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Heat Illness: Heat Exhaustion and Heat Stroke

Sean C. Robinson, MD, CAQSM and Sherilyn DeStefano, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • A continuum of increasingly severe illness caused by dehydration, electrolyte losses, and failure of thermoregulatory mechanisms when exposed to elevated environmental temperatures

    • He...

DIAGNOSIS

  • Heat exhaustion: Symptoms are milder than in heat stroke, and there are no CNS derangements:

    • Fatigue, lethargy, weakness, dizziness, nausea, vomiting, myalgias, headache, profuse sweating, ta...

TREATMENT

GENERAL MEASURES

  • For heat stroke: immediate body immersion in ice water to cool core temperature. Monitor hemodynamics and airway status (1).

  • Careful fluid and electrolyte replacement with no...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Rest with legs elevated.  

Patient Monitoring

  • Rectal temperature monitoring: Cooling may be discontinued when the core temperature drops to 102° F (38.9° C) and sta...

REFERENCES

1
Roberts WO, Armstrong LE, Sawka MN, et al. ACSM expert consensus statement on exertional heat illness: recognition, management, and return to activity. Curr Sports Med Rep. 2021;20(9):470–...

ADDITIONAL READING

  • Armstrong  LE, Casa  DJ, Millard-Stafford  M, et al. American College of Sports Medicine position stand. Exertional heat illness during training and compe...

CODES

ICD10

  • T67.5XXA Heat exhaustion, unspecified, initial encounter

  • T67.0XXA Heatstroke and sunstroke, initial encounter

  • T67.3XXA Heat exhaustion, anhydrotic, initial encounter

  • T67.4XXA Heat exhaustion d...

CLINICAL PEARLS

  • Exertional heat stroke is a life-threatening medical emergency that requires immediate whole body cooling (cold/ice water immersion preferred).

  • The diagnosis of heat stroke includes an ...

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