Materiały źródłowe

• #1 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  Heatstroke is a severe heat-related illness involving an elevation in body temperature, typically but not always greater than 40 C. The patient has clinical signs of central nervous system dysfunction that may include confusion, ataxia, delirium, or seizures brought on after strenuous physical exertion or exposure to hot weather. This activity illustrates the evaluation and treatment of heat stroke and reviews the role of the interprofessional team in this condition. […] Management of heat stroke includes ensuring adequate airway protection, breathing, and circulation. After ABCs, rapid cooling becomes the mainstay of treatment with ancillary management in response to other end-organ damage. […] Optimal treatment in heatstroke patients relies on early recognition and expedition of rapid cooling. If expecting a heatwave, a designated area with equipment for multiple patients should be available in the emergency department. The physician should understand what resources are available for cooling patients, as each facility may use evaporative, ice-bath, or other methodologies depending on its protocol. Careful coordination with nursing staff is necessary. Close monitoring of patients with a continuous rectal or esophageal temperature probe is necessary, with careful communication to stop cooling measures at the desired 38 to 39C.

• #2 Heat-related Illnesses | Heat | CDC

  https://www.cdc.gov/niosh/heat-stress/about/illnesses.html

  Workers exposed to extreme heat or work in hot environments may be at risk for experiencing heat-related illnesses. […] Workers and supervisors should be trained about heat-related illnesses, symptoms, and first aid. […] Heat stroke is the most serious heat-related illness. […] When heat stroke occurs, the body temperature can rise to 106F or higher within 10 to 15 minutes. […] Heat stroke can cause permanent disability or death if the person does not receive emergency treatment. […] Take the following steps to treat a worker with heat stroke: Call 911 for emergency medical care. […] Move the worker to a shaded, cool area and remove outer clothing. […] Cool the worker quickly, using the following methods: With a cold water or ice bath, if possible. […] Treat a worker who has heat exhaustion by doing the following: Take worker to a clinic or emergency room for medical evaluation and treatment.

• #3 Heat Stroke Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/166320-clinical

  Clinically, 2 forms of heat stroke are differentiated: classic, or nonexertional, heat stroke (NEHS) and exertional heat stroke (EHS). NEHS, which occurs during environmental heat waves, is more common in the very young and the elderly and should be suspected in children, elderly persons, and chronically ill individuals who present with an altered sensorium. NEHS occurs because of failure of the body’s heat dissipating mechanisms. […] On the other hand, EHS affects young, healthy individuals who engage in strenuous physical activity, and EHS should be suspected in all such individuals who exhibit bizarre, irrational behavior or experience syncope. EHS results from increased heat production, which overwhelms the body’s ability to dissipate heat. […] EHS is characterized by hyperthermia, diaphoresis, and an altered sensorium, which may manifest suddenly during extreme physical exertion in a hot environment.

• #4 Heat Stroke Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/166320-clinical

  A number of symptoms (eg, abdominal and muscular cramping, nausea, vomiting, diarrhea, headache, dizziness, dyspnea, weakness) commonly precede the heat stroke and may remain unrecognized. Syncope and loss of consciousness also are observed commonly before the development of EHS. […] EHS commonly is observed in young, healthy individuals (eg, athletes, firefighters, military personnel) who, while engaging in strenuous physical activity, overwhelm their thermoregulatory system and become hyperthermic. […] Risk factors that increase the likelihood of heat-related illnesses include a preceding viral infection, dehydration, fatigue, obesity, lack of sleep, poor physical fitness, and lack of acclimatization. […] NEHS is characterized by hyperthermia, anhidrosis, and an altered sensorium, which develop suddenly after a period of prolonged elevations in ambient temperatures (ie, heat waves).

• #5 Management of exertional heat stroke: a practical update for primary care physicians

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5819979/

  Exertional heat stroke (EHS) is a risk to athletes, the military, and others undergoing strenuous exertion, especially in temperate climates. It is defined as a core temperature of 40C with neurological impairment. It is one of the three commonest causes of deaths in athletes, and, untreated, the mortality may be up to 80%. Even when treated, it is associated with significant short- and long-term morbidity. […] Immediate cooling is the priority, along with maintaining a patent airway and adequate ventilation and circulation. Reducing the core temperature to below 38.9C within 60 minutes is associated with an improved survival. […] Patients should ideally be admitted to hospital for further assessment once cooling has occurred, for monitoring of multi-organ dysfunction. Heat illness is associated with renal failure in 13% of patients, exacerbated by rhabdomyolysis and dehydration, and may require renal replacement therapy.

• #6 Management of exertional heat stroke: a practical update for primary care physicians | British Journal of General Practice

  https://bjgp.org/content/68/668/153

  Exertional heat stroke (EHS) is a risk to athletes, the military, and others undergoing strenuous exertion, especially in temperate climates. It is defined as a core temperature of 40C with neurological impairment. It is one of the three commonest causes of deaths in athletes, and, untreated, the mortality may be up to 80%. […] Immediate cooling is the priority, along with maintaining a patent airway and adequate ventilation and circulation. Reducing the core temperature to below 38.9C within 60 minutes is associated with an improved survival. […] Patients should ideally be admitted to hospital for further assessment once cooling has occurred, for monitoring of multi-organ dysfunction. […] In patients seeking help after the acute episode, it is important to ensure that the organ dysfunction (for example, liver and renal injury, and coagulopathy) has resolved. Persistent organ dysfunction and cognitive abnormalities have been reported, and athletes should be aware that there is an increased risk of a further episode. […] The Faculty of Sports and Exercise Medicine advises that return to exercise should only occur when the athlete is asymptomatic and laboratory investigations have returned to normal, and some authorities advocate no exercise for at least 1 week, regardless of other factors.

• #7

  https://journals.lww.com/nursing/fulltext/2010/09001/keeping_your_cool_when_heatstroke_strikes.3.aspx

  Heat injuries can lead to serious complications, even death. Here’s how to respond. […] In this article, I’ll discuss the signs, symptoms, and treatment of heatstroke and less-serious heat injuries (heat cramps and heat exhaustion). […] The mechanism of heat injury is the same for all three types of heat injuries, with the difference being the severity of the heat injury. Patients who’ve had a heat injury once are more susceptible to heat injuries in the future. […] Risk factors for heat injuries include inadequate acclimatization to a hot environment, infections, fever, recent illness or injury, obesity, dehydration, exertion, fatigue, heavy meals, and ingesting alcohol (a vasodilator) or recreational drugs. […] The best way to prevent heat injuries is to drink adequate amounts of water before, during, and after exercise or exposure to high temperatures.

• #8 Heat Stroke Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/166320-clinical

  A number of symptoms (eg, abdominal and muscular cramping, nausea, vomiting, diarrhea, headache, dizziness, dyspnea, weakness) commonly precede the heat stroke and may remain unrecognized. Syncope and loss of consciousness also are observed commonly before the development of EHS. […] EHS commonly is observed in young, healthy individuals (eg, athletes, firefighters, military personnel) who, while engaging in strenuous physical activity, overwhelm their thermoregulatory system and become hyperthermic. […] Risk factors that increase the likelihood of heat-related illnesses include a preceding viral infection, dehydration, fatigue, obesity, lack of sleep, poor physical fitness, and lack of acclimatization. […] NEHS is characterized by hyperthermia, anhidrosis, and an altered sensorium, which develop suddenly after a period of prolonged elevations in ambient temperatures (ie, heat waves).

