Heat exhaustion: Difference between revisions

Revision as of 01:46, 26 August 2015

Background

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

Etiology

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

Diagnosis

Labs

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

Differential Diagnosis

Environmental heat diagnoses

Treatment

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

Majority of patients can be discharged
Consider admision in pts with CHF or severe electrolyte disturbances

Complications

Rhabdomyolysis

Source

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

Authors:

@@ Line 1: / Line 1: @@
 ==Background==
-#Definition
-##Known heat exposure + temp 37-40 + some combination of:
+Known heat exposure with temperature 37-40C with:
-###Tachycardia
+*Tachycardia
-###Sweating (especially when associated with exercise)
+*Sweating (especially when associated with exercise)
-###N/V
+*Nausea or vomiting
-###Headache
+*Headache
-###Fatigue, weakness
+*Fatigue, weakness
-###Dizziness
+*Dizziness
-###Syncope with prompt return of normal mental status
+*Orthostatic hypotension with normal mental status
-###Severe thirst
-###Normal mental status or mild confusion that responds rapidly (w/in 30min) to cooling
+Etiology
-###Signs of mild to moderate dehydration
+*Occurs via water depletion or sodium depletion or combination
-#Etiology
+*Water depletion occurs in elderly and persons working in hot environments
-##Occurs via water depletion or sodium depletion (or combination of both)
+*Salt depletion occurs when fluid losses are replaced with hypotonic solutions
-###Water depletion occurs in elderly and persons working in hit environments
+==Diagnosis==
-###Salt depletion occurs when fluid losses replaced w/ hypotonic solutions
+Labs
+*Evidence of hemoconcentration
+*May be hyponatremic, isotonic or hypernatremic
+**Depending on ratio of fluid and electrolyte loss to intake
 ==Differential Diagnosis==
@@ Line 21: / Line 24: @@
 ==Treatment==
-#Removal from heat-stressed environment
+*Removal from heat-stressed environment
-#Salt solution
+*Volume and electrolyte replacement
-##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==
-*Majority of pts can be discharged
+*Majority of patients can be discharged
-*Consider admision in pts w/ CHF or severe electrolyte disturbances
+*Consider admision in pts with CHF or severe electrolyte disturbances
 ==Complications==
-#Heat stroke
+[[Rhabdomyolysis]]
-#Heat cramps
-#Rhabdomyolysis (rare)
 ==See Also==
@@ Line 41: / Line 41: @@
 ==Source==
-Tintinalli
+Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339
 [[Category:Environ]]