Fri, 11/02/2018 - 4:18pm
Signs and symptoms
- Altered mental status is a hallmark
- Usually temp > 104 F
- Labs almost always include hepatic dysfunction, can also include rhabdomyolysis or coagulopathies
- Two types of heat stroke:
- Classic (non-exertional): elderly patient with comorbidities, may have anhidrosis, high mortality
- Exertional: young athlete, severe dehydration, more systemic abnormalities
ManagementStart evaporative cooling and target 102 F to prevent overcorrecting
- Ice packs to groin and axilla, can consider GI cold water lavage
- Consider intubation due to aspiration risk
- Start benzodiazepines to prevent shivering
- No indication for anti-pyretics
And don’t forget to always keep a broad differential as discussed by Dr. Cafaro!
- Bouchama, Abderrezak & P Knochel, James. (2002). Heat Stroke. The New England journal of medicine. 346. 1978-88. 10.1056/NEJMra011089.
- Flavio G. Gaudio, Colin K. Grissom. (2016). Cooling Methods in Heat Stroke. The Journal of Emergency Medicine. Volume 50, Issue 4, 607-616. https://doi.org/10.1016/j.jemermed.2015.09.014.