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Heat Illness: Heat Exhaustion and Heat Stroke

Sean C. Robinson, MD, CAQSM and Matthew G. Chan, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • A continuum of increasingly severe heat illnesses caused by dehydration, electrolyte losses, and failure of the body’s thermoregulatory mechanisms when exposed to elevated environmen...

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),(3)[C].

  • Careful fluid and electrolyte replacement w...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Rest with legs elevated (3)[C]. 

Patient Monitoring

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

REFERENCES

1
Lipman GS, Eifling KP, Ellis MA, et al. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness: 2014 update. Wilderness Environ Med.  ...

ADDITIONAL READING

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

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-threating medical emergency that requires immediate whole body cooling (cold/ice water immersion preferred).

  • The diagnosis of heat stroke includes an el...

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