Heat Stroke and its Prevention
Lecturer in Pediatric Nursing, Al-Kareem College of Nursing, Gulbarga, Karnataka India
Children differ from adults with respect to their anatomical and physiologic response to heat stress. Normally children have a body temperature 370 C or 98.60 F and when exposed to sun the temperature may exceed more than 400 C. These differences translate into a potentially greater risk for severe heat illness, especially in children and adolescents.
Heat illness occurs along a spectrum of disease from minor syndromes (e.g., malaria, heat cramps) to life-threatening processes, such as heat stroke. A number of heat related illnesses exist such as: heat edema, heat rashes, heat cramps, heat exhaustion, and heat stroke which may be fatal if not treated promptly and properly.
Heat stroke is defined as a core temperature ≥400C (1040F) accompanied by central nervous system dysfunction in patients with environmental heat exposure.
Heat stroke is characterized by extreme elevation of body temperature (hyperthermia) and associated central nervous system dysfunction, organ dysfunction and can cause permanent brain damage.
Anyone can develop heatstroke, but several factors leads to increased risk such as:
1. Young or old age: In the very young, the central nervous system is not fully developed and in adults over 65, the central nervous system begins to deteriorate, which makes the body less able to cope with changes in body temperature. Both age groups usually have difficulty remaining hydrated, which also increases risk.
2. Genetic response to heat stress: The way the body responds to heat is partly determined by inherited traits. Genes may play a vital role in determining how our body will respond in extremely hot conditions.
3. Situations: Common examples of situations that can lead to heatstroke include military training in hot weather and participation in school sports such as football etc.
Heatstroke can occur in these ways:
Pictures to add in prevention/ Health Education:
Signs and symptoms:
Temperature: High body temperature, exceeds 41°C.
Pulse: increased pulse rate i.e.,> 86 per minute.
Blood pressure: decreased blood pressure, hypotension i.e., 110/60 mm of Hg.
Heatstroke symptoms include:
High body temperature.
Lack of sweating: In heatstroke brought on by hot weather, the skin will feel hot and dry to touch. However, in heatstroke brought on by strenuous exercise, skin may feel moist.
Nausea and vomiting: May feel sick to the stomach or vomit.
Flushed skin: Skin may turn red as the body temperature increases.
Rapid breathing: Breathing may become rapid and shallow.
Racing pulse rate: Pulse may significantly increase because heat stress places a tremendous burden on the heart for help to body cool.
Headache: May experience a throbbing headache.
Confusion: May have seizures, hallucinate, or have difficulty speaking or understanding what others are saying.
History collection and physical examination is been collected by physician and it is as follows:
· Heatstroke is a multisystem disorder that potentially can affect almost every organ system.
· Hot and dry skin.
· Blue lips and nails.
· Low blood pressure.
· Central Nervous System damage like convulsions, etc.
· Rhabdomyolysis (It is the breakdown of muscle fibers that leads to the release of muscle fiber contents (myoglobin) into the bloodstream which is harmful to the kidney and causes kidney damage).
· ARF (Acute renal failure) especially Exertional Heat Stroke.
· Acute liver failure due to hepatic necrosis and cholestasis generally occurs in the first 48 hours.
· ARDS (Acute Respiratory Distress Syndrome)
· Drink plenty of fluids during vigorous or outdoor activities (including sunbathing), especially on hot days which helps in sweating, maintain normal body temperature and prevent dehydration.
· Advice to drink 7-8 litre of fluid/day to prevent heat stroke.
· Make sure that adolescent dresses in light coloured, lightweight, tightly-woven, loose-fitting cotton clothing on hot days because it reflects sun ray and keep the body cool.
· Schedule vigorous activity and sports for cooler times of the day. Take rest periods in shady or cool aspects.
· Makes sure that adolescent is protected from the sun and wears a hat and sunglasses, and uses an umbrella. Use a sunscreen that is at least SPF (sun protection factor) 15.
· Increase time spent outdoors gradually to get the adolescent's body used to the heat.
· Teach adolescents to take frequent drink breaks and "wet down" or mist them with a spray bottle to avoid becoming overheated.
· Try to spend as much time indoors as possible on very hot and humid days.
· Teach adolescent to warm-up and cool-down before and after exercising.
· Advice to use fan and air conditioners to keep cool in hot indoors.
· If adolescent has a medical condition or taking medication, consult the physician for further advice for preventing heat-related illnesses.
4. Educate to have nutritious diet and contraindicate the fluids such as alcohol and beverages during hot weather.
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Received on 18.02.2014 Modified on 12.03.2014
Accepted on 28.03.2014 © A&V Publication all right reserved