• #9 What doctors wish patients knew about heat stroke | American Medical Association

  https://www.ama-assn.org/delivering-care/population-care/what-doctors-wish-patients-knew-about-heat-stroke

  In children, the central nervous system is not fully developed. And similarly in adults 65 or older, the central nervous system—although fully developed—starts to deteriorate, which makes your body less able to cope with changes in the body temperature, Dr. Bangash said. So, both age groups are at higher risk. […] Certain chronic illnesses—such as heart or lung diseases—can increase your risk of heat stroke, Dr. Bangash said. […] If you see anyone who shows any signs of heat stroke, the immediate steps should be to call 911 and try to get that patient to the hospital, Dr. Bangash said. […] Rapid and effective cooling is a cornerstone of treatment, he emphasized. […] With heat stroke, age, severity of illness and the underlying health of a person are all factors that impact the recovery process, Dr. Bangash said.

• #10 What doctors wish patients knew about heat stroke | American Medical Association

  https://www.ama-assn.org/delivering-care/population-care/what-doctors-wish-patients-knew-about-heat-stroke

  In children, the central nervous system is not fully developed. And similarly in adults 65 or older, the central nervous system—although fully developed—starts to deteriorate, which makes your body less able to cope with changes in the body temperature, Dr. Bangash said. So, both age groups are at higher risk. […] Certain chronic illnesses—such as heart or lung diseases—can increase your risk of heat stroke, Dr. Bangash said. […] If you see anyone who shows any signs of heat stroke, the immediate steps should be to call 911 and try to get that patient to the hospital, Dr. Bangash said. […] Rapid and effective cooling is a cornerstone of treatment, he emphasized. […] With heat stroke, age, severity of illness and the underlying health of a person are all factors that impact the recovery process, Dr. Bangash said.

• #11 Dangers of Heatstroke in Nursing Home Residents | Disparti Law Group

  https://www.dispartilaw.com/dangers-of-heatstroke-in-nursing-home-residents/

  These conditions, often coupled with medications that either interfere with the body’s sweating mechanism or impair cognitive function, significantly increase the susceptibility of these individuals to heat-related illnesses. […] Nursing homes should be aware of how to respond to each heat-related illness before the patient’s condition worsens. […] For nursing home residents, it’s especially important to note any changes in behavior or physical condition, as they may not always be able to communicate their discomfort clearly. […] If heatstroke is suspected, it is critical to seek emergency medical help immediately and begin cooling the individual by any means available, such as immersing them in cool water or applying ice packs to key areas like the neck, armpits, and groin. […] Nursing home operators face the complex task of ensuring the safety of their residents while also maintaining seamless business operations during scorching heat waves.

• #12

  https://journals.lww.com/nursing/fulltext/2010/09001/keeping_your_cool_when_heatstroke_strikes.3.aspx

  Heat injuries can lead to serious complications, even death. Here’s how to respond. […] In this article, I’ll discuss the signs, symptoms, and treatment of heatstroke and less-serious heat injuries (heat cramps and heat exhaustion). […] The mechanism of heat injury is the same for all three types of heat injuries, with the difference being the severity of the heat injury. Patients who’ve had a heat injury once are more susceptible to heat injuries in the future. […] Risk factors for heat injuries include inadequate acclimatization to a hot environment, infections, fever, recent illness or injury, obesity, dehydration, exertion, fatigue, heavy meals, and ingesting alcohol (a vasodilator) or recreational drugs. […] The best way to prevent heat injuries is to drink adequate amounts of water before, during, and after exercise or exposure to high temperatures.

• #13

  https://journals.lww.com/nursing/fulltext/2010/09001/keeping_your_cool_when_heatstroke_strikes.3.aspx

  Heat injuries can lead to serious complications, even death. Here’s how to respond. […] In this article, I’ll discuss the signs, symptoms, and treatment of heatstroke and less-serious heat injuries (heat cramps and heat exhaustion). […] The mechanism of heat injury is the same for all three types of heat injuries, with the difference being the severity of the heat injury. Patients who’ve had a heat injury once are more susceptible to heat injuries in the future. […] Risk factors for heat injuries include inadequate acclimatization to a hot environment, infections, fever, recent illness or injury, obesity, dehydration, exertion, fatigue, heavy meals, and ingesting alcohol (a vasodilator) or recreational drugs. […] The best way to prevent heat injuries is to drink adequate amounts of water before, during, and after exercise or exposure to high temperatures.

• #14 What doctors wish patients knew about heat stroke | American Medical Association

  https://www.ama-assn.org/delivering-care/population-care/what-doctors-wish-patients-knew-about-heat-stroke

  It’s imperative to drink plenty of fluids because the more you hydrate, the more you’re able to sweat and maintain a normal body temperature. […] For people taking medications for chronic medical conditions, it’s very important to know your medications and your conditions to see if they put you at an increased risk of heat stroke, Dr. Bangash said. […] All kinds of strenuous activities for prolonged periods in high temperatures will put you at risk, Dr. Bangash said. […] Another thing I want to emphasize, especially with the changing climate, is to please, at all costs, do not leave children in a car, Dr. Bangash said.

• #15

  https://journals.lww.com/nursing/fulltext/2010/09001/keeping_your_cool_when_heatstroke_strikes.3.aspx

  Heat injuries can lead to serious complications, even death. Here’s how to respond. […] In this article, I’ll discuss the signs, symptoms, and treatment of heatstroke and less-serious heat injuries (heat cramps and heat exhaustion). […] The mechanism of heat injury is the same for all three types of heat injuries, with the difference being the severity of the heat injury. Patients who’ve had a heat injury once are more susceptible to heat injuries in the future. […] Risk factors for heat injuries include inadequate acclimatization to a hot environment, infections, fever, recent illness or injury, obesity, dehydration, exertion, fatigue, heavy meals, and ingesting alcohol (a vasodilator) or recreational drugs. […] The best way to prevent heat injuries is to drink adequate amounts of water before, during, and after exercise or exposure to high temperatures.

• #16

  https://journals.lww.com/nursing/fulltext/2010/09001/keeping_your_cool_when_heatstroke_strikes.3.aspx

  Heat injuries can lead to serious complications, even death. Here’s how to respond. […] In this article, I’ll discuss the signs, symptoms, and treatment of heatstroke and less-serious heat injuries (heat cramps and heat exhaustion). […] The mechanism of heat injury is the same for all three types of heat injuries, with the difference being the severity of the heat injury. Patients who’ve had a heat injury once are more susceptible to heat injuries in the future. […] Risk factors for heat injuries include inadequate acclimatization to a hot environment, infections, fever, recent illness or injury, obesity, dehydration, exertion, fatigue, heavy meals, and ingesting alcohol (a vasodilator) or recreational drugs. […] The best way to prevent heat injuries is to drink adequate amounts of water before, during, and after exercise or exposure to high temperatures.

• #17

  https://journals.lww.com/nursing/fulltext/2010/09001/keeping_your_cool_when_heatstroke_strikes.3.aspx

  Heat injuries can lead to serious complications, even death. Here’s how to respond. […] In this article, I’ll discuss the signs, symptoms, and treatment of heatstroke and less-serious heat injuries (heat cramps and heat exhaustion). […] The mechanism of heat injury is the same for all three types of heat injuries, with the difference being the severity of the heat injury. Patients who’ve had a heat injury once are more susceptible to heat injuries in the future. […] Risk factors for heat injuries include inadequate acclimatization to a hot environment, infections, fever, recent illness or injury, obesity, dehydration, exertion, fatigue, heavy meals, and ingesting alcohol (a vasodilator) or recreational drugs. […] The best way to prevent heat injuries is to drink adequate amounts of water before, during, and after exercise or exposure to high temperatures.

