Heat Stroke

By:    Published: May 16, 2012

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Of the 3 types of heat emergencies: heat cramps, heat exhaustion and heat stroke, heat stroke is the most dangerous. Heat cramps occur when salt is lost from the body due to excess sweating. Heat exhaustion can follow if the individual then becomes dehydrated. If left untreated, heat stroke can occur, which can lead to shock, organ failure, brain damage or death. By taking the proper precautions in hot weather, all three of these conditions can usually be prevented.

Definition

Heat stroke is a condition that occurs when the body can no longer regulate its own temperature as a result of being exposed to extremely high temperatures. It occurs when heat cramps and heat exhaustion have progressed to the most severe form. As your body continues to overheat, your condition will continue to worsen until heat stroke occurs. Heatstroke is confirmed when your body reaches a temperature of 104 F or above. Young children, elderly adults and individuals with certain health condition are more susceptible to heat stroke.

Causes

Heat stroke occurs as a result of lengthy exposure to extreme heat or from participating in physical activity in high temperatures. Prior to the development of heat stroke, heat cramps and heat exhaustion will occur.

Heat cramps develop as a result of being exposed to extremely high temperatures or physical activities. These cramps commonly occur during hot weather or when heavy physical activity is performed. Generally, heat cramps can be treated by hydrating with plenty of water or electrolyte-containing fluids, like sports drinks, followed by rest in a cool area.

Heat cramps that aren’t treated properly can lead to the development of heat exhaustion. Heat exhaustion is treated in much the same way as heat cramps – with plenty of liquids and rest in a cool area.

If heat exhaustion is not treated, or if the individual does not respond to treatment, heat stroke can occur. There are 2 different types of heat stroke, each diagnosed according to the cause for its development.

  • Nonexertional heat stroke refers to heat stroke that develops after an individual is exposed to a hot environment. This exposure to high temperatures causes the body temperature to rise. This form of heat stroke usually occurs during the hot summer months when temperatures and humidity levels are at their highest. Physical activity is not a factor in the development of nonexertional heat stroke.
  • Exertional heat stroke occurs when the rise in body temperature occurs as a result of performing physical activity in very hot environments. This commonly occurs during exercise and heavy physical labor.

Symptoms

Symptoms of heat cramps and heat exhaustion are generally the same. If the condition progresses to heat stroke, additional symptoms can occur. Symptoms of heat cramps and heat exhaustion include:

  • An elevated body temperature of 104 F or above
  • Muscle cramps
  • Muscle weakness
  • Nausea and vomiting
  • Skin turns red
  • Headache
  • Rapid breathing

If the condition worsens and heat stroke occurs, additional symptoms may include:

  • Skin feels hot and dry when touched (when heat stroke is hot weather-induced)
  • Skin feels moist when touched (when heat stroke is exercise-induced)
  • Skin continues to get redder
  • Muscles become rigid or limp
  • No sweating
  • Racing heart
  • Confusion
  • Seizures
  • Hallucinations
  • Difficulty speaking
  • Loss of consciousness
  • Coma

Risk Factors

Infants and young children are especially susceptible to heat stroke, as are the elderly. This is because the ability to handle extreme heat at either a very young or very old age is significantly decreased. For infants and small children, the central nervous system is not advanced enough to cope with elevated temperatures. In the elderly, the central nervous system has deteriorated. Both the very young and the very old also have difficult staying adequately hydrated, which also increases their risk of developing heat stroke. Additional risk factors include:

  • Wearing too much clothing (sweat cannot evaporate)
  • Alcohol consumption
  • Dehydration
  • Inherited traits that result in poor response to heat
  • Physical exertion during hot weather
  • Not being used to high temperatures (relocating from a cooler climate or during an early heat wave)
  • No air conditioner (to lower humidity levels)
  • Taking certain medications
  • Having certain health conditions (heart disease, lung disease, obesity, etc.)

Diagnostic Tests

Most doctors can tell immediately if an individual is experiencing heat stroke simply by asking questions and doing a quick physical examination. When uncertain, doctors may order some simple diagnostic tests to confirm heat stroke. A blood test can check for low sodium and potassium levels. A urine test will check the color of the urine and examine kidney function. X-rays and other diagnostic imaging tests may be ordered if damage to internal organs is suspected.

Treatment Options

The main goal of heat stroke treatment is to cool the body back down to a normal temperature. Your doctor will start treatment immediately to help prevent or reduce any damage to vital organs. Treatment options include:

  • Cold water immersion (cold water bath, sometimes with ice)
  • Evaporation cooling (mist cool water onto body while fanning warm air to help evaporate the water and cool the skin)
  • Ice wrapping (cooling blanket used to wrap the body, ice applied to groin, neck, armpits and back to lower body temperature)
  • Muscle relaxers (medications given to stop the shivering that may result from cooling treatments. Shivering elevates body temperature)

Home Remedies

Although home remedies such as drinking plenty of fluid and going to a cool area can be helpful in treating heat cramps and heat exhaustion, heat stroke is much more serious and requires additional measures. Home remedies that can help bring heat cramps and heat exhaustion under control and prevent heat stroke include:

  • Moving to a cooler area, out of sun and high heat
  • Get into an air conditioned environment
  • Drink plenty of fluids
  • Cool off with a fan
  • Cover the body with cool, damp sheets
  • Mist the body with cool water
  • Take a cool shower or bath

Considerations

Heat stroke is a serious condition. Complications can include shock, brain damage; permanent organ damage, coma or death. Fortunately, heat stroke is highly preventable. Steps to prevent heatstroke are as simple as wearing light colored, loose clothing when in the sun, staying well-hydrated and avoiding strenuous activity during the hottest time of day.

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