Heat exhaustion: Difference between revisions

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==Background==
==Background==
#Definition
Results from exposure to excessive heat or exposure to extreme temperature for prolonged period of time.
##Known heat exposure + temp 37-40 + some combination of:
*Can result from exposure to [[heat wave]]
###Tachycardia
*Predicted to increase due to increasing climate temperatures
###Sweating (especially when associated with exercise)
 
###N/V
===Etiology<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>===
###Headache
*Occurs via water depletion or sodium depletion or combination  
###Fatigue, weakness
*Water depletion occurs in elderly and persons working in hot environments
###Dizziness
*Salt depletion occurs when fluid losses are replaced with hypotonic solutions
###Syncope with prompt return of normal mental status
 
###Severe thirst
==Clinical Features<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>==
###Normal mental status or mild confusion that responds rapidly (w/in 30min) to cooling
[[File:PMC3040629 ehp-119-a81f1 2.png|thumb|Man with signs of heat exhaustion, including copious sweating.]]
###Signs of mild to moderate dehydration
Known heat exposure with temperature 37-40C with:
#Etiology
*[[Tachycardia]]
##Occurs via water depletion or sodium depletion (or combination of both)
*Sweating (especially when associated with exercise)
###Water depletion occurs in elderly and persons working in hit environments
*[[Nausea]] or [[vomiting]]
###Salt depletion occurs when fluid losses replaced w/ hypotonic solutions
*[[Headache]]
*[[Fatigue]], [[weakness]]
*[[Dizziness]]
*Orthostatic [[hypotension]] with ''normal'' mental status
*Mentation is normal (in contrast to [[heatstroke]])


==Differential Diagnosis==
==Differential Diagnosis==
{{Template:Heat Emergencies}}
{{Template:Heat Emergencies}}


==Treatment==
==Evaluation==
===Workup===
*Evidence of hemoconcentration
*May be [[hyponatremic]], isotonic or [[hypernatremic]]
**Depending on ratio of fluid and electrolyte loss to intake
 
===Diagnosis===
*Typically a clinical diagnosis
 
==Treatment<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>==
#Removal from heat-stressed environment
#Removal from heat-stressed environment
#Salt solution
#[[volume repletion|Volume]] and [[electrolyte repletion]]
##Oral or IV depending on severity
#*Oral versus IV depending on severity
#Active cooling  
#Aggressive cooling to 39C if patient does not respond to 30min of fluid replacement
##Consider dropping temp to 39 if pt does not respond to 30min of fluid replacement


==Disposition==
==Disposition<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>==
*Majority of pts can be discharged
*Majority of patients can be discharged
*Consider admision in pts w/ CHF or severe electrolyte disturbances
*Consider admission in patients with CHF or severe electrolyte disturbances
*If not treated properly, may evolve to [[Heat Stroke]]


==Complications==
==Complications==
#Heat stroke
*[[Rhabdomyolysis]]
#Heat cramps
#Rhabdomyolysis (rare)


==See Also==
==See Also==
Line 40: Line 51:
*[[Heat Emergencies]]
*[[Heat Emergencies]]


==Source==
==References==
Tintinalli
<references/>
 
[[Category:Environmental]]
 
[[Category:Environ]]

Latest revision as of 12:28, 29 May 2022

Background

Results from exposure to excessive heat or exposure to extreme temperature for prolonged period of time.

  • Can result from exposure to heat wave
  • Predicted to increase due to increasing climate temperatures

Etiology[1]

  • Occurs via water depletion or sodium depletion or combination
  • Water depletion occurs in elderly and persons working in hot environments
  • Salt depletion occurs when fluid losses are replaced with hypotonic solutions

Clinical Features[2]

Man with signs of heat exhaustion, including copious sweating.

Known heat exposure with temperature 37-40C with:

Differential Diagnosis

Environmental heat diagnoses

Evaluation

Workup

  • Evidence of hemoconcentration
  • May be hyponatremic, isotonic or hypernatremic
    • Depending on ratio of fluid and electrolyte loss to intake

Diagnosis

  • Typically a clinical diagnosis

Treatment[3]

  1. Removal from heat-stressed environment
  2. Volume and electrolyte repletion
    • Oral versus IV depending on severity
  3. Aggressive cooling to 39C if patient does not respond to 30min of fluid replacement

Disposition[4]

  • Majority of patients can be discharged
  • Consider admission in patients with CHF or severe electrolyte disturbances
  • If not treated properly, may evolve to Heat Stroke

Complications

See Also

References

  1. ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339
  2. ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339
  3. ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339
  4. ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339
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