• #18 Heatstroke Guide For Cats And Dogs | RSPCA Pet Insurance

  https://www.rspcapetinsurance.org.au/pet-care/health-and-wellbeing/heatstroke-hyperthermia

  All dogs are susceptible to heatstroke so owners need to make sure that they take active steps to prevent it. However, some other predisposing factors for dogs can include: […] Brachycephalic anatomy (flat-face) is a major risk factor for heatstroke. Adequate snout length is very important for losing body heat. Flat-faced breeds also often suffer from serious obstructive breathing problems which also significantly impairs their ability to lose heat.

• #19 HEAT STROKE | PPT

  https://www.slideshare.net/slideshow/heat-stroke-257403683/257403683

  Heat stroke is a life-threatening condition where the body’s core temperature rises above 104F due to prolonged exposure to high temperatures. […] Nursing care focuses on continuous cooling and monitoring of vital signs. […] Treatment involves rapidly cooling the body through methods like cold baths and cooling blankets. […] Nursing care for heat stroke patient includes monitoring the vital signs, immersing the patient in cold water, and using evaporation cooling techniques. […] In heat stroke, a person’s body temperature rises to 104F (40C) or higher. […] Nursing care involves applying ice packs to the patient’s armpits, groin, neck, and back. […] Nursing care should also include educating patient and family members about the signs and symptoms of hyperthermia and the importance of increased fluid intake to avoid dehydration.

• #20 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Heat exhaustion and heatstroke are part of a continuum of heat-related illness. Both are common and preventable conditions affecting diverse patients. […] Untreated heat exhaustion can progress to heatstroke, a much more serious illness involving central nervous system dysfunction such as delirium and coma. […] Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. […] Physicians also must monitor electrolyte abnormalities, be alert to signs of renal or hepatic failure, and replace fluids in patients with heatstroke. […] Most experts believe that physicians and public health officials should focus greater attention on prevention. […] If a patient is suffering from heat-stroke, rapid diagnosis and effective cooling are crucial, because the condition triggers a series of metabolic events that may progress to irreversible injury or death.

• #21 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Heatstroke is a much more severe entity than heat exhaustion. The diagnosis of heatstroke rests on two critical factors: hyperthermia and central nervous system dysfunction. […] It is essential that clinicians recognize the signs of heatstroke and initiate cooling rapidly. […] Initial evaluation of a patient with suspected heatstroke should include an assessment of the airway, breathing, and circulation. […] Physical manifestations of heatstroke include hot, dry skin, as peripheral vasoconstriction often is present. […] Prompt reversal of hyperthermia is the cornerstone of heatstroke treatment. […] Immediate initiation of rapid and effective cooling is crucial in a patient with heatstroke. […] Cooling methods generally are categorized as external or internal. […] Medications have shown little efficacy in treating heatstroke. […] Heatstroke must be viewed as multisystem failure. […] Preparation for and understanding of heat-stroke can help prevent much of its associated morbidity and mortality.

• #22 What doctors wish patients knew about heat stroke | American Medical Association

  https://www.ama-assn.org/delivering-care/population-care/what-doctors-wish-patients-knew-about-heat-stroke

  Heat stroke is a severe heat-related illness that involves a significant elevation in body temperatures, usually as a result of prolonged exposure to high temperatures or physical exertion in high temperatures, Dr. Bangash said, noting heat stroke is seen most commonly when there’s a sudden increase in environmental temperatures. […] The earliest phase of heat stroke is called a hyperthermic neurologic phase, Dr. Bangash said, noting, you’ll see hyperthermia, a significant elevation of body temperature, causing confusion, slurred speech, agitation and sometimes irritability. In severe cases, seizures and coma are possible. […] Meanwhile, heat stroke is the more severe form of heat-related illness, where you see more neurologic symptoms and much less sweating because the sweating mechanisms have been exhausted, he said.

• #23 Heat Stroke Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/166320-clinical

  Patients with NEHS initially may exhibit a hyperdynamic circulatory state, but, in severe cases, hypodynamic states may be noted. […] Classic heat stroke most commonly occurs during episodes of prolonged elevations in ambient temperatures. It affects people who are unable to control their environment and water intake (eg, infants, elderly persons, individuals who are chronically ill), people with reduced cardiovascular reserve (eg, elderly persons, patients with chronic cardiovascular illnesses), and people with impaired sweating (eg, from skin disease or ingestion of anticholinergic or psychiatric drugs). […] Symptoms of CNS dysfunction are present universally in persons with heat stroke. Symptoms may range from irritability to coma. […] Patients commonly exhibit a hyperdynamic state, with tachycardia, low systemic vascular resistance, and a high cardiac index. However, a hypodynamic state, with a high systemic vascular resistance and a low cardiac index, may occur in patients with preexisting cardiovascular disease and low intravascular volume.

• #24

  https://journals.lww.com/nursingcriticalcare/fulltext/2009/07000/keeping_your_cool_when_heatstroke_strikes.7.aspx

  Heat injuries (heat cramps, heat exhaustion, and heatstroke) can lead to serious complications, even death. Here’s how to respond when the body loses its ability to maintain a stable temperature. […] The mechanism of heat injury is the same for all three types of heat injuries, with the difference being the severity of the heat injury. Patients who’ve had a heat injury once are more susceptible to heat injuries in the future. […] The classic signs and symptoms of heatstroke include early disorientation similar to that seen in heat exhaustion. Disorientation may range from irrational behavior to frank psychosis and unconsciousness. The patient’s skin will be hot and flushed and may be dry because he may stop sweating. His temperature may be as high as 109.4F (43C). […] With this information in mind, let’s consider Mr. Harris, the man who collapsed during a baseball game.

• #25

  https://journals.lww.com/nursing/fulltext/2010/09001/keeping_your_cool_when_heatstroke_strikes.3.aspx

  The classic signs and symptoms of heatstroke include early disorientation similar to that seen in heat exhaustion. […] Other signs include vomiting, diarrhea, tachycardia, and tachypnea, which may be profound; his respiratory rate may be as high as 60. […] The ECG may show nonspecific ST-segment and T-wave changes and various atrial and ventricular dysrhythmias. […] With this information in mind, let’s consider Mr. Harris, the man who collapsed during a baseball game. […] When the paramedics arrive soon after, they find that Mr. Harris’s systolic BP is 80 mm Hg by palpation and his temperature is 105 F (40.6 C) by skin strip. […] If initial treatment doesn’t lower Mr. Harris’s temperature, the healthcare provider may consider immersing Mr. Harris in ice water. […] Mr. Harris’s hyperthermia responds to the iced gastric lavage, sponging, and fanning. […] After 2 days in the ICU, Mr. Harris is transferred to the step-down unit. He’s discharged 2 days later, having suffered no permanent damage from his heatstroke.

