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Heatstroke and Heat Injury

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

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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.

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Last updated: April 29, 2010


"Heatstroke and Heat Injury." Pocket ICU Management, PocketMedicine.com, Inc, 2010. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534090/all/Heatstroke_and_Heat_Injury.
Heatstroke and Heat Injury. Pocket ICU Management. PocketMedicine.com, Inc; 2010. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534090/all/Heatstroke_and_Heat_Injury. Accessed April 19, 2019.
Heatstroke and Heat Injury. (2010). In Pocket ICU Management. Available from https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534090/all/Heatstroke_and_Heat_Injury
Heatstroke and Heat Injury [Internet]. In: Pocket ICU Management. PocketMedicine.com, Inc; 2010. [cited 2019 April 19]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534090/all/Heatstroke_and_Heat_Injury.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Heatstroke and Heat Injury ID - 534090 Y1 - 2010/04/29/ BT - Pocket ICU Management UR - https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534090/all/Heatstroke_and_Heat_Injury PB - PocketMedicine.com, Inc DB - Anesthesia Central DP - Unbound Medicine ER -