UW prie intox. nonexertional vs exertional heat stroke, heat exaustion

Question 1

Uw table. exertional heat. risk factors?

Answer 1

strenous activity during hot and humid weather

Dehydration, poor aclimatization

Lack of physical fitness, obesity

MEDICATIONS: anticholinergic, antihistamine, phenothiazines, TCA, antipsychotic

Question 2

Uw table. exertional heat. CP?

Answer 2

Temp. >40 C + CNS dysfunction

Organ or tissue damage: renal or hepatic failure, DIC, ARDS

Question 3

Uw table. exertional heat. Mx?

Answer 3

RAPID COOLING: ice eater immersion preferred; can consider high-flow cold water dousing, ice wet towel rotation, evaporative cooling

Fluid resuscitation, electrolyte correction

Mx of end organ complicatiobs

NO ROLE FOR ANTIPYRETIC THERAPY

Question 4

Uw table. NONexertional heat. risk factors?

Answer 4

elderly, obesity, poor physical fitness

Alcohol, medications

High temperature, high humidity, lack air conditioning

Question 5

Uw table. NONexertional heat. CP?

Answer 5

Temp 40 + CNS dysfunction (encephalopathy, seizure)

Tachy, tachypnea +/- hypotension, flushing, +/- diaphoresis

End organ dysfuncrtion (DIC, pulmonary edema, renal/hepatic dysfunction)

Hemoconcentration

Question 6

Uw table. NONexertional heat. Mx?

Answer 6

Stabilization (ie ABC)
Rapid cooling (evaporative techniques are best tolerated in the elderly)
ANTIPYRETICS/DANTROLENE ARE NOT INDICATED

Mx of end organ damage

Question 7

Uw. Exertional heat vs NONexertional heat.

in what settting they differ?

Answer 7

nonexertional: patients with chronic medical conditions.

exertional: in. healthy individuals who are undergoing stressful activity in extreme heat and humidity >75 proc

Question 8

UW. HEAT EXHAUSTION (cia dar atskiras). CP?

Answer 8

due to INADEQUATE FLUID AND SALT REPLACEMENT

Temp < 40

CNS dysfunction is not present

Profuse sweating, nausea, vomiting, tachy, hypotension

Question 9

UW. HEAT EXHAUSTION. MX?

Answer 9

Cool patient (air conditioning, cool water shower)

Salt-containing oral fluids.

Question 10

UW. A 13-year-old girl with cystic fibrosis is evaluated in the emergency department after developing lightheadedness and nausea during an outdoor soccer game. The patient bumped heads with another player 10 minutes into the game but did not lose consciousness and continued playing. Near the end of the second half, she developed profound generalized weakness, felt she was going to pass out, and had to be carried off the field. Her parents say that she has been well except for runny nose and congestion the past 4 days. Temperature is 39 C (102 F), pulse is 136/min, and respirations are 26/min. The patient is alert and oriented but is sweating profusely. While being assessed, she develops abdominal cramps and nausea and then vomits. Which of the following is the most likely diagnosis in this patient?

Answer 10

HEAT EXHAUSTION

Question 11

UW. heat exhaustion

Although exertional heat stroke (EHS) may present in a similar manner, the absence of CNS dysfunction in this patient suggests she has heat exhaustion.

Answer 11

.

Question 12

UW. Heat exhaustion typically occurs after prolonged exercise (eg, soccer) in high ambient temperatures, particularly in the setting of high humidity, which limits evaporative cooling from sweat.

Answer 12

.

Question 13

UW. Heat exhaustion is characterized by hyperthermia; NO CNS IMPAIREMENT

Answer 13

.