What is heat stroke ?

It seems a bit weird to be writing about what is heat stroke , the first aid for it and related illness in the middle of a dreary Melbourne winter, however, in Saudi Arabia, where my sister is soon to relocate, it is always hot…damn, hot.

This one’s for you sis.

Heat related illnesses are caused by heat exposure above the bodies inbuilt ability to thermoregulate or get your body temperature back to normal. Heat stroke is distinct from the fever you experience when fighting infection. A fever is caused by excess heat coming from those brilliantly intricate chemical reactions that your immune system uses to fight a bug.

Heat Stroke Risk Factors:

The main risk factor is prolonged exposure to the sun, with activity. Things that increase risk of Heat Stroke include:

  • Pre-existing health conditions such as obesity, alcoholism and being under weight.
  • Medications including anti-histamines, diuretics, stimulants and some anti-depressants and antipsychotics.
  • Some illicit drugs including cocaine and amphetamines.

What is heat stroke?

Classical heat stroke passes through a variety of stages on its way to being fatal. Some of the first signs are thirst, profuse sweating, muscle cramps and dizziness. At these first warning signs you should get out of the heat and rehydrate. If you don’t, a relatively minor ailment can progress to dry skin, respiratory problems, numbness, rapid, strong pulse and loss of consciousness. A temperature higher than 40.6 degrees will confirm heat stroke in a patient but normally diagnosis is made from clinical history alone, i.e. he was jogging in the sun then fainted.

Heat stroke Prevention:

grey What is heat stroke ?Like many conditions, the best treatment for Heat Stroke is prevention:

  • Wear light loose fitting clothes that block the sun but allow you to sweat (evaporative cooling).
  • Avoid strenuous training during the hottest time of day – 11am to 3pm.
  • Avoid dehydrating substances like alcohol, caffeine and stimulant medicines, they can make heat stroke come on much faster.
  • In humid climates remember that cooling by evaporation of sweat is limited, cotton in light colours are the best clothes and just hang in the shade by a pool sipping a (non-alcoholic) martini.
  • Vents in hats not only look fashionable but they allow the sweat to evaporate from the head.
  • Drink plenty of water or isotonic drinks.
  • Umbrella hats look ridiculous but are the best hats ever invented to prevent heat stroke.


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Heat stroke Treatment

If prevention is unsuccessful the body temperature must be lowered immediately. The mainstay of treatment is cooling and rehydration (with salty drinks exactly like those used in diarrhoea) The patient should be moved to a cool area (indoors, or at least in the shade) and clothing removed to promote heat loss. This is called passive cooling.

Should passive cooling fail to resolve symptoms or if the patient is really sick, active cooling methods may be used: Basically this means bathing person either totally or in part in cool water.

Wrapping the patient in wet towels or clothes can be counter-productive as towels etc can act as insulation and increase the body temperature. Cold compresses to the head, neck, groin and torso will help to rapidly cool the victim. A fan or anything else suitable may be used to aid evaporative cooling. Evaporation is really helpful as the water in contact with skin literally sucks heat out of a patient as it evaporates.

Immersing a seriously ill patient into a bathtub of cool (but not cold) water is the most recognised method of cooling. This requires the effort of 4-5 people and the patient should be monitored carefully during treatment. If it gets to this stage you need to seek urgent medical advice. Immersion should be avoided for an unconscious patient, but if there is no alternative the patient’s head must be held above water.

Heat stroke prognosis

Let’s face it, most people know to get out of the sun when they start getting headachy and slow. But even if you miss the early warning signs the prognosis is good. Most people recover fully from a bout of Heat Stroke with only a decent head ache to show for their troubles. Drinking isotonic rehydration fluids (used in diarrhoea) and over the counter headache tablets will fix this in time.

After you’ve recovered from heat stroke, you’ll probably be more sensitive to high temperatures during the following week. So it’s best to avoid hot weather and  heavy activity until your doctor tells you that it’s safe to resume your normal activities.

There are wildly varying reports on the prognosis after serious Heat Stroke requiring hospitalisation, the best bet is to avoid this situation!


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