• #26 HEAT STROKE | PPT

  https://www.slideshare.net/slideshow/heat-stroke-257403683/257403683

  Heat stroke is a life-threatening condition where the body’s core temperature rises above 104F due to prolonged exposure to high temperatures. […] Nursing care focuses on continuous cooling and monitoring of vital signs. […] Treatment involves rapidly cooling the body through methods like cold baths and cooling blankets. […] Nursing care for heat stroke patient includes monitoring the vital signs, immersing the patient in cold water, and using evaporation cooling techniques. […] In heat stroke, a person’s body temperature rises to 104F (40C) or higher. […] Nursing care involves applying ice packs to the patient’s armpits, groin, neck, and back. […] Nursing care should also include educating patient and family members about the signs and symptoms of hyperthermia and the importance of increased fluid intake to avoid dehydration.

• #27

  https://journals.lww.com/nursing/fulltext/2010/09001/keeping_your_cool_when_heatstroke_strikes.3.aspx

  The classic signs and symptoms of heatstroke include early disorientation similar to that seen in heat exhaustion. […] Other signs include vomiting, diarrhea, tachycardia, and tachypnea, which may be profound; his respiratory rate may be as high as 60. […] The ECG may show nonspecific ST-segment and T-wave changes and various atrial and ventricular dysrhythmias. […] With this information in mind, let’s consider Mr. Harris, the man who collapsed during a baseball game. […] When the paramedics arrive soon after, they find that Mr. Harris’s systolic BP is 80 mm Hg by palpation and his temperature is 105 F (40.6 C) by skin strip. […] If initial treatment doesn’t lower Mr. Harris’s temperature, the healthcare provider may consider immersing Mr. Harris in ice water. […] Mr. Harris’s hyperthermia responds to the iced gastric lavage, sponging, and fanning. […] After 2 days in the ICU, Mr. Harris is transferred to the step-down unit. He’s discharged 2 days later, having suffered no permanent damage from his heatstroke.

• #28 Heat Stroke: Symptoms, Causes and Treatment | Red Cross

  https://www.redcross.org/take-a-class/resources/learn-first-aid/heat-stroke?srsltid=AfmBOopsA95XvSmGzjQh9524Rm9ku58dWhmKvY5-uqZMv2LR9gL4NUN9

  Heat stroke is a life-threatening emergency. […] The person may vomit. […] Call 9-1-1 and get equipment if the person requires immediate emergency medical treatment. […] After calling 9-1-1, apply one of the following rapid cooling methods based on your resources: Immediately immerse them up to their neck in cold water if safe to do. […] Continue methods for 20 minutes, until the person feels better or EMS arrives. […] Give care for shock, if necessary. […] Watch for changes in condition, including breathing and responsiveness, and give care as appropriate and trained.

• #29 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Heatstroke is a much more severe entity than heat exhaustion. The diagnosis of heatstroke rests on two critical factors: hyperthermia and central nervous system dysfunction. […] It is essential that clinicians recognize the signs of heatstroke and initiate cooling rapidly. […] Initial evaluation of a patient with suspected heatstroke should include an assessment of the airway, breathing, and circulation. […] Physical manifestations of heatstroke include hot, dry skin, as peripheral vasoconstriction often is present. […] Prompt reversal of hyperthermia is the cornerstone of heatstroke treatment. […] Immediate initiation of rapid and effective cooling is crucial in a patient with heatstroke. […] Cooling methods generally are categorized as external or internal. […] Medications have shown little efficacy in treating heatstroke. […] Heatstroke must be viewed as multisystem failure. […] Preparation for and understanding of heat-stroke can help prevent much of its associated morbidity and mortality.

• #30 Heat stroke in children – UpToDate

  https://www.uptodate.com/contents/heat-stroke-in-children

  Heat stroke occurs in patients with environmental heat exposure and is defined as a core body temperature ≥40 to 40.5°C (104 to 105°F) accompanied by central nervous system (CNS) dysfunction. […] The diagnostic criteria for patients with heat stroke are elevated core temperature (≥40 to 40.5°C [104 to 105°F]) and central nervous system (CNS) abnormalities following environmental heat exposure. […] Children with heat stroke require aggressive treatment because the extent of end-organ damage and mortality is related to the duration of hyperthermia. […] We suggest that children with heat stroke undergo prehospital treatment with either cold-water immersion (if equipment and trained personnel are immediately available for initiation of this technique), tarp-assisted cooling, or evaporative external cooling while ensuring expeditious transport to definitive care.

• #31 Heatstroke – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/heat-stroke/diagnosis-treatment/drc-20353587

  Healthcare professionals can often diagnose heatstroke without testing. However, laboratory tests can confirm the diagnosis, rule out other causes for symptoms and find out if there is any organ damage. […] Heatstroke treatment centers on cooling the body to a standard temperature to prevent or reduce damage to the brain and vital organs. To do this, a healthcare professional may take these steps: […] If you have symptoms of heatstroke, seek emergency medical help. Others should take steps to cool you off while waiting for emergency help to arrive. […] If you notice signs of heat-related illness, lower your body temperature and prevent your condition from progressing to heatstroke.

• #32

  https://journals.lww.com/nursingcriticalcare/fulltext/2009/07000/keeping_your_cool_when_heatstroke_strikes.7.aspx

  The initial lab tests reveal a CK level of 78,200 units/L, consistent with severe heatstroke. Mr. Harris’s serum sodium level is 128 mEq/L, indicating hyponatremia, and his blood glucose is 60 mg/dL, indicating hypoglycemia, both conditions associated with heatstroke. […] If initial treatment doesn’t lower Mr. Harris’s temperature, the healthcare provider may consider immersing Mr. Harris in ice water. This lowers the patient’s temperature but may cause shivering, which generates more heat. […] Mr. Harris’s hyperthermia responds to the iced gastric lavage, sponging, and fanning. He’ll be admitted to the intensive care unit (ICU) after he’s stable because of the potential for severe complications: systemic inflammatory response syndrome, renal failure, respiratory failure, and liver failure.

• #33

  https://journals.lww.com/nursingcriticalcare/fulltext/2009/07000/keeping_your_cool_when_heatstroke_strikes.7.aspx

  The initial lab tests reveal a CK level of 78,200 units/L, consistent with severe heatstroke. Mr. Harris’s serum sodium level is 128 mEq/L, indicating hyponatremia, and his blood glucose is 60 mg/dL, indicating hypoglycemia, both conditions associated with heatstroke. […] If initial treatment doesn’t lower Mr. Harris’s temperature, the healthcare provider may consider immersing Mr. Harris in ice water. This lowers the patient’s temperature but may cause shivering, which generates more heat. […] Mr. Harris’s hyperthermia responds to the iced gastric lavage, sponging, and fanning. He’ll be admitted to the intensive care unit (ICU) after he’s stable because of the potential for severe complications: systemic inflammatory response syndrome, renal failure, respiratory failure, and liver failure.

• #34

  https://www.nursingcenter.com/journalarticle?Article_ID=593951&Journal_ID=230572&Issue_ID=593907

  Most patients who receive prompt and aggressive treatment recover from HS. However, recovery is poor in patients with initial CNS dysfunction, persistent hypotension, and decreased cardiac output. […] The incidence of ARF in EHS is approximately 30% and 50% in CHS. […] Rhabdomyolysis becomes clinically apparent when the peak CK values exceed 10,000 U/I. […] Many cases of classic and exertional HS are preventable. […] The clinical signs of HS include dizziness, nausea, vomiting, change in mental status or LOC, headache, piloerection, muscle cramps, occasionally diarrhea, and unsteady gait. […] Treatment is aimed at rapid reduction in core temperature by external cooling methods, fluid resuscitation, and prevention of complications. […] The prognosis is related to the severity of the CNS injury and duration of the hyperthermia.

