Environmental heat diagnoses: Difference between revisions
| Line 15: | Line 15: | ||
==Clinical Features== | ==Clinical Features== | ||
===Heat Illness Types=== | ===Heat Illness Types=== | ||
#Heat cramps | #[[Heat cramps]] | ||
#*Muscles cramps due to electrolyte depletion | #*Muscles cramps due to electrolyte depletion | ||
#Heat syncope | #[[Heat syncope]] | ||
#*Prolonged standing +vasodilation + volume loss --> decreased central venous return --> decreased CO--> decreased cerebral profusion pressure | #*Prolonged standing +vasodilation + volume loss --> decreased central venous return --> decreased CO--> decreased cerebral profusion pressure | ||
#Heat exhaustion (temperature usually < 40°C) | #[[Heat exhaustion]] (temperature usually < 40°C) | ||
#*headache, n/v, weakness, vertigo, no CNS dysfunction | #*headache, n/v, weakness, vertigo, no CNS dysfunction | ||
#*Water depletion: inadequate fluid replacement to match fluid loss (sweat) | #*Water depletion: inadequate fluid replacement to match fluid loss (sweat) | ||
#*Salt depletion: large volume of fluid loss is replaced with water (with inadequate salt) | #*Salt depletion: large volume of fluid loss is replaced with water (with inadequate salt) | ||
#Heat stroke (temperature usually > 40°C) | #[[Heat stroke]] (temperature usually > 40°C) | ||
#*Similar to heat exhaustion plus CNS dysfunction (seizure, AMS), transaminitis, DIC, rhabdomyolysis | #*Similar to heat exhaustion plus CNS dysfunction (seizure, AMS), transaminitis, DIC, rhabdomyolysis | ||
Revision as of 17:29, 9 February 2017
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 (relient 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 profusion 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
Environmental heat diagnoses
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