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Heat Stroke - May 2013

HEAT STROKE
 
Heat stroke is the most serious form of heat injury and is a medical emergency. If you suspect that someone has heat stroke -- also known as sunstroke.
Heat stroke can kill or cause damage to the brain and other internal organs.
Heat stroke often occurs as a progression from milder heat-related illnesses such as heat cramps, heat syncope (fainting), and heat exhaustion.
Heat stroke 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 heat stroke is a core body temperature greater than 105 degrees Fahrenheit, with complications involving the central nervous system that occur after exposure to high temperatures.
 
SYMPTOMS
 
The hallmark symptom of heat stroke is a core body temperature above 105 degrees Fahrenheit. 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
·         Behavioral changes such as confusion, disorientation, or staggering
·         Seizures
·         Unconsciousness
 
FIRST AID
If you suspect that someone has a heat stroke, transport the person to a hospital. Any delay 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 101 to 102 degrees Fahrenheit. 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.
 
 
RISK FACTORS
 
Heat stroke is most likely to affect older people who live in apartments or homes lacking air-conditioning or good airflow. Other high-risk groups include people of any age who don't drink enough water, have chronic diseases, or who drink excessive amounts of alcohol.
 
Other risk factors associated with heat-related illness include:
Age: Infants and children up to age 4, and adults over age 65, are particularly vulnerable because they adjust to heat more slowly than other people.
Health conditions: These include heart, lung, or kidney disease, obesity or underweight, 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, tranquilizers, 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 heat stroke.
 
 
PREVENTION
When the heat index is high, it's best to stay in an air-conditioned environment. If you must go outdoors, you can prevent heat stroke by taking these steps:
·         Wear lightweight, light-colored, 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
·         Take additional precautions when exercising or working outdoors.
·         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 heat stroke include:
·         Monitoring the color of your urine. Darker urine is a sign of dehydration. Be sure to drink enough fluids to maintain very light-colored 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, because both substances can make you lose more fluids and worsen heat-related illness.
The easiest and safest way to replace salt and other electrolytes during heat waves is to drink sports beverages 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.
 
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