Hyperthermia

Question 1

most common etiology of the altered athlete?

Answer 1

• hyponatremia
• hypoglycemia
• heat stroke

Check RECTAL temp, glucose and sodium

Question 2

• intact mental status
• normal to slight elevated core temperature
• fatigue or malaise
• orthostatic, tachycardia
• nausea, vomiting, diarrhea

Answer 2

Heat exhaustion

Question 3

• altered mental status
• elevated core temperature
• hot, dry skin (may have exhausted capcity for sweating)
• weakness, nausea, vomiting, headache
• multi-organ system failure

Answer 3

heat stroke

Question 4

• faint or dizzy
• excessive sweating
• cool, pale, clammy skin
• rapid weak pulse
• nausea or vomiting
• muscle cramps

Answer 4

heat exhaustion

Question 5

• throbbing headache
• no sweating
• body temp above 103; red, hot, dry skin
• rapid, strong pulse
• nausea or vomiting
• may lose consciousness

Answer 5

Heat stroke

Question 6

who is at risk for hyperthermia?

Answer 6

• diminished cardiopulmonary reserve
• obesity/ overweight
• extensive scarring
• acute sunburn impairs sweating
• medications: increased heat production, compromised function of thermoregulatory centers

Question 7

tips to avoid hyperthermia

Answer 7

• heat acclimatization
• improved/increased physical conditioning
• avoid clothing/apparel that impedes evaporative and convective heat loss
• best treatment is prevention

Question 8

treatment of hyperthermia

Answer 8

• ABCs
• check blood sugar
• rectal temperature only
• cool em off, rapid cooling, cool until temperature less than 101F
• cold water immersion, evaporative cooling

Question 9

resusitation in hyperthermia

Answer 9

• hypotension secondary to severe dehydration, fluid shifts, cytokine storm
• two large bore peripheral IVs
• cold (4 degree celcius) crystalloid infusion
• large infusions necessary (multiple liters)
• if refractory, start vasopressors

Question 10

• most effective treatment option
• twice as rapid as evaporative heat loss
• limitations: unstable patients not so appropriate; challenging to set up

Answer 10

coldwater immersion

Question 11

• use of fans/air movement and spraying/dosing patient with water
• but does decrease morbidity and mortality

Answer 11

evaporative cooling

Question 12

• cold IVF administration
• not a primary treatment but used in combination with extra-corporeal cooling
• inadequate data for body cavity lavage and intravascular cooling devices (as opposed to hypothermia treatment/management)

Answer 12

Internal cooling