• #35 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  Heat stroke is a medical emergency and continues to be one of the leading causes of preventable death in sports. Rapid reduction of the core body temperature is the cornerstone of treatment because the duration of hyperthermia is the primary determinant of outcome. Patients diagnosed with exertional heat stroke (EHS) or nonexertional heat stroke (NEHS) should be admitted to the hospital for at least 48 hours to monitor for complications. […] Once heat stroke is suspected, cooling must begin immediately and must be continued during the patient’s resuscitation. The American College of Sports Medicine recommends that cooling be initiated at the scene, before transporting the patient to an emergency department for further evaluation and treatment. […] Rehydration therapy alone is insufficient for heat stroke patients and should be combined with active cooling.

• #36 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  Some studies have shown that promptly reducing the exposure time to excessive heat can dramatically improve long-term outcomes and decrease irreversible injury. If treatment is initiated within this so-called golden hour and is aggressive enough to rapidly reduce the core body temperature, complications (including multisystem organ failure) may be averted and the patient may have a much better prognosis. […] Removal of restrictive clothing and spraying water on the body, covering the patient with ice watersoaked sheets, or placing ice packs in the axillae and groin may reduce the patient’s temperature significantly. Patients who are unable to protect their airway should be intubated. Patients who are awake and responsive should receive supplemental oxygen. […] Intensive care personnel must pay meticulous attention to the airway, reduce the temperature, limit the production of heat, optimize circulation, and monitor for and treat complications.

• #37 Heatstroke: First aid

  https://www.mayoclinic.org/first-aid/first-aid-heatstroke/basics/art-20056655

  Heatstroke happens when body temperature rises quickly and a person can’t cool down. It can be life-threatening by causing damage to the brain and other vital organs. It may be caused by doing strenuous activity in the heat or by being in a hot place for too long. Heatstroke can happen without having any previous heat-related condition, such as heat exhaustion. […] If you suspect heatstroke, call 911 or your local emergency number. Then move the person out of the heat right away. […] For heatstroke, cool the person through whatever means available. For example: Put the person in a cool tub of water or a cool shower. Spray the person with a garden hose. Sponge the person with cool water. Fan the person while misting with cool water. Place ice packs or cool, wet towels on the neck, armpits and groin. Cover the person with cool, damp sheets. If the person is conscious, offer chilled water, a sports drink containing electrolytes or another nonalcoholic beverage without caffeine. Begin CPR if the person loses consciousness and shows no signs of circulation, such as breathing, coughing or movement.

• #38 Heat Stroke: Symptoms, Treatment & Recovery

  https://my.clevelandclinic.org/health/diseases/21812-heatstroke

  Heat stroke is a life-threatening condition in which heat overwhelms your body’s ability to manage its temperature. […] Heat stroke is life-threatening and requires immediate medical treatment. The longer your body temperature remains high, the greater your risk of complications (like organ damage) or death. […] If you or someone around you has signs or symptoms of heat stroke, call 911 or your local emergency services number immediately. […] Heat stroke treatment involves quickly cooling down your body and monitoring for complications. This requires care in an emergency room. […] Call 911 immediately if you (or someone you’re with) has signs of heat stroke. But don’t wait for help to arrive to begin treating heat stroke. The sooner your body starts cooling down ideally within 30 minutes of the start of symptoms the better your chances of recovery.

• #39 Heat Stroke: Symptoms, Treatment & Recovery

  https://my.clevelandclinic.org/health/diseases/21812-heatstroke

  Heat stroke affects a person’s ability to stay aware and awake, so they’ll likely need bystanders to help. […] Here’s what you should do for someone with signs of heat stroke: Move the person out of the sun or heat to a cooler spot. […] Heat stroke diagnoses usually happen in the emergency room. Providers quickly need to get a sense of what you were doing when symptoms started and what exactly you’re experiencing. […] Providers will closely monitor you for signs of complications and give you further treatment as needed. This might include IV fluids (through a vein). […] Because heat stroke can lead to life-threatening complications, every minute counts when it comes to getting medical care.

• #40 Article Bites #41: Consensus Statement – Prehospital Care of Exertional Heat Stroke – NAEMSP

  https://naemsp.org/2022-7-13-article-bites-41-consensus-statement-prehospital-care-of-exertional-heat-stroke/

  The motto of EHS treatment in prehospital settings is “cool first, transport second.” Ideal and goal treatment for EHS is cooling the patient to under 104.5 degrees Fahrenheit in under 30 minutes from time of collapse. This goal is to reduce the end organ dysfunction, morbidity and mortality of this severe hyperthermia. […] Cold saline infusion alone is not an adequate cooling strategy and should be implored in conjunction with other cooling techniques. […] Exertional Heat Stroke is an emergent medical condition that relies on timely treatment in order to reduce morbidity and mortality. EMS is in a unique position to provide rapid recognition, assessment and treatment of these patients.

• #41 Guideline for the Treatment of Heat Stroke | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/guideline-for-the-treatment-of-heat-stroke

  Predicted increases in heat-related weather phenomena will result in increasing heat exposures and heat injuries such as heat stroke. […] These SCCM guidelines outline recommendations for the treatment of patients with heat stroke. […] Active cooling measures are recommended over passive cooling methods, with cold- or ice-water immersion achieving the fastest cooling rate. […] In patients with heat stroke, there is no evidence to support pharmacological interventions that affect temperature control, so they should be avoided. […] We recommend active cooling methods over passive cooling in patients with heat stroke. […] Clinicians should prioritize cooling methods that achieve the most rapid rate of cooling. […] Clinicians should choose cooling methods that reach the target temperature within 30 minutes from recognition of heat stroke symptoms.

• #42 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  Heat stroke is a medical emergency and continues to be one of the leading causes of preventable death in sports. Rapid reduction of the core body temperature is the cornerstone of treatment because the duration of hyperthermia is the primary determinant of outcome. Patients diagnosed with exertional heat stroke (EHS) or nonexertional heat stroke (NEHS) should be admitted to the hospital for at least 48 hours to monitor for complications. […] Once heat stroke is suspected, cooling must begin immediately and must be continued during the patient’s resuscitation. The American College of Sports Medicine recommends that cooling be initiated at the scene, before transporting the patient to an emergency department for further evaluation and treatment. […] Rehydration therapy alone is insufficient for heat stroke patients and should be combined with active cooling.

• #43 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  Some studies have shown that promptly reducing the exposure time to excessive heat can dramatically improve long-term outcomes and decrease irreversible injury. If treatment is initiated within this so-called golden hour and is aggressive enough to rapidly reduce the core body temperature, complications (including multisystem organ failure) may be averted and the patient may have a much better prognosis. […] Removal of restrictive clothing and spraying water on the body, covering the patient with ice watersoaked sheets, or placing ice packs in the axillae and groin may reduce the patient’s temperature significantly. Patients who are unable to protect their airway should be intubated. Patients who are awake and responsive should receive supplemental oxygen. […] Intensive care personnel must pay meticulous attention to the airway, reduce the temperature, limit the production of heat, optimize circulation, and monitor for and treat complications.

