Updated: 9/9/2020

Heat Illness and Stroke

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Heat Cramps
  • Definition
    • painful contractions of large muscle groups because of decreased hydration and a decrease of serum sodium and chloride.
    • cramps can also occur secondary to increased water intake leading to dilutional hyponatremia
  • Treatment
    • rapid cooling
    • stretching
    • electrolyte and fluid replacement
Heat Syncope
  • Definition
    • transient loss of consciousness with peripheral vasodilation and decreased cardiac output with normal body temperature.
  • Pathophysiology
    • results from sever orthostatic event secondary to elevated temperatures
  • Treatment
    • fluid replacement
    • lying supine with leg elevation
Heat Exhaustion
  • Definition
    • defined as a core temperature of less than 102.2 degrees F (39 degrees C) and an absence of central nervous system dysfunction.
  • Epidemiology
    • the most common heat-induced condition
  • Pathophysiology
    • hypernatremic heat exhaustion results from inadequate water replacement.
  • Symptoms
    • consist of profuse sweating and nausea/vomiting
  • Treatment
    • table salts
    • IV hydration
    • cooling
Heat Illness
  • Treatment
    • drink fluids
    • low osmolarity solution (<10%)
    • carbs and stimulate GI fluid absorption
  • Monitor weight
  • 5% loss - not able to return to play
  • 7% loss - see physician
Heat Stroke  
  • Introduction
    • a medical emergency with a high death rate that results from failure of the thermoregulatory mechanisms of the body 
  • Definition  
    • hyperthermia
    • tachycardia/tachypnea
    • central nervous system dysfunction 
    • cessation of sweating with hot, dry skin
    • anhidrosis 
    • Body temperature above 40.5 degrees Celsius
  • Epidemiology
    • second most common cause of death in football players
  • Treatment
    • rapid reduction in body core temperature
      • lower temp below 39°C (102° F) with
      • ice immersion
      • cooling blanket
      • fanning
      • internal cooling if needed
      • IV hydration
  • Complications
    • heat sensitivity
      • may last 1 year
 

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Questions (6)
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(OBQ13.205) A 26-year-old football player develops tachycardia and hot, dry skin during a game. He is found to have a temperature of 41 degrees C, but is not sweating. Further examination reveals the player is not oriented to time or place, and he soon develops convulsions. Which of the following is the most important next step in treatment? Tested Concept

QID: 4840
1

Aggressive administration of IV fluids

15%

(788/5117)

2

Administer acetaminophen

1%

(27/5117)

3

Lay him supine with leg elevation

2%

(92/5117)

4

Rapid cooling with ice immersion

82%

(4177/5117)

5

Administration of IV antibiotics

0%

(13/5117)

L 2 B

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(SAE07SM.73) A 20-year-old soccer player who collapsed after a goal kick reports weakness and nausea. He appears slightly confused. Examination reveals that he is not sweating. His skin is warm and dry. The outdoor temperature is 80 degrees F (26.6 degrees C) with a relative humidity of 80%. Management should consist of Tested Concept

QID: 8735
1

a drink of water.

3%

(9/314)

2

a sports drink with electrolytes.

13%

(41/314)

3

placement in the reverse Trendelenburg position in a shaded area.

8%

(24/314)

4

immersion in a warm water bath.

1%

(4/314)

5

transportation to the emergency department.

75%

(234/314)

L 1 E

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(SAE07SM.43) Which of the following best describes heat stroke? Tested Concept

QID: 8705
1

Transient loss of consciousness with peripheral vasodilation and decreased cardiac output with normal body temperature

3%

(13/495)

2

A condition involving painful contractions of large muscle groups because of decreased hydration and a decrease of serum sodium and chloride

2%

(9/495)

3

Hypernatremia in poorly conditioned athletes, manifested by thirst and oliguria with a core temperature of less than 102.2 degrees F (39 degrees C)

1%

(7/495)

4

Hyperthermia, central nervous system dysfunction, and loss of thermoregulatory function

94%

(463/495)

5

A transient condition that responds to glucose administration

0%

(1/495)

L 1 E

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(SBQ07SM.43) Which of the following conditions are characterized by hyperthermia, central nervous system dysfunction, and loss of thermo-regulatory function? Tested Concept

QID: 1428
1

Heat syncope

1%

(12/1555)

2

Heat cramps

0%

(7/1555)

3

Heat exhaustion

1%

(19/1555)

4

Heat stroke

90%

(1401/1555)

5

Heat shock

7%

(111/1555)

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