Heatstroke: Symptoms and treatment

(Source: webmd)

 Heatstroke is the most serious form of heat-related illness and is a medical emergency. If you suspect that someone has heatstroke - which some people refer to as sunstroke .Heatstroke can kill or cause damage to the brain and other internal organs. Although heatstroke is most common in babies, the elderly and those with long-term medical conditions, it also takes a toll on healthy young physically active people such as athletes.

Heatstroke often occurs as a progression from milder heat-related illnesses such as heat cramps, heat syncope ( fainting) and heat exhaustion. However, it can strike even if you have no previous signs of heat injury.

Heatstroke results from prolonged exposure to high temperatures - usually in combination with dehydration - which leads to failure of the body's temperature control system. The medical definition of heatstroke is a core body temperature greater than 41°C, with complications involving the central nervous system that occur after exposure to high temperatures. Other common symptoms include nausea, rapid heartbeat, muscle cramps, seizures, confusion, disorientation, cessation of heavy sweating and sometimes loss of consciousness or coma.
 


Risk factors for heatstroke

Heatstroke is most likely to affect older people who live in flats or homes lacking good airflow and with inadequately shaded south-facing windows. Other high-risk groups include babies and young children, and people of any age who don't drink enough water, have chronic diseases, have mental disabilities or who drink excessive amounts of alcohol. People who spend a lot of time being physically active in hot weather are also at greater risk.

The risk of heat-related illness dramatically increases when the heat index climbs to 26°C or more. So it's important - especially during heatwaves - to pay attention to the maximum temperature reported in your local weather forecasts and to remember that it will be hotter in the sun than in the shade.

If you live in an urban area, you may be especially prone to develop heatstroke during a prolonged heatwave, particularly if there are stagnant atmospheric conditions and poor air quality. In what is known as the "heat island effect," asphalt and concrete store heat during the day and only gradually release it at night, resulting in higher night-time temperatures.

Other risk factors associated with heat-related illness include:

Age. Infants and children up to age four, and adults over 75 years old, are particularly vulnerable because they adjust to heat more slowly than other people.

Health conditions. These include heart, lung or kidney disease, being obese or underweight, having high blood pressure, diabetes, mental illness, sickle cell trait, alcoholism, sunburn and any conditions that cause fever.

Medications. These include antihistamines, diet pills, diuretics, sedatives, tranquillizers, stimulants, seizure medications (anticonvulsants), heart and blood pressure medications such as beta-blockers and vasoconstrictors, and medications for psychiatric illnesses such as antidepressants and antipsychotics. Illegal drugs such as cocaine and methamphetamine also are associated with increased risk of heatstroke.

People with diabetes - who are at increased risk of emergency hospital visits, hospitalisation and death from heat-related illness - may be especially likely to underestimate their risk during heat waves.
 


 


Consult with your doctor or healthcare provider to see if your health conditions and medications are likely to affect your ability to cope with extreme heat and humidity.

Preventing heatstroke

When the temperature is high it's best to stay indoors in a cool room. If you must go outdoors, you can prevent heatstroke by taking these steps:

Wear lightweight, light-coloured, loose-fitting clothing and a wide-brimmed hat.

Use a sunscreen with a sun protection factor (SPF) of 30 or more.

Drink extra fluids. To prevent dehydration, it's generally recommended to drink at least eight glasses of water, fruit juice or vegetable juice per day. Because heat-related illness also can result from salt depletion, it may be advisable to substitute an electrolyte-rich sports drink for water during periods of extreme heat and humidity.

Take additional precautions when exercising or working outdoors. The general recommendation is to drink 750ml (1.25 pints) of fluid two hours before exercise and consider adding another 225ml (8floz) of water or sports drink right before exercise. During exercise, you should consume another 225ml (8floz) of water every 20 minutes, even if you don't feel thirsty.

Reschedule or cancel outdoor activity. If possible, shift your time outdoors to the coolest times of the day, either early morning or after sunset.

Other strategies for preventing heatstroke include:

Monitoring the colour of your urine. Darker urine is a sign of dehydration. Make sure you drink enough fluids to maintain very light-coloured urine.

Measuring your weight before and after physical activity. Monitoring lost water weight can help you determine how much fluid you need to drink.

Avoid fluids containing caffeine or alcohol. Both substances can make you lose fluids and worsen heat-related illness. Also, do not take salt tablets unless your doctor has told you to do so. The easiest and safest way to replace salt and other electrolytes during heat waves is to drink sports drinks or fruit juice.

Check with your doctor before increasing liquid intake if you have epilepsy or heart, kidney or liver disease, are on fluid-restricted diets, or have a problem with fluid retention.

If you live in a flat or house without fans, try to spend at least two hours each day - preferably during the hottest part of the day - in an air-conditioned environment. Avoid rooms with south-facing windows, which get the most sunlight. At home, draw your curtains or blinds during the hottest part of the day. If you can, open windows at night on two sides of your building to create cross-ventilation.
 


 


Symptoms of heatstroke

The hallmark symptom of heatstroke is a core body temperature above 41°C. But fainting may be the first sign.

Other symptoms may include:

Throbbing headache
Dizziness and light-headedness
Lack of sweating despite the heat
Red, hot and dry skin
Muscle weakness or cramps
Nausea and vomiting
Rapid heartbeat, which may be either strong or weak
Rapid, shallow breathing
Behavioural changes such as confusion, disorientation or staggering
Seizures
Unconsciousness

First aid for heatstroke

If you suspect that someone has a heatstroke, call 999 immediately or bring the person to a hospital. Any delay in seeking medical help can be fatal.

While waiting for the paramedics to arrive, initiate first aid. Move the person to an air-conditioned environment - or at least a cool, shady area - and remove any unnecessary clothing.

If possible, take the person's core body temperature and initiate first aid to cool it to below 40°C. If no thermometers are available, don't hesitate to initiate first aid.

You may also try these cooling strategies:

Fan air over the patient while wetting his or her skin with water from a sponge or garden hose.

Apply ice packs to the patient's armpits, groin, neck and back. Because these areas are rich with blood vessels close to the skin, cooling them may reduce body temperature.

Immerse the patient in a shower or tub of cool water, or an ice bath.

If emergency response is delayed, call the hospital Accident & Emergency department for additional instructions.

After you've recovered from heatstroke, you'll probably be more sensitive to high temperatures during the following week. It's best to avoid hot weather and heavy exercise until your doctor tells you that it's safe to resume your normal activities.

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