Heat stroke is an emergent and life-threatening form of heat illness. According to "Sheehy's Emergency Nursing Principles and Practice," mortality as high as 70 percent is directly related to the speed and effectiveness of diagnosis and treatment. During heat stroke, the body's physiologic systems fail to dissipate heat and cool down.
Identification
As noted in "Sheehy's Emergency Nursing Principles and Practice," heat stroke is characterized by an elevated core body temperature of 104 degree Fahrenheit or greater. Heat stroke is the least common of the heat related illnesses, but it is the most serious.
History
Heat stroke can occur from prolonged exposure to high ambient temperatures and humidity or from exertional heat stroke. Older patients, the chronically ill, and those who live in poorly ventilated homes without air conditioning are at risk for heat stroke from sustained high ambient temperatures. Children locked in cars on hot days are also at a high risk because of poor dissipation of environmental heat. Exertional heat stroke is more common in young, healthy athletes or recruits. In these individuals the heat production overcomes the internal dissipation mechanisms.
Symptoms
Heat stroke generally occurs suddenly. Early symptoms may include headache, dizziness, nausea and visual disturbances. The skin is hot, flushed and usually dry. Patients will become anxious, confused and may have hallucinations. As heat stroke progresses, loss of muscle coordination, combativeness and coma will follow if medical treatment is not provided.
Treatment
Treatment for heat stroke is aimed at reducing the core body temperature as rapidly as possible. Patients should be removed from the heat source and have clothing removed to start the cooling process. Padded ice packs may be placed on the armpits, neck and groin areas to help cool body temperature. Aggressive cold water cooling is not recommended as it may lead to seizures. Heat stroke patients require medical attention. In heat stroke the underlying cause is the dysfunction of the heat-regulating mechanism. It is not caused by a primary sodium loss, therefore replacing sodium, or salt will not fix the problem.
Outcome
Patients with heat stroke are hospitalized and monitored for other complications which may include clotting disorders, kidney failure, cardiac abnormalities and coma. According to "Current Diagnosis and Treatment Emergency Medicine," with early diagnosis and treatment, 80 to 90 percent of previously healthy patients should survive.
References
- "Sheeny's Emergency Nursing Principles and Practice"; Mosby Elsevier; 2010
- "Current Diagnosis and Treatment Emergency Medicine"; McGraw Hill; 2008
