Heat exhaustion: Difference between revisions
 
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==Definition==
==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<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>===
*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


Acute heat-related injury due to volume depletion; Temp can be low, high or normal (>37 but  <40)
==Clinical Features<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>==
[[File:PMC3040629 ehp-119-a81f1 2.png|thumb|Man with signs of heat exhaustion, including copious sweating.]]
Known heat exposure with temperature 37-40C with:
*[[Tachycardia]]
*Sweating (especially when associated with exercise)
*[[Nausea]] or [[vomiting]]
*[[Headache]]
*[[Fatigue]], [[weakness]]
*[[Dizziness]]
*Orthostatic [[hypotension]] with ''normal'' mental status
*Mentation is normal (in contrast to [[heatstroke]])


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


==Risk Factors==
==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


Underlying factors (poor fluid intake, hot environment, inappropriate clothing)
==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
#[[volume repletion|Volume]] and [[electrolyte repletion]]
#*Oral versus IV depending on severity
#Aggressive cooling to 39C if patient does not respond to 30min of fluid replacement


Underlying illness (endocrine disorders, cardiac disease, burns)
==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 patients can be discharged
*Consider admission in patients with CHF or severe electrolyte disturbances
*If not treated properly, may evolve to [[Heat Stroke]]


Poorly adaptive thermoregulatory mechanisms
==Complications==
 
*[[Rhabdomyolysis]]
Medication use (anticholinergics, B-blockers, alcohol, diuretics)
 
 
==Symptoms==
 
 
Thirst, cephalgia, dizziness, weakness, n/v, myalgia, anxiety
 
 
==Treatment==
 
 
Volume replacement
 
Balanced salt solutions
 


==See Also==
==See Also==
*[[Heat Stroke]]
*[[Heat Emergencies]]


 
==References==
Environ: [[Heat StrokE]]
<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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