Heat

Question 1

core body temp for hyperthermia

Answer 1

> 38.5°C (101.3°F)

Question 2

meds that inhibit sweat production

Answer 2

anticholinergics
antidepressants
 antihistamines
 neuroleptics
 zonisamide
 sympathomimetics
alpha- and beta-blockers

Question 3

what are heat cramps caused by

Answer 3

typically hyponatremia and volume depletion

Question 4

what is at heat rash/prickly heat

where does it typically present

Answer 4

Skin irritation due blocked sweat ducts trapping sweat beneath the skin

neck, groin, chest, folds

Question 5

what do you NOT use with heat edema

Answer 5

diuretics

Question 6

when does heat edema typically occur

Answer 6

when going from cold to hot places

Question 7

*s/sxs of heat exhaustion

Answer 7

Normal (or slightly elevated) core temp
Fatigue, malaise, weakness
N/V/D
Tachycardia/orthostatic hypotension
****Intact mental status
Anxiety
Cutaneous flushing
Sweating

Question 8

tx for heat exhaustion

Answer 8

Initiate external cooling immediately – move to cool area, remove excess clothing, spray with lukewarm water, ice packs, pt supine w/ legs elevated

Gradual rehydration – oral and/or IV

Monitor for progression

Question 9

what does high core body temp lead to

Answer 9

proteins to denature which leads to multi-system organ damage

Decreased cerebral hypoperfusion leads to mental status changes, can develop cerebral ischemia

Body is unable to regulate core temp

Question 10

heat stroke s/sxs

Answer 10

Elevated core temp (typically >40.5°C)
Hot, dry skin (although some patients are diaphoretic)
Vague prodrome – HA, N/V, weakness
**CNS symptoms – confusion, slurred speech, hallucinations, ataxia, seizures, syncope, delirium, coma
Hyperdynamic CV response – high CVP, low SVR, tachycardia
Elevated hepatic transaminases
Coagulopathy
Rhabdomyolysis and renal failure

Question 11

what do you NOT use as tx for heat stroke

Answer 11

antipyretics- can be harmful and are ineffective

Question 12

most effective heat stroke tx

Answer 12

ice water immersion

Question 13

heat stroke complications

Answer 13

Disseminated Intravascular Coagulation (DIC)-check PT & PTT
Acute Kidney Injury
Rhabdomyolysis
Adult Respiratory Distress Syndrome (ARDS)
GI bleed
Hepatocellular Necrosis (Shock Liver)-highest heat generating organ in body
Mortality <10% if treated appropriately but can have permanent neurologic injury in up to 20% of cases

Question 14

highest heat generating organ in body

Answer 14

liver