Medical history (history of illness) represents an important component in the diagnosis of heat illness/heat stroke or sunstroke. Family history What is the general health of your relatives? Social anamnesis Current medical history/systemic history (somatic and psychological complaints) [third-party history, if applicable]. What symptoms have you noticed? How long have the symptoms been present? Have … Heat Stroke and Sunstroke: Medical History
Differential diagnoses for suspected heat stroke. Endocrine, nutritional, and metabolic disorders (E00-E90). Pheochromocytoma – neuroendocrine (affecting the nervous system) catecholamine-producing tumor of the chromaffin cells of the adrenal medulla (85% of cases) or sympathetic ganglia (nerve cord that runs along the spine in the thoracic (chest) and abdominal (stomach) regions) (15% of cases). Thyrotoxic crisis … Heat Stroke and Sunstroke: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by heat illness/heat stroke or sunstroke: Blood, blood-forming organs – Immune system (D50-D90). Disseminated intravascular coagulation; Disseminated Intravascular Coagulation (DIC syndrome, for short; consumption coagulopathy) – Coagulopathy (clotting disorder) resulting from intravascular activation of blood clotting. Cardiovascular System (I00-I99). Cardiovascular failure … Heat Stroke and Sunstroke: Secondary Diseases
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height, body temperature; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Neurological examination – including testing of pupils, reflexes.
2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Small blood count Inflammatory parameters – CRP (C-reactive protein) or PCT (procalcitonin). Electrolytes – sodium, potassium, magnesium. Fasting glucose (fasting blood sugar) Blood gas analysis (BGA) Renal parameters – urea, creatinine. Coagulation … Heat Stroke and Sunstroke: Test and Diagnosis
Therapy target Reduction of body temperature in heat exhaustion or heat stroke: treatment goal is to reduce core body temperature to values < 40 °C within 30 minutes (“golden half hour”). Therapy recommendations For sunstroke: staying in a cool place and cooling with cool packs, etc. is usually sufficient. Application of cool infusions In heat … Heat Stroke and Sunstroke: Drug Therapy
Obligatory medical device diagnostics Measurements of body temperature and blood pressure Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnosis. Computed tomography/magnetic resonance imaging of the skull (cranial CT or.cCT/cranial MRI or cMRI) – for further diagnosis in cases … Heat Stroke and Sunstroke: Diagnostic Tests
Note: The symptoms of heat illness described below (heat cramps, heat exhaustion, and heat stroke) can develop completely independently of each other and seemingly abruptly, i.e., there is no particular sequence of specific stages of illness. The following symptoms and complaints may indicate sunstroke: High red hot head Pale, sweaty skin Nausea (nausea)/vomiting Cephalgia (headache) … Heat Stroke and Sunstroke: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Sunstroke results from prolonged direct sunlight on the unprotected head and neck, resulting in irritation of the meninges (brain membranes) and brain tissue, which can lead to an inflammatory response. Note: Heat illnesses (heat cramps, heat exhaustion, and heat stroke) can develop completely independently and seemingly abruptly, i.e., there is no … Heat Stroke and Sunstroke: Causes
Heat prevention measures (see below “Heat stroke and sunstroke/prevention”). General Measures Immediately make an emergency call! (Call number 112) Vital signs – respiration, cardiovascular, neurological findings, glucose levels – obtained? If necessary, initiate immediate measures! Measurement of core body temperature (rectal measurement; in heat stroke usually: > 40.5 °C). Reduction of body temperature in heat … Heat Stroke and Sunstroke: Therapy
To prevent heat stroke and sunstroke, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Insufficient fluid and electrolyte intake (electrolyte deficiency), i.e. insufficient compensation of sweat losses. Consumption of stimulants Alcohol* (alcohol consumption is considered a risk factor for heat illness regardless of physical exertion). Drug use (can trigger hyperthermia). … Heat Stroke and Sunstroke: Prevention