• #44 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  The goal of treatment is to reduce the temperature by at least 0.2C/min to approximately 39C. […] Antipyretics (eg, acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs) have no role in the treatment of heat stroke because antipyretics interrupt the change in the hypothalamic set point caused by pyrogens; they are not expected to work on a healthy hypothalamus that has been overloaded, as in the case of heat stroke. […] Immediate administration of benzodiazepines is indicated in patients with agitation and shivering, to stop excessive production of heat. […] Recommendations on the administration of intravenous fluids for circulatory support differ among patient populations and depend on the presence of hypovolemia, preexisting medical conditions, and preexisting cardiovascular disease.

• #45 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  The goal of treatment is to reduce the temperature by at least 0.2C/min to approximately 39C. […] Antipyretics (eg, acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs) have no role in the treatment of heat stroke because antipyretics interrupt the change in the hypothalamic set point caused by pyrogens; they are not expected to work on a healthy hypothalamus that has been overloaded, as in the case of heat stroke. […] Immediate administration of benzodiazepines is indicated in patients with agitation and shivering, to stop excessive production of heat. […] Recommendations on the administration of intravenous fluids for circulatory support differ among patient populations and depend on the presence of hypovolemia, preexisting medical conditions, and preexisting cardiovascular disease.

• #46 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  Some studies have shown that promptly reducing the exposure time to excessive heat can dramatically improve long-term outcomes and decrease irreversible injury. If treatment is initiated within this so-called golden hour and is aggressive enough to rapidly reduce the core body temperature, complications (including multisystem organ failure) may be averted and the patient may have a much better prognosis. […] Removal of restrictive clothing and spraying water on the body, covering the patient with ice watersoaked sheets, or placing ice packs in the axillae and groin may reduce the patient’s temperature significantly. Patients who are unable to protect their airway should be intubated. Patients who are awake and responsive should receive supplemental oxygen. […] Intensive care personnel must pay meticulous attention to the airway, reduce the temperature, limit the production of heat, optimize circulation, and monitor for and treat complications.

• #47 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Heatstroke is a much more severe entity than heat exhaustion. The diagnosis of heatstroke rests on two critical factors: hyperthermia and central nervous system dysfunction. […] It is essential that clinicians recognize the signs of heatstroke and initiate cooling rapidly. […] Initial evaluation of a patient with suspected heatstroke should include an assessment of the airway, breathing, and circulation. […] Physical manifestations of heatstroke include hot, dry skin, as peripheral vasoconstriction often is present. […] Prompt reversal of hyperthermia is the cornerstone of heatstroke treatment. […] Immediate initiation of rapid and effective cooling is crucial in a patient with heatstroke. […] Cooling methods generally are categorized as external or internal. […] Medications have shown little efficacy in treating heatstroke. […] Heatstroke must be viewed as multisystem failure. […] Preparation for and understanding of heat-stroke can help prevent much of its associated morbidity and mortality.

• #48 Guideline for the Treatment of Heat Stroke | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/guideline-for-the-treatment-of-heat-stroke

  Predicted increases in heat-related weather phenomena will result in increasing heat exposures and heat injuries such as heat stroke. […] These SCCM guidelines outline recommendations for the treatment of patients with heat stroke. […] Active cooling measures are recommended over passive cooling methods, with cold- or ice-water immersion achieving the fastest cooling rate. […] In patients with heat stroke, there is no evidence to support pharmacological interventions that affect temperature control, so they should be avoided. […] We recommend active cooling methods over passive cooling in patients with heat stroke. […] Clinicians should prioritize cooling methods that achieve the most rapid rate of cooling. […] Clinicians should choose cooling methods that reach the target temperature within 30 minutes from recognition of heat stroke symptoms.

• #49 Heatstroke – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/heat-illness/heatstroke

  Heat exhaustion can transition to heatstroke as heat illness progresses and is characterized by impairment of mental status and neurologic function. […] Diagnosis is usually clear from a history of exertion and environmental heat. Heatstroke is differentiated from heat exhaustion by presence of the following: CNS dysfunction, Temperature 40 C. […] The importance of rapid recognition and effective, aggressive cooling cannot be overemphasized. […] Cold water immersion results in the lowest morbidity and mortality rates and is the treatment of choice when available. […] Evaporative cooling is also very effective and works best if the patient has adequate peripheral circulation (requiring adequate cardiac output). […] Cooling measures should be stopped once temperature reaches approximately 39 C to avoid overcooling and causing iatrogenic hypothermia.

• #50 Guideline for the Treatment of Heat Stroke | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/guideline-for-the-treatment-of-heat-stroke

  Clinicians should prioritize cooling modalities that achieve a cooling rate greater than or equal to 0.155 C/min. […] We recommend against the use of dantrolene in patients with heat stroke. […] The routine use of acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDS), and salicylates for temperature reduction should be avoided. […] Prophylactic antibiotics or prophylactic antiseizure medications should only be used in the context of research.

• #51 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  The goal of treatment is to reduce the temperature by at least 0.2C/min to approximately 39C. […] Antipyretics (eg, acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs) have no role in the treatment of heat stroke because antipyretics interrupt the change in the hypothalamic set point caused by pyrogens; they are not expected to work on a healthy hypothalamus that has been overloaded, as in the case of heat stroke. […] Immediate administration of benzodiazepines is indicated in patients with agitation and shivering, to stop excessive production of heat. […] Recommendations on the administration of intravenous fluids for circulatory support differ among patient populations and depend on the presence of hypovolemia, preexisting medical conditions, and preexisting cardiovascular disease.

• #52 Guideline for the Treatment of Heat Stroke | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/guideline-for-the-treatment-of-heat-stroke

  Clinicians should prioritize cooling modalities that achieve a cooling rate greater than or equal to 0.155 C/min. […] We recommend against the use of dantrolene in patients with heat stroke. […] The routine use of acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDS), and salicylates for temperature reduction should be avoided. […] Prophylactic antibiotics or prophylactic antiseizure medications should only be used in the context of research.

• #53 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  The use of dantrolene has been shown in several small trials to be ineffective and is not recommended in treating heat stroke. The use of benzodiazepines in heat stroke may have merit for a patient who is agitated and shivering; however, empiric treatment is inadvisable until further studies are undertaken. […] Finally, expedited rapid cooling has been shown in several RCT both directly and indirectly to be the most effective treatment to limit mortality in heatstroke.

• #54 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  Treatment of rhabdomyolysis involves infusion of large amounts of intravenous fluids (fluid requirements may be as high as 10 L), alkalinization of the urine, and infusion of mannitol. […] Heat stroke commonly leads to severe but reversible hepatic damage. […] Pulmonary edema is a common complication of heat stroke and may be due to a number of factors, including fluid overload from aggressive rehydration, renal failure, congestive heart failure, and ARDS. […] Acute kidney injury (AKI) may occur because of direct thermal injury of the kidney, myoglobinuria, hypotension, and/or shock (acute tubular necrosis).

• #55 Heat Stroke Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/166320-clinical

  Acute kidney injury is a common complication of heat stroke and may be due to hypovolemia, low cardiac output, and myoglobinuria (from rhabdomyolysis). […] Heat stroke is a multisystem insult that potentially can affect almost every organ system. […] The central nervous system (CNS) is especially sensitive to the damaging effects of hyperthermia. Widespread cell death occurs but is more evident in the region of the cerebellum (Purkinje cells). […] Acute kidney injury may occur in as many as 25-30% of patients who have heat stroke (especially EHS). […] Rhabdomyolysis was observed in almost all patients with EHS and in as many as 86% of patients with NEHS.

