Heat stroke, heat exhaustion, overheating, heat stroke or hyperthermia syndrome is a life-threatening condition in which the body temperature can reach a critical level of over 39 degrees Celsius due to intense heat and physical exertion. Furthermore, the body is no longer able to cool the body down to normal temperatures by sufficient sweat production due to its own insufficient heat regulation. This results in circulatory shock or death from overheating. Urgent medical help must be called immediately (emergency number 112).
What is heat stroke?
First aid for heat stroke in summer. Click to enlarge. Heat stroke, heat exhaustion or hyperthermia syndrome is a condition of the body as a result of improper heat regulation. Heat stroke often occurs in the summer when people are overexposed to the sun and or heat without releasing enough body heat in the form of sweat (sweating) or body temperature. In this case, sweating in particular serves as a temperature regulator against overheating, because the sweat and air cause so-called transpiration, which cools the body down through the cooled sweat. In medicine, heat stroke is counted among the heat injuries, which can also include sunstroke. If the body temperature is more than 40 degrees Celcius, without the fever is present, one speaks of a heat stroke. The untreated consequence can lead to death, because from about 42 degrees Celsius body temperature, the protein in the cells (eg muscle cells) coagulate.
Causes
The causes of heat stroke are obvious. Mostly in the summer, when temperatures exceed 30 degrees Celsius and the sun heats the body unhindered, this can lead to heat stroke. Often, heavy physical work or sport also favors heat stroke, since the body temperature increases further and the circulation is additionally challenged. If the body is not cooled down again by sufficient drinking and sweating and the body temperature remains at more than 40 degrees Celsius, heat stroke is almost inevitable. Older people in particular put on too much clothing, even in summer and when it is very hot, so that the body heat can escape only poorly. This accumulation of heat then leads to unconsciousness or fainting. In addition, the circulation can be life-threateningly disturbed. Urgent medical assistance is then necessary.
Symptoms, complaints and signs
Typical symptoms of heat stroke are an increased body temperature of more than 40 degrees Celsius as well as a high pulse, dizziness and nausea. The skin feels hot and dry due to reduced sweat production and is red. Blood pressure is normal at the beginning, but drops as the disease progresses. As the condition progresses, circulatory collapse may occur, associated with impaired consciousness and coma. Without intensive medical treatment, heat stroke can lead to death. In heat stroke, the cardiovascular system is overloaded, which can lead to sweating, dizzy spells and palpitations. Accompanying panic attacks may occur. In the area of the brain, insufficient blood flow can cause what is known as cerebral edema. In this case, water leaks from the vessels into the brain and causes swelling, which is manifested by increasing headaches and neck pain, apathy, confusion and coma. In infants and young children, heat stroke can be recognized by red, dry skin and increased irritability. The baby also refuses food and shows signs of impaired consciousness. In severe cases, seizures and unconsciousness occur. In addition, the body temperature rapidly rises above 41 degrees Celsius.
Course of the disease
The course of heat stroke depends on the intensity of the body temperature and how long the affected person has been overheated. Therefore, if heat stroke is suspected, an emergency physician should be called immediately. The doctor will then try to stabilize the circulation and bring the body temperature back down. If help is not provided by third parties, heat stroke can have life-threatening consequences. Helpers should not leave the heatstroke victim alone, but should try to place him or her in a stable lateral position and, in extreme cases, apply cardiac massage and mouth-to-mouth resuscitation in the event of cardiac arrest and respiratory failure.
Complications
Heat stroke is caused by the overheating of the human organism, so this clinical picture is naturally associated with serious complications. It is not uncommon for various accompanying symptoms to occur in connection with heat stroke, which make it necessary to be treated by a doctor. These accompanying symptoms include severe headaches, nausea, vomiting, dizziness, lightheadedness, fever and a general state of exhaustion. Those who seek medical treatment early in such a case will be able to effectively combat or eliminate the above-mentioned complications. However, if you do not seek medical treatment at this point, you run a very high risk. It is not uncommon for the individual clinical pictures to worsen considerably, so that a visit to the doctor becomes unavoidable. In most cases, long-lasting headaches occur in connection with heat stroke, which are usually associated with a feeling of nausea. Repeated vomiting is also not uncommon in cases of severe heat stroke. Thus, it is true that heat stroke naturally brings with it many different complications that can worsen considerably if left untreated. However, those who seek medical and drug treatment at an early stage will be able to avoid or effectively alleviate the existing complications. Definitely, the affected person should get out of the sun, because under certain circumstances there may be acute danger to life.
When should one go to the doctor?
