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Hyperthermia, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Range of progressively more severe illnesses due to increasingly overwhelming heat stress

  • Begins with dehydration and electrolyte abnormalities and progresses to thermoregulatory dysf...

Diagnosis

Signs and Symptoms

Heat Stroke

  • Classic triad: Hyperthermia, CNS dysfunction, hot skin (often with anhidrosis)

  • Core temp: >105°F (40.5°C)

  • CNS:

    • Severe confusion/delirium

    • Lethargy or coma

    • Seizure

    • At...

Treatment

Pre-Hospital

  • Initiate cooling measures for severe heat illness

    • Remove from heat stress

    • Disrobe patient

    • Cover body with wet sheet

Initial Stabilization/Therapy

  • ABCs

  • Continuous core temperature monit...

Follow-Up

Disposition

Admission Criteria

  • Heat stroke – admit to the ICU

  • Heat exhaustion – admit to general or monitored floor if:

    • Severe electrolyte abnormalities

    • Renal failure or evidence of rhabdomyolysi...

Pearls and Pitfalls

  • Cannot make diagnosis of heat stroke without temp >40.5°C and severe CNS dysfunction.

  • Management of heat stroke requires management of ABCs and rapid cooling.

  • Continuous core moni...

Additional Reading

  • Hausfater  P, Doumenc  B, Chopin  S, et al. Elevation of cardiac troponin I during non-exertional heat-related illness in the context of a heatwave. Crit Care.  2010;14(3):R99.

  • ...

Codes

ICD9

  • 992.0 Heat stroke and sunstroke

  • 992.2 Heat cramps

  • 992.5 Heat exhaustion, unspecified

  • 992.1 Heat syncope

  • 992.3 Heat exhaustion, anhydrotic

  • 992.6 Heat fatigue, transient

  • 992.7 Heat edema

ICD10

  • T67.0XX...

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