EMS A to Z: Hyperthermia

Show Notes:

From your hosts, Dr. Josh Gaither, Dr. Amber Rice, and Dr. Rachel Munn

Heat related illness falls into categories including:

Mild illness, such as heat cramps

Heat exhaustion:

Characterized by fatigue, nausea, malaise, dizziness, headache, diaphoresis, flushed skin, tachycardia.

Temperature usually < 104F

Heat stroke:

Characterized by the above symptoms including neurologic abnormalities such as altered mental status and seizures; can also have anhidrosis, shock, and hypotension.

Temperature usually > 104

Can be divided into categories:

Environmental / classic

Think about this in elderly or comorbid patients who are unable to adequately control their environment.

Drug / toxin

Examples include sympathomimetic toxicity, anticholinergic toxicity, serotonin syndrome, neuroleptic malignant syndrome

Exertional

Athletes or workers who exert themselves in hot environments, particularly without acclimatization

How is it treated?

Cool the patient!

Best strategies include: moving to a cool or shady area, removing excess clothing, wetting the skin, providing air movement or a breeze.

Patients may require more aggressive measures such as ice baths, transport to a hospital, IV fluids, etc.

Don’t forget to widen your differential and consider other etiologies of elevated temp / altered mental status such as infectious concerns, seizure, hypoglycemia, etc.