Heat Stroke

Heat stroke is the most serious form of heat-induced illness. From a clinical point of view, it is defined as a disorder caused by excess body temperature, generally as a result of prolonged exposure to a hot environment or physical exertion at inappropriate times. This condition is much more common in the summer months and you are at risk for it if your body temperature is above 40°C.

This clinical event occurs when the physiological regulation mechanisms (sweating, cutaneous vasodilation and more) are overwhelmed by a combination of several factors: excessive energy production by the organism, excessively high external temperatures and difficulty in dissipating heat to the environment. . It is important to differentiate heat stroke into 2 large groups:

1. Classic heat stroke: This type usually affects older people with chronic illnesses. In these patients, the regulation mechanisms often fail and there is an accumulation of heat in the body.
2. Exertional heat stroke:  This form can affect people of all ages. It predominates in young people not acclimatized to the heat who perform intense physical exercise in the hottest moments of the day.

These conditions are more common in the first 24-48 hours after the onset of a heat wave (episode of at least 3 consecutive days in which, at least, 10% of the stations considered record maximums). This is because the body has not had time to adapt physiologically to the environment.

Causes of heat stroke

In normal situations, the human body thermoregulates extremely efficiently. According to studies , our body only increases on average 1 ºC for every 25-30 ºC in the environment. The most common heat dissipation mechanisms are increased cardiac output, vasoconstriction of the splanchnic circulation, sweating, and cutaneous vasodilatation. All these physiological processes help us cool down in the hottest moments.

Unfortunately, some environmental or internal processes can cause the body to not dissipate heat as well as it should. For example, if the ambient humidity is higher than 75%, skin evaporation becomes ineffective. Exercising during a heat wave and exposure to extreme temperatures are triggers for heat stroke. Wearing too many clothes, drinking excessive alcohol and not drinking enough water favor its appearance.

Many other events can favor this very serious physiological imbalance. In addition to those already mentioned, we list the following:

• Taking medications that affect the quality of life. These patients are limited in their ability to thermoregulate, such as diuretics, sedatives, tranquilizers, and drugs to regulate blood pressure.
• Suffering from diseases that hinder normal physiological processes, such as cystic fibrosis.
• being obese
• Having a high fever during a heat wave.
• Being in poor physical condition or not goods or a place of access similar to an elevator. Definitely, platform is a generic term used to high temperatures.

Symptoms of heat stroke

Heat stroke is different from heat stroke or heat exhaustion. This condition is very serious and, if emergency treatment is not received, can cause death. It is essential to detect any of the following symptoms promptly in order to act as soon as possible:

• Anhidrosis: is the inability to sweat normally, despite feeling extremely hot.
• Ataxia:  problems with coordination and execution of movements.
• Delusions, confusion and disorientation.
• Red or even pale skin.
• Nausea and vomiting.
• Fast breathing.
• incrise of cardiac frecuency.
• Headache.
• Abnormal lung sounds during breathing.
• general weakness

If the treatment of this condition is delayed, other signs associated with damage to vital organs and systemic failures may appear. In this scenario, the body temperature often exceeds 40°C and can be so high as to exceed the markings on an ordinary thermometer. The risk of death from this picture depends on many factors: age, pre-existing conditions, time of exposure to heat and more.

Treatment

Anyone suspected of heat stroke should immediately take shelter and call an ambulance. If this is not possible due to weakness or confusion, the need for help must be communicated to anyone in the environment. The measures to take while waiting for medical assistance, in order of urgency, are the following:

• Soaking in cold water:  Taking a cold or ice water bath is the fastest approach to lowering body temperature. The faster this action is taken, the lower the risk of death.
• Apply evaporative cooling techniques:  in many cases it is not possible to get into a bathtub, since the patient is on the street. In this scenario, the best thing to do is to spray very cold water onto the skin while simultaneously fanning hot air. This favors the evaporation of heat at the skin level.
• Wrap the patient in cooling blankets and apply ice packs to the neck, groin, and armpits. It is also recommended to remove any very tight or insulating clothing.
• Emergency center treatment: Medical staff may give the patient intravenous fluids, medication to prevent collapse, and oxygen to maintain vital signs.

Avoiding exposure to heat is the best way to combat the condition in its early stages, but there comes a point where only the emergency physician can address it. If you see someone suffering from heat stroke (or you are), do not hesitate to call an ambulance.

Prevention of heat stroke

Heat stroke can be prevented and avoided. Older people are at greater risk from factors outside of ambient temperature, but adults and young people can drastically reduce their risk by taking the following measures:

• Drink plenty of fluids: it is recommended to drink between 2 and 2.5 liters of water a day, especially in the hottest times of the year. Hydration is essential for sweating mechanisms to be effective.
• Wearing loose and light clothing: shorts, skirts, t-shirts, and suspenders are the best allies when it comes to going out in the summer.
• Do not stay in a parked car for longer than necessary: ​​with the windows closed, a car exposed to the sun without air conditioning can reach almost 50°C. It is always better to get out of the car if it is stopped, even if it is hot outside.
• Take things easy:  avoid physical exercise during the hottest hours of the day. If this is not possible, drink plenty of fluids and take frequent breaks.
• Limit the consumption of alcohol and caffeine: these substances can favor the appearance of heat stroke.

Heat stroke is an increasingly common event, especially due to the rapid onset of heat waves and the slow (but constant) increase in temperatures. Luckily, it can be prevented if you take the appropriate measures. In the hottest months of the year, take it easy and stay well hydrated.