Heat Stroke

Heat stroke is a medical emergency. Understand the difference between heat exhaustion and heat stroke and you can save a life. This is not uncommon and every year we hear of deaths on the football field in August from players over heating during practice. Increase fluids and be aware of the symptoms.

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Exposure to hight temperatures over time with decreased cooling and inadequate heat loss will lead to heat stroke. This can be viewed as the end stage of heat exhaustion. This diagnosis is a high medical emergency with mortality and morbidity reaching as high as eighty percent. In the outdoors and if far from medical care the outcome is poor and iffy.

Heat stroke can be an abrupt onset. The importance of hydration and monitoring ones symptoms on the trail are extremely important.

Heat Stroke Symptoms

  1. Headache and fatigue
  2. Skin is very dry and hot temp can reach 105 F
  3. Sweating is often absent
  4. Pulse rapid and thready
  5. Disoriented and confused
  6. Neurological signs and symptoms and brain damage is not uncommon

Heat Stroke Treatment

Treatment in the outdoors will be very limited as the items needed will most likely not be available hence the importance of immediate transport. Transport in an ideal situation would be for the patient not to walk and have some type of makeshift gurney or sled.

Treatment should be rapid cooling with ice or cool water immediately as well as fanning to accelerate cooling. IF THE PATIENT BEGINS TO SHIVER STOP FANNING AND COOLING FOR TEN MINUTES OR UNTIL SHIVERING STOPS. Shivering will increase core body temperature. If possible temperature should be taken every ten minutes. Again probably impossible in the outdoors.

In the Urgent care or Emergency Department cooled IV fluids, Ice packs, IV Valium to reduce seizures and a multitude of labs. Many athletes and young high school football players can be misdiagnosed as they may be brought in early and are still sweating. Assume the worse diagnosis and one can always back off on the cooling as they improve.