• #56 Heatstroke – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/heat-illness/heatstroke

  Patients should be admitted to an intensive care unit and observed for multiple organ dysfunction, disseminated intravascular coagulation, and rhabdomyolysis. […] Mortality and morbidity are significant in heatstroke patients but vary markedly with age, underlying disorders, maximum temperature and, most importantly, duration of hyperthermia and promptness of cooling. […] Rapid recognition of heatstroke and effective, aggressive cooling are extremely important. […] Use cool water immersion or evaporative cooling to rapidly cool the patient. […] Patients will require intensive care monitoring with aggressive supportive care.

• #57

  https://www.nursingcenter.com/journalarticle?Article_ID=593951&Journal_ID=230572&Issue_ID=593907

  Most patients who receive prompt and aggressive treatment recover from HS. However, recovery is poor in patients with initial CNS dysfunction, persistent hypotension, and decreased cardiac output. […] The incidence of ARF in EHS is approximately 30% and 50% in CHS. […] Rhabdomyolysis becomes clinically apparent when the peak CK values exceed 10,000 U/I. […] Many cases of classic and exertional HS are preventable. […] The clinical signs of HS include dizziness, nausea, vomiting, change in mental status or LOC, headache, piloerection, muscle cramps, occasionally diarrhea, and unsteady gait. […] Treatment is aimed at rapid reduction in core temperature by external cooling methods, fluid resuscitation, and prevention of complications. […] The prognosis is related to the severity of the CNS injury and duration of the hyperthermia.

• #58 HEAT STROKE | PPT

  https://www.slideshare.net/slideshow/heat-stroke-257403683/257403683

  Heat stroke is a life-threatening condition where the body’s core temperature rises above 104F due to prolonged exposure to high temperatures. […] Nursing care focuses on continuous cooling and monitoring of vital signs. […] Treatment involves rapidly cooling the body through methods like cold baths and cooling blankets. […] Nursing care for heat stroke patient includes monitoring the vital signs, immersing the patient in cold water, and using evaporation cooling techniques. […] In heat stroke, a person’s body temperature rises to 104F (40C) or higher. […] Nursing care involves applying ice packs to the patient’s armpits, groin, neck, and back. […] Nursing care should also include educating patient and family members about the signs and symptoms of hyperthermia and the importance of increased fluid intake to avoid dehydration.

• #59 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  Heatstroke is a severe heat-related illness involving an elevation in body temperature, typically but not always greater than 40 C. The patient has clinical signs of central nervous system dysfunction that may include confusion, ataxia, delirium, or seizures brought on after strenuous physical exertion or exposure to hot weather. This activity illustrates the evaluation and treatment of heat stroke and reviews the role of the interprofessional team in this condition. […] Management of heat stroke includes ensuring adequate airway protection, breathing, and circulation. After ABCs, rapid cooling becomes the mainstay of treatment with ancillary management in response to other end-organ damage. […] Optimal treatment in heatstroke patients relies on early recognition and expedition of rapid cooling. If expecting a heatwave, a designated area with equipment for multiple patients should be available in the emergency department. The physician should understand what resources are available for cooling patients, as each facility may use evaporative, ice-bath, or other methodologies depending on its protocol. Careful coordination with nursing staff is necessary. Close monitoring of patients with a continuous rectal or esophageal temperature probe is necessary, with careful communication to stop cooling measures at the desired 38 to 39C.

• #60 Hyperthermia & Heat-Related Illnesses Nursing Diagnosis & Care Plan – Nurseslabs

  https://nurseslabs.com/hyperthermia/

  Heat cramps are painful, involuntary muscle spasms that usually occur during or after intense physical activity in high temperatures. […] Nursing assessment is vital for patients with hyperthermia as it helps determine the severity, underlying cause, and appropriate interventions. […] Nursing interventions for hyperthermia include measures to reduce body temperature such as cooling techniques (e.g., applying cool compresses, using fans), encouraging adequate fluid intake, and monitoring vital signs to assess response to interventions and prevent complications. […] Recognize the signs and symptoms of heat exhaustion or heat-related illness. […] Recognize the signs and symptoms of heatstroke. […] Loosen or remove excess clothing and covers and apply ice packs. […] Place ice packs on areas with high vascularity such as the groin, axillae, neck, and torso, while ensuring that ice packs are covered with a towel or sheet to protect the skin.

• #61 Hyperthermia & Heat-Related Illnesses Nursing Diagnosis & Care Plan – Nurseslabs

  https://nurseslabs.com/hyperthermia/

  Heat cramps are painful, involuntary muscle spasms that usually occur during or after intense physical activity in high temperatures. […] Nursing assessment is vital for patients with hyperthermia as it helps determine the severity, underlying cause, and appropriate interventions. […] Nursing interventions for hyperthermia include measures to reduce body temperature such as cooling techniques (e.g., applying cool compresses, using fans), encouraging adequate fluid intake, and monitoring vital signs to assess response to interventions and prevent complications. […] Recognize the signs and symptoms of heat exhaustion or heat-related illness. […] Recognize the signs and symptoms of heatstroke. […] Loosen or remove excess clothing and covers and apply ice packs. […] Place ice packs on areas with high vascularity such as the groin, axillae, neck, and torso, while ensuring that ice packs are covered with a towel or sheet to protect the skin.

• #62 Hyperthermia & Heat-Related Illnesses Nursing Diagnosis & Care Plan – Nurseslabs

  https://nurseslabs.com/hyperthermia/

  Sponge the patient with cold water or spray the patient using a spray bottle while placing a fan to blow air directly on the patient. […] Administer diazepam (Valium) or chlorpromazine (Thorazine) as indicated. […] Administer antipyretics cautiously (only if infection is suspected). […] Encourage adequate fluid intake. […] Understand that administering antipyretic medications have little use in treating hyperthermia. […] Administer IV fluids, such as normal saline or lactated Ringers solution, as ordered. […] Assess for signs of dehydration and electrolyte imbalances. […] Evaluate cardiovascular function and for electrolyte imbalances (e.g., hyperkalemia or hypocalcemia).

• #63 Providing Care for Dogs with Heatstroke

  https://todaysveterinarynurse.com/emergency-medicine-critical-care/providing-care-to-dogs-with-heatstroke/

  Providing Care for Dogs with Heatstroke. Every second counts with a patient suffering heatstroke. Intensive nursing care must be provided to increase the patient’s chance for survival. […] Heatstroke patients require constant and intensive nursing care. Monitor these patients for trends; even if a patient seems to be stabilizing, notify the veterinarian of any changes in vital parameters. […] The goal is normalization of blood pressure (i.e., mean arterial pressure of 80 to 120 mm Hg or systolic pressure of 110 to 160 mm Hg). […] As a veterinary professional, you will probably encounter a patient who is experiencing heatstroke. You will need to communicate effectively and quickly to the client. Understanding the needs of your patient will enable you to provide the best nursing care possible. Because every second counts with these patients, treatment must be administered quickly and intensive nursing care must be provided to increase the patient’s chance for survival.

