{"id":5060,"date":"2011-07-14T20:23:04","date_gmt":"2011-07-14T20:23:04","guid":{"rendered":"http:\/\/crashtext.org\/misc\/5060.htm\/"},"modified":"2011-10-02T20:22:12","modified_gmt":"2011-10-02T20:22:12","slug":"heat-illness","status":"publish","type":"post","link":"https:\/\/crashingpatient.com\/environmental\/heat-illness.htm\/","title":{"rendered":"Heat Illness"},"content":{"rendered":"
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Heat Loss:<\/p>\n
Radiation-loss to ambient air<\/p>\n
Convection-air currents<\/p>\n
Conduction-direct contact with cooler object<\/p>\n
Evaporation-sweating<\/p>\n
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Heat loss is reduced by phenothiazines, anticholinergics, B-Blockers, Ca-Blockers, Diuretics, Amphetamines, LSD, Cocaine, MAO Inhibitors<\/p>\n
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hyponatremia leading to muscle cramping, usually the calves, thighs, and shoulders.<\/p>\n
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hyperventilation leading to respiratory alkalosis<\/p>\n
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salt depletion from sweating, leads to hypovolemia and hypoperfusion.\u00a0 Patient will retain normal mental status and neurologic exam.\u00a0 Temperature may only be slightly elevated.\u00a0 The patient will look spent.<\/p>\n
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Need CNS dysfunction and Temp>40<\/p>\n
Breakdown of central thermoregulatory control<\/p>\n
Hyperpyrexia, altered mental status, neurologic findings, and possibly the absence of sweating<\/p>\n
Can lead to NCPE, ARDS, LFT elevations, ATN, Hematuria, Rhabdomyolysis, DIC<\/p>\n
Immediate, aggressive cooling down to <39\u00b0 C using ice packs in groin and axilla, spray the patient continuously with water, place in front of fan.<\/p>\n
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Fluid loss is usually not large.\u00a0 Give 2 L of NS and then cut back to ~500 cc\/hr.<\/p>\n
ABG c Lactate, CBC, Lytes, LFTs, PT\/PTT, UA and Myoglobin.<\/p>\n
Shivering can be controlled with benzos or meperidine.<\/p>\n
Antipyretics are not effective.<\/strong><\/p>\n <\/p>\n |\u00a0\u00a0 \u00a0\u00a0 |\u00a0\u00a0 \u00a0\u00a0 |<\/p>\n","protected":false},"excerpt":{"rendered":" Array<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[9],"tags":[],"yoast_head":"\n