Heatstroke and Heat Injury

Heatstroke and Heat Injury is a topic covered in the Pocket ICU Management.

To view the entire topic, please or purchase a subscription.

Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drug, procedures and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and MEDLINE Journals. Explore these free sample topics:

Anesthesia Central

-- The first section of this topic is shown below --

First Things First (assess & treat for the following)

  • For malignant hyperthermia, emergently administer dantrolene sodium 2 mg/kg IV, repeated q5min, up to 10 mg/kg total dose.
  • Definitions
    • Exertional heatstroke: seen in relatively healthy individuals who overexert themselves during times of high ambient temperature and humidity (endogenous heat generation exceeds heat dissipation)
    • Non-exertional heatstroke: seen in elderly or ill individuals w/ impaired thermoregulation during times of higher-than-normal ambient temperatures
    • Iatrogenic: drug-induced neuroleptic malignant syndrome (NMS) or malignant hyperthermia (MH)
    • Acclimatization: the physiologic process of adaptation over time to work in a hot environment (increased sweat production, decreased sweat sodium concentration, increased aldosterone secretion, increased cardiac output, decreased heart rate)
  • Morbidity & mortality are most directly determined by the duration of hyperpyrexia, followed by the extent of temp elevation.
    • Rapid identification & treatment of heatstroke is crucial to survival.
    • In elderly & ill, central thermoregulation is commonly impaired & the diagnosis can be overlooked or mistaken for other etiologies.
  • Dehydration is not a universal finding, especially in non-exertional heatstroke victims; IV fluid resuscitation must be individualized according to pt volume status.
  • Cooling can be adequately accomplished by placing pt in an air-conditioned room, applying ice packs, giving tepid water sponge baths & directing fans across the pt.
  • Don’t forget the ABCs! Pts are often obtunded. Ensure airway protection to prevent aspiration as well as ventilation & oxygenation.
  • In an urban setting, cocaine intoxication is one of the most common causes of heatstroke.

-- To view the remaining sections of this topic, please or purchase a subscription --

Last updated: April 29, 2010