Heat Stroke

Leon, Lisa R.; Bouchama, Abderrezak

doi:10.1002/cphy.c140017

Cited by 360 publications

(382 citation statements)

References 395 publications

(505 reference statements)

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“…Heat exposure may also alter mental states through thermosensitive physiological processes (Leon & Bouchama, 2015;Page et al, 2007). Emotional wellbeing may diminish because individuals are forced to stay indoors for extended periods, have to alter their daily schedules and face increased cooling expenditures, e.g., due to running air conditioners (Deschênes, 2012).…”

mentioning

confidence: 99%

Increasing ambient temperature reduces emotional well-being

Noelke

McGovern

Corsi

et al. 2016

Environmental Research

153

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mentioning

confidence: 99%

Increasing ambient temperature reduces emotional well-being

Noelke

McGovern

Corsi

et al. 2016

Environmental Research

153

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“…Hyperthermia should quickly be suspected in patients who collapse on hot days, especially if there are factors involved that would impede cooling (2). Our case report illustrates the vulnerability of the brain to high temperatures and shows that diagnosis can be difficult in the first hours and days (1,3,4).…”

Section: Discussionmentioning

confidence: 82%

“…Hyperthermia is defined as a core body temperature above 37.5 ºC, and arises due to inadequate thermoregulation (1,4,5). Symptoms of hyperthermia include varying degrees of tachycardia, hyperventilation, hypotension, feelings of loss of strength/weakness, nausea and dizziness.…”

Section: Discussionmentioning

confidence: 99%

Mannen som falt om i åkeren

Ødemark¹,

Koht²

2017

Tidsskriftet

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(born 1969), MD, PhD, specialist in neurology, senior consultant, head of research, and associate professor. The author has completed the ICMJE form and reports no conflicts of interest.On one of the hottest days of the Norwegian summer, a man collapsed in a field. He was admitted to hospital where he underwent a wide range of tests owing to reduced consciousness and high body temperature. He went on to develop an unusual disease course with multiple organ failure and neurological deficits.The man, who was in his forties and of foreign origin, was in Norway as a seasonal agricultural worker. On the day he was hospitalised, after working in the fields for a few hours he had stated that he felt unwell -before collapsing. He was admitted to the nearest hospital in an unconscious state.Upon admission, the only information available about the patient was that he had suddenly collapsed. He had apparently been in good health earlier in the day. The ambulance call report was not scanned into the medical records, and information about how he had been found unconscious was not relayed to the hospital personnel.Upon admission, he had greatly reduced consciousness, a Glasgow Coma Scale score of 3-4 points, and in a preliminary neurological workup his pupils were non-reactive to light. The ambulance personnel had provided partial ventilatory support during his transport to the hospital. Upon arrival in the emergency department, he was not breathing unaided. He was immediately intubated without prior sedation and responded only with some coughing. Tympanic temperature was measured at 41.2 ºC, rectal temperature was not measured. He showed signs of circulatory shock -with cold, moist and blue-mottled skin, hypotension and tachycardia (blood pressure 70/30 mm Hg, pulse 175 beats/min, sinus tachycardia). He was considered to be critically ill and in need of intensive care. Echocardiography showed normal left ventricle contractility. The inferior vena cava had completely collapsed and there was very poor filling of both ventricles. CT head, CT thorax and CT abdomen were normal. Blood tests, blood cultures and cerebrospinal fluid analysis were performed. The blood tests revealed severe renal impairment, heart failure and high creatine kinase levels (CK) ( Table 1). No cooling interventions were performed in the acute

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“…[7] This is thought to lead to the multi-organ failure that causes death in severe or untreated cases. [8] Exercise-associated hyponatraemia…”

Section: Heat Strokementioning

confidence: 99%

“…If there is biochemical evidence of rhabdomyolysis, promoting positive fluid balance, diuresis with furosemide, and alkalinisation of urine with sodium bicarbonate can be considered. [7,8] In contrast to fever, there is no role for paracetamol and non-steroidal anti-inflammatory drug use in heat stroke, which may cause further harm. [10] Dantrolene has also not been shown to contribute to management.…”

Section: Hospital Managementmentioning

confidence: 99%

Heat-related illness in the African wilderness

Hofmeyr

Dalton

2017

S Afr Med J

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A fit-looking 23-year-old male participant in a summer mountain trail run collapses 3 km from the end of the 25 km race. Despite the altitude, ambient temperatures are warm, and the participants have been exposed to the full sun for several hours. On your first assessment, he is very confused, with a weak, rapid pulse (160 beats per minute). His skin is wet and cool. A passing member of the same running club alleges that he is not known to have any medical conditions. You notice that his water bottles are both empty. As fellow runners help you carry him to the nearby medical-aid station, a rapidly expanding differential diagnosis fills your thoughts. BackgroundWilderness heat-related illnesses span a continuum of medical problems caused by the generation of, and/or exposure to, excessive heat in the wilderness environment. They can range from minor annoyances to life-threatening conditions. Endogenous heat production is directly dependent on the sum of that from inescapable sources, such as basal cellular metabolism and cardiorespiratory work, and heat generated by physical exertion. All heat exchange (gain or loss) occurs through four mechanisms: conduction, convection, radiation and evaporation. Conduction refers to the direct transfer of heat from one object to another through contact. Convection is heat gain or loss due to movement of a fluid (such as air); a convection oven or wind chill from an Antarctic breeze are similar examples. Radiation describes transfer of heat through electromagnetic waves, epitomised by the heat of the sun on skin. Evaporation is the loss of heat induced by the phase change from liquid to gas, which is dramatically affected by ambient vapour pressure or relative humidity.Many animals have developed ingenious strategies to adapt their physiology to control heat gain or loss. Indeed, it is hypothesised that particular human traits -our upright stance, complex bony structure of the foot, nuchal ligament, relatively hairless skin and copious capacity for perspiration -evolved to give us an advantage in chasing down prey in the prehistorical African heat.[1] Today, however, humans are unique in their ability to adapt the environment to control their physiology through behaviour and material means: use of clothing, shelter, and devices such as heaters and air conditioners. Despite this, we cannot alter the laws of thermodynamics, and people in the wilderness are subject to the same exposure and thermal exchange mechanisms as our primitive ancestors. Fortunately, the development of modern science, clothing technology, and an understanding of physiology allow us to function successfully in environments of extreme heat under many adverse circumstances (Fig. 1).Risk factors traditionally considered to increase our susceptibility to the deleterious effects of heat stress include obesity, lack of acclimatisation to hot environments, poor physical fitness, extremes of age, underlying illness (e.g. cardiac conditions, hyperthyroidism), dehydration, certain medications (e.g. beta blockers, anti...

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Heat Stroke

Cited by 360 publications

References 395 publications

Increasing ambient temperature reduces emotional well-being

Increasing ambient temperature reduces emotional well-being

Mannen som falt om i åkeren

Heat-related illness in the African wilderness

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