Heat exhaustion: Difference between revisions
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==Background== | ==Background== | ||
Results from exposure to excessive heat or exposure to extreme temperature for prolonged period of time. | |||
*Can result from exposure to [[heat wave]] | |||
*Predicted to increase due to increasing climate temperatures | |||
===Etiology<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>=== | ===Etiology<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>=== | ||
*Occurs via water depletion or sodium depletion or combination | *Occurs via water depletion or sodium depletion or combination | ||
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==Clinical Features<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>== | ==Clinical Features<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>== | ||
[[File:PMC3040629 ehp-119-a81f1 2.png|thumb|Man with signs of heat exhaustion, including copious sweating.]] | |||
Known heat exposure with temperature 37-40C with: | Known heat exposure with temperature 37-40C with: | ||
*Tachycardia | *[[Tachycardia]] | ||
*Sweating (especially when associated with exercise) | *Sweating (especially when associated with exercise) | ||
*[[Nausea]] or [[vomiting]] | *[[Nausea]] or [[vomiting]] | ||
*[[Headache]] | *[[Headache]] | ||
*Fatigue, weakness | *[[Fatigue]], [[weakness]] | ||
*Dizziness | *[[Dizziness]] | ||
*Orthostatic hypotension with normal mental status | *Orthostatic [[hypotension]] with ''normal'' mental status | ||
*Mentation is normal (in contrast to [[ | *Mentation is normal (in contrast to [[heatstroke]]) | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Evaluation== | ==Evaluation== | ||
===Workup=== | |||
*Evidence of hemoconcentration | *Evidence of hemoconcentration | ||
*May be [[hyponatremic]], isotonic or [[hypernatremic]] | *May be [[hyponatremic]], isotonic or [[hypernatremic]] | ||
**Depending on ratio of fluid and electrolyte loss to intake | **Depending on ratio of fluid and electrolyte loss to intake | ||
===Diagnosis=== | |||
*Typically a clinical diagnosis | |||
==Treatment<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>== | ==Treatment<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>== | ||
#Removal from heat-stressed environment | #Removal from heat-stressed environment | ||
#Volume and electrolyte | #[[volume repletion|Volume]] and [[electrolyte repletion]] | ||
#*Oral versus IV depending on severity | #*Oral versus IV depending on severity | ||
#Aggressive cooling to 39C if patient does not respond to 30min of fluid replacement | #Aggressive cooling to 39C if patient does not respond to 30min of fluid replacement | ||
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==Disposition<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>== | ==Disposition<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>== | ||
*Majority of patients can be discharged | *Majority of patients can be discharged | ||
*Consider | *Consider admission in patients with CHF or severe electrolyte disturbances | ||
*If not treated properly, may evolve to [[Heat Stroke]] | |||
==Complications== | ==Complications== | ||
Latest revision as of 12:28, 29 May 2022
Background
Results from exposure to excessive heat or exposure to extreme temperature for prolonged period of time.
- Can result from exposure to heat wave
- Predicted to increase due to increasing climate temperatures
Etiology[1]
- Occurs via water depletion or sodium depletion or combination
- Water depletion occurs in elderly and persons working in hot environments
- Salt depletion occurs when fluid losses are replaced with hypotonic solutions
Clinical Features[2]
Known heat exposure with temperature 37-40C with:
- Tachycardia
- Sweating (especially when associated with exercise)
- Nausea or vomiting
- Headache
- Fatigue, weakness
- Dizziness
- Orthostatic hypotension with normal mental status
- Mentation is normal (in contrast to heatstroke)
Differential Diagnosis
Environmental heat diagnoses
Evaluation
Workup
- Evidence of hemoconcentration
- May be hyponatremic, isotonic or hypernatremic
- Depending on ratio of fluid and electrolyte loss to intake
Diagnosis
- Typically a clinical diagnosis
Treatment[3]
- Removal from heat-stressed environment
- Volume and electrolyte repletion
- Oral versus IV depending on severity
- Aggressive cooling to 39C if patient does not respond to 30min of fluid replacement
Disposition[4]
- Majority of patients can be discharged
- Consider admission in patients with CHF or severe electrolyte disturbances
- If not treated properly, may evolve to Heat Stroke
Complications
See Also
References
- ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339
- ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339
- ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339
- ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339