Environmental heat diagnoses: Difference between revisions
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==Background== | |||
*Heat related illnesses includes a wide range diagnoses from benign [[heat rash]] to [[heat stroke]]. | |||
===Types of heat dissipation=== | |||
*Conduction: heat exchange between two surfaces in contact (placing ice pack in axilla) | |||
*Convection: heat exchange between a surface and a fluid (fanning) | |||
*Radiation: transfer of heat between body and environment through electromagnetic waves (reliant on temperature gradient) | |||
===Heat Illness Etiology=== | |||
''All types are due to inadequate thermoregulation'' | |||
#Classic Heat Illness | |||
#*Occurs without physical exertion | |||
#Exertional | |||
#*Preceded by physical activity | |||
==Clinical Features== | |||
===Heat Illness Types=== | |||
#[[Heat cramps]] | |||
#*Muscles cramps due to electrolyte depletion | |||
#[[Heat syncope]] | |||
#*Prolonged standing +vasodilation + volume loss → decreased central venous return → decreased CO→ decreased cerebral perfusion pressure | |||
#[[Heat exhaustion]] (temperature usually < 40°C) | |||
#*headache, n/v, weakness, vertigo, no CNS dysfunction | |||
#*Water depletion: inadequate fluid replacement to match fluid loss (sweat) | |||
#*Salt depletion: large volume of fluid loss is replaced with water (with inadequate salt) | |||
#[[Heat stroke]] (temperature usually > 40°C) | |||
#*Similar to heat exhaustion plus CNS dysfunction (seizure, AMS), transaminitis, DIC, rhabdomyolysis | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
''See also [[hyperthermia]]'' | |||
{{Template:Heat Emergencies}} | {{Template:Heat Emergencies}} | ||
==Evaluation== | |||
*Clinical diagnosis | |||
*Evaluate for alternate etiologies of [[hyperthermia]] if no clear exposure | |||
==Management== | |||
#[[Heat cramps]] | |||
#*Mild: oral electrolyte solution | |||
#*Severe: IV NSS | |||
#[[Heat syncope]] | |||
#*Supine position | |||
#[[Heat exhaustion]] | |||
#*Mild: oral fluid replacement | |||
#*Severe: IV fluid replacement and replete electrolytes as needed | |||
#[[Heat stroke]] | |||
#*ABCs | |||
#*Rapid cooling | |||
#*IVF, replete electrolytes | |||
#*Benzos: for seizures and shivering | |||
==Disposition== | |||
*[[Heat stroke]] requires admission | |||
*Other conditions can be discharged after improvement with treatment | |||
==See Also== | ==See Also== | ||
*[[Hyperthermia]] | |||
*[[Celsius Fahrenheit Temperature Conversion]] | *[[Celsius Fahrenheit Temperature Conversion]] | ||
[[Category: | ==References== | ||
<references/> | |||
[[Category:Environmental]] |
Revision as of 02:14, 9 February 2021
Background
- Heat related illnesses includes a wide range diagnoses from benign heat rash to heat stroke.
Types of heat dissipation
- Conduction: heat exchange between two surfaces in contact (placing ice pack in axilla)
- Convection: heat exchange between a surface and a fluid (fanning)
- Radiation: transfer of heat between body and environment through electromagnetic waves (reliant on temperature gradient)
Heat Illness Etiology
All types are due to inadequate thermoregulation
- Classic Heat Illness
- Occurs without physical exertion
- Exertional
- Preceded by physical activity
Clinical Features
Heat Illness Types
- Heat cramps
- Muscles cramps due to electrolyte depletion
- Heat syncope
- Prolonged standing +vasodilation + volume loss → decreased central venous return → decreased CO→ decreased cerebral perfusion pressure
- Heat exhaustion (temperature usually < 40°C)
- headache, n/v, weakness, vertigo, no CNS dysfunction
- Water depletion: inadequate fluid replacement to match fluid loss (sweat)
- Salt depletion: large volume of fluid loss is replaced with water (with inadequate salt)
- Heat stroke (temperature usually > 40°C)
- Similar to heat exhaustion plus CNS dysfunction (seizure, AMS), transaminitis, DIC, rhabdomyolysis
Differential Diagnosis
See also hyperthermia
Environmental heat diagnoses
Evaluation
- Clinical diagnosis
- Evaluate for alternate etiologies of hyperthermia if no clear exposure
Management
- Heat cramps
- Mild: oral electrolyte solution
- Severe: IV NSS
- Heat syncope
- Supine position
- Heat exhaustion
- Mild: oral fluid replacement
- Severe: IV fluid replacement and replete electrolytes as needed
- Heat stroke
- ABCs
- Rapid cooling
- IVF, replete electrolytes
- Benzos: for seizures and shivering
Disposition
- Heat stroke requires admission
- Other conditions can be discharged after improvement with treatment