heat by diverting blood to the skin and by sweating. Profuse sweating may lead to an excessive loss of fluids and salts, resulting in heat exhaustion. This condition is rarely serious, but, if exposure to heat continues, heatstroke may occur as the body's normal cooling mechanisms break down and the temperature of the body rises. Heatstroke is a lifethreatening medical emergency.

Heat exhaustion and heatstroke most commonly occur above 40°C (104°F). High humidity levels increase the risk of heatstroke because sweating is ineffective and heat loss is decreased.

Who is at risk of heat exhaustion and heatstroke?

Heat exhaustion and heatstroke may affect otherwise healthy people, particularly after physical exertion in a hot climate. People who come from temperate climates and travel to the tropics need time to acclimatize to the heat before they can safely exert themselves.

The body's cooling mechanisms are less efficient in infants and in elderly people, making them more susceptible to heat exhaustion and heatstroke. Diabetes mellitus, obesity, alcohol dependence, and chronic heart failure all reduce the body's ability to lose heat. Diarrhoea may contribute to dehydration and increase the risk of developing heat exhaustion and heatstroke.

What are the symptoms heat exhaustion and heatstroke?

After prolonged exposure to hot conditions, the following symptoms of heat exhaustion may develop:

If exposure to heat continues, the body temperature rises and heatstroke may develop, causing symptoms such as:

  • Fast, shallow breathing.
  • Confusion and disorientation.
  • Seizures.

Left untreated, heatstroke may progress to coma in minutes. Death may be due to kidney failure, acute heart failure, or direct heat-induced damage to the brain.

What can I do?

Heat exhaustion can be treated easily. The affected person should rest in a cool place (ideally in an air-conditioned building) and sip cool, salty drinks until he or she feels comfortable. If heatstroke is suspected, he or she should be admitted to hospital as soon as possible.

What might the doctor do?

Once in hospital, the person is examined, and blood tests are carried out to assess the level of salts in the blood.

Treatment for heatstroke is usually carried out in an intensive care unit. Body temperature is lowered by sponging the body with tepid water or loosely wrapping the person in a wet sheet and placing him or her near a fan. Intravenous fluids are given. Once the body temperature has been reduced to 38°C (100°F), these cooling procedures are stopped to prevent the development of hypothermia. Monitoring is carried out continuously to make sure that the body temperature is returning to normal levels and that vital organs are functioning normally. In some severe cases, mechanical ventilation may be required to assist breathing.

Most people with heat exhaustion recover in a few hours if they are moved to a cooler place and fluids are gradually replaced. If heatstroke is treated promptly, most people recover after a few days of bed rest, although their body temperature may fluctuate for several weeks afterwards.

Can heat exhaustion and heatstroke be prevented?

Heat-related disorders can be largely prevented by avoiding strenuous exertion in the heat of the day, spending as much time as possible in the shade, consuming large quantities of liquids, and avoiding alcoholic drinks.

Posted 09.09.2010

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