Fast Five Quiz: Are You Familiar With Key Elements Regarding Heat Stroke?

Richard H. Sinert, DO

Disclosures

August 02, 2017

Risk factors that increase the likelihood of heat-related illnesses include a preceding viral infection, dehydration, fatigue, obesity, lack of sleep, poor physical fitness, and lack of acclimatization.

Heat stroke is defined as hyperthermia exceeding 106°F associated with an altered sensorium. However, when a patient is allowed to cool down before measurement of the temperature (as may occur during transportation in a cool ambulance or evaluation in an emergency department), the measured temperature may be lower than 106°F, making the temperature criterion relative. Anhidrosis, or lack of sweating, has been cited as a feature of heat stroke, but some patients with heat stroke present with profuse sweating. Because of variable presentations, a high index of suspicion is needed to avoid delays in diagnosis and treatment.

Although lack of acclimatization is a risk factor for heat stroke, EHS also can occur in acclimatized individuals who are subjected to moderately intense exercise. EHS also may occur because of increased motor activity due to drug use, such as cocaine and amphetamines, and as a complication of status epilepticus.

Patients with NEHS may initially exhibit a hyperdynamic circulatory state, but in severe cases, hypodynamic states may be noted.

For more on the presentation of heat stroke, read here.

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