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:Environ]]
==References==
<references/>
[[Category:Environmental]]

Revision as of 02:14, 9 February 2021

Background

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

  1. Classic Heat Illness
    • Occurs without physical exertion
  2. Exertional
    • Preceded by physical activity

Clinical Features

Heat Illness Types

  1. Heat cramps
    • Muscles cramps due to electrolyte depletion
  2. Heat syncope
    • Prolonged standing +vasodilation + volume loss → decreased central venous return → decreased CO→ decreased cerebral perfusion pressure
  3. 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)
  4. 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

  1. Heat cramps
    • Mild: oral electrolyte solution
    • Severe: IV NSS
  2. Heat syncope
    • Supine position
  3. Heat exhaustion
    • Mild: oral fluid replacement
    • Severe: IV fluid replacement and replete electrolytes as needed
  4. 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

References