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Sunrise over Gulf of Mexico

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Presentation on theme: "Sunrise over Gulf of Mexico"— Presentation transcript:

1 Sunrise over Gulf of Mexico

2 Heat Illness and Heat Stroke
Inability to maintain normal body temp due to excess heat production or decreased heat transfer to environment

3 3 Forms of Heat Illness Heat Stress Heat Exhaustion Heat Stroke
Feeling of discomfort, decreased Performance Normal body temp Heat Exhaustion Mild dehydration Temp – 104 Intense discomfort, thirst, N/V Transient confusion (No other neuro symptoms) Heat Stroke Body temp >104 Neuro dysfunction

4 Heat Stroke Classic (nonexertional) Exertional
Environmental exposure to heat Young children, elderly, disabled Exertional Young, healthy individuals Athletes, military recruits Heavy exercise in high temps and humidity

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6 Heat Stroke Among high school athletes, heat stroke is 3rd leading cause of mortality May ignore symptoms until they collapse Risk factors: prolonged exercise in warm, humid environment

7 Physiologic Cooling Mechanisms
Evaporation (of sweat) Ineffective relative humidity >75% Convection, conduction, and radiation Ineffective >95F

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9 Much more than little adults
Children are at increased risk for heat illness Higher metabolic rate- higher heat production Increased surface area to mass ratio- increased absorption of heat Smaller absolute blood volume and lower cardiac output- limits transfer of heat from core to surface Lower sweat rate per gland and start at higher temps Inadequate fluid replenishment Longer to acclimate to hot environments (10-14days)

10 Critical Thermal Maximum (CTM)
Degree of elevated body temp and duration that can be tolerated b/f cell damage occurs Core body temp for 45min

11 DDx Sepsis/Encephalitis CNS Conditions (Dysregulation)
Congenital anomalies or traumatic brain injury Status Epilepticus Toxidromes Anticholinergics, Salicylate, Stimulants Serotonin Syndrome Neuroleptic Malignant Syndrome Malignant Hyperthermia Thyroid Storm Hemorrhagic Shock and Encephalopathy Syndrome

12 Stabilization ABCDE Continuous temp monitoring (rectal probe)
Rapid Cooling Evaporative cooling of greatest benefit Spray with water while using high-flow fans Can decrease temp by 0.27F/min Ice packs to neck, axillae, groin as adjunct Cooling blankets not as beneficial Cold water immersion is effective but not practical Chilled IV saline (little data)

13 Cooling Bring temp down to <104F as rapidly as possible
Stop cooling measures at 100.4F Use benzos to stop shivering

14 Treatment of End Organ Dysfunction
Rhabdomyolysis hyperkalemia, hypocalcemia, hyperphosphatemia DIC Acute Renal Failure Hyponatremic dehydration/ Hypovolemic shock Cardiogenic shock Pulmonary edema Liver failure Cerebral Edema

15 Outcome Mortality Permanent neurologic damage t>107.6
Up to 15% in adolescents Up to 63% in elderly Permanent neurologic damage t>107.6 Heat Intolerance

16 Prevention Infants: avoid excessive bundling or bedding
If sweating at night- dangerous sign Lightly colored vehicle with window cracked: 145F in 40minutes Keep parked cars locked Increased awareness to high risk groups

17 Sporting Events Light colored clothing
Never wear material that restricts sweat loss 500ml within 2hrs prior to event 250ml q 20 minutes while exercising


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