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heat exhaustion
Epidemiology:
1) occurs most commonly in individuals:
a) poorly aclimatized to a hot environment
b) in poor physical condition
3) elderly, especially those taking diuretics are more prone to heat illness
Pathology:
1) increased body temperature
2) cardiac output increases
3) blood vessels in skin dilate
4) blood is shunted to periphery of body
Clinical manifestations:
1) manifestations common to all forms of heat injury
a) headache
b) weakness
c) nausea & vomiting
d) vertigo
e) faintness
f) tachycardia
g) hypotension
h) pallor
2) other manifestations
a) flu-like syndrome
b) anorexia
c) urge to defecate
d) copious sweating
e) normal or subnormal body temperature
f) cold, clammy skin
g) dilated pupils
Laboratory:
1) complete blood count
2) electrolytes
3) urinalysis
Special laboratory:
-> electrocardiogram
Differential diagnosis:
1) heat stroke (only core temperature can distinguish heat exhaustion from heat stroke)
2) sepsis
3) myocardial infarction
Management:
1) recumbent position
2) rest in cool environment
3) hypotonic fluid replacement
4) follow-up within 1 week
a) ensure complete recovery
b) work-up & management of pre-existing illnesses as indicated
5) patient education
a) acclimatize slowly to hotter, more humid environments
b) adequate hydration
Related
hyperthermia (pyrexia)
General
heat injury; heat stress; heat illness
References
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 1178-80
- Hyperthermia-Too Hot for Your Health
http://www.niapublications.org/engagepages/hyperther.asp