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Vital sign temperature



Heat Stroke


<!--<h1>Heat Stroke</h1>--> Heat stroke is a failure of the body to rid itself of heat. In this condition, heat-loss mechanisms fail in response to increased environmental temperature. It differs from fever in that there is no release of endogenous pyrogen or resetting of the hypothalamic set-point. It is seen in those whose heat dissipating mechanisms are compromised, such as infants and the elderly, the obese, alcoholics, those taking certain drugs (i.e., phenothiazines, anticholinergics, antihistamines, sympathomimetics) and in some engaged in heavy exertion (i.e. marathon runners). Anticholinergics, diuretics, phenothiazines, and antihistamines suppress the sweating process. <br> <br> When the temperature approaches 106F (41C), tachycardia and weakness occur. Neurological changes appear, ranging from disorientation and bizarre behavior to seizures and unconsciousness. Although sweating may occur initially, the sweating process eventually fails and the skin is hot and dry. Cells are damaged, proteins are denatured, mitochondria and cell membranes are destroyed and hemorrhages occur. Complications include shock, brain damage, acidosis, muscle cell disruption, kidney and liver failure and intravascular coagulation. <br> <br> The severity of the outcome is a function of the age and health of the patient, medicines taken and degree of acclimatization. Early death is from cerebral edema, brain cell damage and circulatory failure. Later problems involve the heart, central nervous system and kidneys from rhabdomyolysis and acute tubular necrosis. <br> <br> <strong>Treatment: </strong>in the field, immediate cooling is mandatory. The person is moved to a cool environment, the clothing is removed and he is splashed or sprayed with normal-temperature water. <br> <br> In the emergency department normal saline is administered at 1 liter per hour. Fanning is begun and ice-packs are applied to the groin and axillae. Treatment is discontinued when the core temperature is 100.4F (38C). <br> <br>


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