Heat exhaustion: Difference between revisions
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==Background== | ==Background== | ||
===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 | |||
==Clinical Features<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>== | |||
Known heat exposure with temperature 37-40C with: | Known heat exposure with temperature 37-40C with: | ||
*Tachycardia | *Tachycardia | ||
*Sweating (especially when associated with exercise) | *Sweating (especially when associated with exercise) | ||
*Nausea or vomiting | *[[Nausea]] or [[vomiting]] | ||
*Headache | *[[Headache]] | ||
*Fatigue, weakness | *Fatigue, weakness | ||
*Dizziness | *Dizziness | ||
*Orthostatic hypotension with normal mental status | *Orthostatic hypotension with normal mental status | ||
==Differential Diagnosis== | |||
{{Template:Heat Emergencies}} | |||
==Diagnosis== | ==Diagnosis== | ||
Labs | Labs | ||
*Evidence of hemoconcentration | *Evidence of hemoconcentration | ||
*May be hyponatremic, isotonic or hypernatremic | *May be [[hyponatremic]], isotonic or [[hypernatremic]] | ||
**Depending on ratio of fluid and electrolyte loss to intake | **Depending on ratio of fluid and electrolyte loss to intake | ||
== | ==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 and electrolyte replacement | |||
#*Oral versus IV depending on severity | |||
#Aggressive cooling to 39C if patient 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 patients can be discharged | *Majority of patients can be discharged | ||
*Consider admision in | *Consider admision in patients with CHF or severe electrolyte disturbances | ||
==Complications== | ==Complications== | ||
[[Rhabdomyolysis]] | *[[Rhabdomyolysis]] | ||
==See Also== | ==See Also== | ||
| Line 40: | Line 41: | ||
*[[Heat Emergencies]] | *[[Heat Emergencies]] | ||
== | ==References== | ||
[[Category:Environ]] | [[Category:Environ]] | ||
Revision as of 12:12, 26 August 2015
Background
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]
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
Differential Diagnosis
Environmental heat diagnoses
Diagnosis
Labs
- Evidence of hemoconcentration
- May be hyponatremic, isotonic or hypernatremic
- Depending on ratio of fluid and electrolyte loss to intake
Treatment[3]
- Removal from heat-stressed environment
- Volume and electrolyte replacement
- Oral versus IV depending on severity
- Aggressive cooling to 39C if patient does not respond to 30min of fluid replacement
Disposition[4]
- Majority of patients can be discharged
- Consider admision in patients with CHF or severe electrolyte disturbances
Complications
See Also
References
- ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339
- ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339
- ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339
- ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339