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Heat stroke

"Heatstroke" and "heatstrokes" redirect here. For other uses, see Heatstroke (disambiguation).
"Sunstroke" redirects here. For other uses, see Sunstroke (disambiguation).
Not to be confused with Heat intolerance.

Heat stroke
Other namesSun-stroke, siriasis[1]
Person being cooled with water spray, one of the treatments of heat stroke, in Iraq in 1943
SpecialtyEmergency medicine
SymptomsHigh body temperature, red, dry or damp skin, headache, dizziness, confusion, nausea[2]
ComplicationsSeizures, rhabdomyolysis, kidney failure[3]
TypesClassic, exertional[3]
CausesHigh external temperatures, physical exertion[3][4]
Risk factorsExtremes of age, heat waves, high humidity, certain drugs, heart disease, skin disorders[3]
Diagnostic methodBased on symptoms[3]
Differential diagnosisNeuroleptic malignant syndrome, malaria, meningitis[3]
TreatmentRapid cooling, supportive care[4]
PrognosisRisk of death <5% (exercise induced), up to 65% (non-exercise induced)[3]
Deaths> 600 per year (US)[4]

Heat stroke or heatstroke, also known as sun-stroke, is a severe heat illness that results in a body temperature greater than 40.0 °C (104.0 °F),[4] along with red skin, headache, dizziness, and confusion.[2] Sweating is generally present in exertional heatstroke, but not in classic heatstroke.[5] The start of heat stroke can be sudden or gradual.[3] Heatstroke is a life-threatening condition due to the potential for multi-organ dysfunction,[6] with typical complications including seizures, rhabdomyolysis, or kidney failure.[3]

Heat stroke occurs because of high external temperatures and/or physical exertion.[3][4] It usually occurs under preventable prolonged exposure to extreme environmental or exertional heat.[6] However, certain health conditions can increase the risk of heat stroke, and patients, especially children, with certain genetic predispositions are vulnerable to heatstroke under relatively mild conditions.[7]

Preventive measures include drinking sufficient fluids and avoiding excessive heat.[8] Treatment is by rapid physical cooling of the body and supportive care.[4] Recommended methods include spraying the person with water and using a fan, putting the person in ice water, or giving cold intravenous fluids.[4] Adding ice packs around a person is reasonable but does not by itself achieve the fastest possible cooling.[4]

Heat stroke results in more than 600 deaths a year in the United States.[4] Rates increased between 1995 and 2015.[3] Purely exercise-induced heat stroke, though a medical emergency, tends to be self-limiting (the patient stops exercising from cramp or exhaustion) and fewer than 5% of cases are fatal. Non-exertional heatstroke is a much greater danger: even the healthiest person, if left in a heatstroke-inducing environment without medical attention, will continue to deteriorate to the point of death, and 65% of the most severe cases are fatal even with treatment.[3]

  1. ^ Herrick RT (April 1986). "Heat illness in the athlete: siriasis is serious". Alabama Medicine. 55 (10): 28, 33–28, 37. PMID 3706086.
  2. ^ a b "Warning Signs and Symptoms of Heat-Related Illness". www.cdc.gov. Archived from the original on July 13, 2017. Retrieved July 17, 2017.
  3. ^ a b c d e f g h i j k l Leon LR, Bouchama A (April 2015). "Heat stroke". Comprehensive Physiology. 5 (2): 611–647. doi:10.1002/cphy.c140017. ISBN 9780470650714. PMID 25880507.
  4. ^ a b c d e f g h i Gaudio FG, Grissom CK (April 2016). "Cooling Methods in Heat Stroke". The Journal of Emergency Medicine. 50 (4): 607–616. doi:10.1016/j.jemermed.2015.09.014. PMID 26525947.
  5. ^ Cite error: The named reference NEJM2019 was invoked but never defined (see the help page).
  6. ^ a b Bouchama A, Knochel JP (June 2002). "Heat stroke". The New England Journal of Medicine. 346 (25): 1978–1988. doi:10.1056/nejmra011089. PMID 12075060.
  7. ^ Wang HJ, Lee CS, Yee RS, Groom L, Friedman I, Babcock L, et al. (October 2020). "Adaptive thermogenesis enhances the life-threatening response to heat in mice with an Ryr1 mutation". Nature Communications. 11 (1): 5099. Bibcode:2020NatCo..11.5099W. doi:10.1038/s41467-020-18865-z. PMC 7547078. PMID 33037202.
  8. ^ "Tips for Preventing Heat-Related Illness|Extreme Heat". www.cdc.gov. June 19, 2017. Archived from the original on July 29, 2017. Retrieved July 17, 2017.

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