Heat Stroke and Sunstroke: Medical History

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)