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 you currently worked hard physically in the sun?
- Have you taken your body temperature? If so, how high is it?
- Do you feel restless, anxious?*
- Is your breathing rapid?*
- Do you have a headache?
- Do you have nausea?*
- Do you have chills?*
- Do you have a dry warm skin?*
- Has the patient suffered a seizure?* [extraneous history].
- Was the patient unconscious?* [Extraneous history]
Vegetative anamnesis including nutritional anamnesis.
- How much did you drink today?
- What did you drink today?
- What have you eaten in the last few days?
- Do you have diarrhea?
- Have you been drinking alcohol?
- Do you use drugs? If yes, what drugs and how often per day or per week?
- Do you have your head and neck covered in the sun?
Self history including medication history.
- Pre-existing conditions (cardiovascular disease, diabetes mellitus, febrile illness, viral infection).
- Operations
- Allergies
Medication history
Medications that may negatively affect thermoregulation or provoke desiccosis (dehydration):
- Α2-Adrenoceptor agonists (α2-agonists for short).
- Laxatives
- Anticholinergics, antidepressants: increase heat production and thus increase body temperature, which leads to increased sweating and thus electrolyte losses!
- Antihistamines
- Benzodiazepines
- Beta-blockers: reduction in cardiac output, which may impair heat adaptation.
- Diuretics and ACE inhibitors/angiotensin II receptor antagonists: dehydration and/or electrolyte imbalance due to hyponatremia.
- Ephedrine-containing drugs
- Calcium channel blockers (calcium antagonists, calcium antagonists).
- Lithium
- Neuroleptics, Selective Serotonin Reuptake Inhibitors (SSRIs): inhibition of central thermoregulation.
- Mao inhibitor
- Muscarinic receptor antagonists: decrease sweat secretion and thus risk of overheating.
- Phenothiazines
- Salicylates
- Thyroid hormones
- Sedation by dopaminergic and Parkinson’s drugs: lowering the perception of heat exhaustion or reducing the feeling of thirst and thus risk of exsiccosis.
- Serotonin-releasing substances (SSRIs, tramadol, triptans).
- Tricyclic antidepressants
Environmental history
- High ambient temperature*
- Heat (heat day: > 30 °C; desert day: > 35 °C)Note: Above 37 degrees it can be critical for humans, especially if it is humid.
- High humidity
- Lack of air movement
- Lack of shadow
* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Data without guarantee)