If symptoms such as headache, nausea or dizziness are noticed after a prolonged stay in the sun, it is possibly heat stroke. A doctor should be consulted if the symptoms persist for more than a few hours and increase in intensity as they progress. If other symptoms such as palpitations or impaired consciousness occur, a doctor must be consulted immediately. In the event of circulatory collapse and other complications, the emergency medical services should be alerted. Persons who already suffer from a disease of the heart or the cardiovascular system should consult a doctor immediately in the event of the above-mentioned symptoms. The same applies to pregnant women and the elderly. With children, if there are signs of heat stroke, they should go to the pediatrician on the same day. If in doubt, it is advisable to go to the nearest hospital. The right person to contact in case of heat stroke is the family doctor or a specialist in circulatory diseases. The emergency medical service can provide initial information about the symptoms of hyperthermia syndrome and suggest further measures to the affected person.
Treatment and therapy
After heat stroke has been diagnosed by the emergency physician (emergency number 112), he will first try to prevent the patient from circulatory collapse. At the same time, he will try to lower the body temperature again. Initial treatment measures can also already be carried out by passers-by or companions. These include:
1. move the heatstroke victim to a cool, shady place.
2. Position the patient in the recovery position, if possible with the upper body slightly elevated.
3. cool the body with cool air (fan), cool compresses (towels) or cold packs. 4. observe the heat stroke victim until the emergency physician arrives
5. if breathing and pulse stops, immediately start cardiopulmonary resuscitation.
Normally, the patient is then taken by the doctor to a hospital for further treatment. Here, further measures are then initiated to stabilize the circulation and body temperature.
Outlook and prognosis
When heat stroke is diagnosed, the affected person should not be left alone and kept awake, as the condition of the sick person can deteriorate rapidly. Likewise, breathing and pulse should be constantly monitored. If fainting has occurred, place the patient’s legs elevated so that blood can flow more easily to the brain. If the patient is unconscious, the stable lateral position is advisable, since blood flow to the brain and other organs may also be disturbed. If respiratory arrest or circulatory failure occurs, chest compressions and ventilation must be performed. Heat stroke can affect anyone, including the young and healthy. A fatal outcome is more likely to occur in children, since their temperature regulation is not yet fully developed, and in the elderly or chronically ill.Therefore, the course of heat stroke depends not only on the factors that caused it, but also on the age and state of health of the person affected. Depending on the severity, collapse may occur, accompanied by fever and nausea to complete circulatory collapse and severe brain damage. In the worst case, heat stroke is fatal. The majority of sufferers survive heat stroke without permanent damage.
Prevention
Of course, heat stroke can be prevented. Logically, the first preventive measure should be to avoid excessive increase in body temperature. So this means wearing weather-appropriate clothing in the summer and also a hat or parasol if the sun is strong. Furthermore, enough should be drunk and the body should be cooled down by cool showers or bathing in cool waters. Lastly, excessive heavy physical exertion should be avoided. This includes sports and heavy physical work. Furthermore, it is advisable to spend more time in the shade. Hot teas have also proven to be favorable, as they serve as a fluid supply on the one hand and on the other hand make the body sweat, so that the sweat can cool down the body temperature.
Aftercare
Mild heat stroke usually does not require medical treatment or aftercare. Through self-applied first aid measures, symptoms usually disappear within a few hours. However, if medical treatment by a family doctor or even an emergency physician became necessary due to longer lasting symptoms or the severity of the heat stroke, an appropriately coordinated aftercare must be provided. If cerebral edema has developed, the diuretics prescribed must be taken strictly as prescribed by the physician. This is the only way to promote fluid excretion via the kidneys and further reduce the edema. If the edema was acutely life-threatening and surgery was performed, good wound hygiene should be observed in the weeks following the operation. In younger children, observation of behavioral changes within the next few days is required. These may manifest as abdominal pain, sensitivity to touch, sleep disturbances, sensitivity to light and sound, or general malaise. Seizures, fever, clouding of consciousness or vomiting are also possible. All of these symptoms may indicate sun-stung meningitis and require immediate medical consultation and treatment. In general, for all those affected, avoid prolonged exposure to the sun and physical exertion in the near future, ensure adequate hydration, and protect against recurrence of sunstroke by wearing appropriate headgear or using a parasol.
What you can do yourself
If heat stroke is suspected, first aid measures should be taken immediately. The affected person should first be taken to a cool, shady place. The head and neck can be cooled with cold compresses. In the case of mild sunstroke, a cold shower and some rest are often enough to help. In addition, care must be taken to ensure that the affected person drinks enough – preferably water or apple spritzer – and maintains consciousness. If there is any disturbance of consciousness or nausea, it is best to alert the emergency physician immediately. Until then, affected persons should be positioned slightly upwards so that the head and upper body are well supplied with blood. In severe heat stroke, watch for panic attacks and symptoms of dehydration or apathy. If corresponding symptoms occur, treatment by a physician is absolutely necessary. In any case, bed rest and rest is then indicated until symptoms subside. Heat stroke in infants and young children requires immediate treatment in a hospital or by an emergency physician. Again, get the affected person out of the sun, cool them down and give them plenty to drink. In addition, preventive measures should be taken to avoid a recurrence of heat stroke.