• #64 Heatstroke (sunstroke): Signs, Symptoms, First Aid, and Treatment

  https://www.webmd.com/a-to-z-guides/heat-stroke-symptoms-and-treatment

  Heatstroke happens when your body temperature rises very high, usually because of being in a hot environment. It can damage your brain and other internal organs and be fatal. […] If you think that someone has heatstroke, immediately call 911 or take the person to a hospital. Any delay in seeking medical help can be fatal. […] Recovering from heatstroke can take about a week or longer. It depends on your age, the severity of your heatstroke, and any medical conditions you may have. Try to avoid hot weather and heavy exercise until your doctor tells you that it’s safe to resume your normal activities. […] Heatstroke is a medical emergency that requires immediate treatment. Call 911 if you or someone you’re with is showing signs of the illness, including headache, muscle weakness, dizziness, confusion, nausea and vomiting, and rapid breathing and heart rate. […] Heatstroke is a medical emergency that cannot be treated at home. Call 911 if you think you or someone else has heatstroke.

• #65 What doctors wish patients knew about heat stroke | American Medical Association

  https://www.ama-assn.org/delivering-care/population-care/what-doctors-wish-patients-knew-about-heat-stroke

  In children, the central nervous system is not fully developed. And similarly in adults 65 or older, the central nervous system—although fully developed—starts to deteriorate, which makes your body less able to cope with changes in the body temperature, Dr. Bangash said. So, both age groups are at higher risk. […] Certain chronic illnesses—such as heart or lung diseases—can increase your risk of heat stroke, Dr. Bangash said. […] If you see anyone who shows any signs of heat stroke, the immediate steps should be to call 911 and try to get that patient to the hospital, Dr. Bangash said. […] Rapid and effective cooling is a cornerstone of treatment, he emphasized. […] With heat stroke, age, severity of illness and the underlying health of a person are all factors that impact the recovery process, Dr. Bangash said.

• #66 Management of exertional heat stroke: a practical update for primary care physicians

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5819979/

  In patients seeking help after the acute episode, it is important to ensure that the organ dysfunction (for example, liver and renal injury, and coagulopathy) has resolved. Persistent organ dysfunction and cognitive abnormalities have been reported, and athletes should be aware that there is an increased risk of a further episode. […] The Faculty of Sports and Exercise Medicine advises that return to exercise should only occur when the athlete is asymptomatic and laboratory investigations have returned to normal, and some authorities advocate no exercise for at least 1 week, regardless of other factors.

• #67 Heat Stroke Recovery: What to Expect After Treatment – Texas Emergency Care

  https://txercare.com/blog/heat-stroke-recovery-what-to-expect-after-treatment/

  Heat stroke recovery is the process your body goes through after being treated for heat stroke, a severe condition caused by extended exposure to high temperatures, often combined with dehydration. This condition can damage your brain and other vital organs, so understanding the recovery phase is essential for ensuring full recovery and preventing future complications. This guide will help you understand what to expect, how to manage your recovery, and when to seek additional medical care. […] Rest is crucial after suffering from heat stroke. Your body needs time to heal from the damage caused by excessive heat. Generally, a few days of rest are recommended, but this may vary depending on the severity of the heat stroke and your overall health condition. During this recovery period: Avoid strenuous activities to prevent further stress on your body. Stay in a cool, comfortable environment to help your body maintain a normal temperature. Focus on getting plenty of sleep to aid the healing process.

• #68 Heat Stroke Recovery: What to Expect After Treatment – Texas Emergency Care

  https://txercare.com/blog/heat-stroke-recovery-what-to-expect-after-treatment/

  Rehydration is a key part of recovery from heat stroke, as the condition often results in significant fluid and electrolyte loss. Replenishing these is vital for recovery. Make sure to: Drink water and electrolyte-rich fluids like sports drinks frequently. Avoid drinks that can cause further dehydration, such as alcohol and caffeine. Monitor your hydration levels by checking for signs like dark urine, dry mouth, or dizziness. […] After heat stroke, it’s important to keep an eye on your health. Some symptoms might indicate complications or the need for further medical attention. Watch for: Persistent headaches or dizziness. Confusion or changes in mental state. Nausea or vomiting. Muscle weakness or cramps. If you experience any of these symptoms, please seek medical attention promptly. […] While many people recover fully from heat stroke, some may experience long-term effects. These can include: Ongoing fatigue that doesn’t improve with rest. Difficulty concentrating or remembering things. Frequent headaches. Greater sensitivity to heat than before.

• #69

  https://journals.lww.com/nursing/fulltext/2010/09001/keeping_your_cool_when_heatstroke_strikes.3.aspx

  Heat injuries can lead to serious complications, even death. Here’s how to respond. […] In this article, I’ll discuss the signs, symptoms, and treatment of heatstroke and less-serious heat injuries (heat cramps and heat exhaustion). […] The mechanism of heat injury is the same for all three types of heat injuries, with the difference being the severity of the heat injury. Patients who’ve had a heat injury once are more susceptible to heat injuries in the future. […] Risk factors for heat injuries include inadequate acclimatization to a hot environment, infections, fever, recent illness or injury, obesity, dehydration, exertion, fatigue, heavy meals, and ingesting alcohol (a vasodilator) or recreational drugs. […] The best way to prevent heat injuries is to drink adequate amounts of water before, during, and after exercise or exposure to high temperatures.

• #70 Heatstroke in Cats: Signs, Treatment, and Prevention | PetMD

  https://www.petmd.com/cat/conditions/systemic/heatstroke-cats

  Cats that become comatose may have cerebral edema, or brain swelling. This may be treated with mannitol, a diuretic IV medication. […] Cats with heatstroke are also more susceptible to sepsis (severe infection throughout the entire body), so antibiotics (such as ampicillin and Clavamox) are often used. […] In mild to moderate cases of heatstroke in cats, pets often make a full recovery by the time they are discharged from the hospital. […] Your veterinarian may want to see your cat back in five to 10 days. This is so that they can perform a recheck examination and lab tests to assess your cats organ function, and sooner if your cat experiences vomiting, diarrhea, or disorientation. […] Keep in mind that cats that have had heatstroke are more sensitive to a recurrence in the future. […] To prevent heatstroke in cats, take the following precautions: Always keep your cat indoors to protect them from predators, heat, and parasites. […] Do not let cats out on a catio on hot or humid days.

• #71 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Heat exhaustion and heatstroke are part of a continuum of heat-related illness. Both are common and preventable conditions affecting diverse patients. […] Untreated heat exhaustion can progress to heatstroke, a much more serious illness involving central nervous system dysfunction such as delirium and coma. […] Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. […] Physicians also must monitor electrolyte abnormalities, be alert to signs of renal or hepatic failure, and replace fluids in patients with heatstroke. […] Most experts believe that physicians and public health officials should focus greater attention on prevention. […] If a patient is suffering from heat-stroke, rapid diagnosis and effective cooling are crucial, because the condition triggers a series of metabolic events that may progress to irreversible injury or death.

• #72 What doctors wish patients knew about heat stroke | American Medical Association

  https://www.ama-assn.org/delivering-care/population-care/what-doctors-wish-patients-knew-about-heat-stroke

  It’s imperative to drink plenty of fluids because the more you hydrate, the more you’re able to sweat and maintain a normal body temperature. […] For people taking medications for chronic medical conditions, it’s very important to know your medications and your conditions to see if they put you at an increased risk of heat stroke, Dr. Bangash said. […] All kinds of strenuous activities for prolonged periods in high temperatures will put you at risk, Dr. Bangash said. […] Another thing I want to emphasize, especially with the changing climate, is to please, at all costs, do not leave children in a car, Dr. Bangash said.

• #73 How to Handle Heat Illness (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/heat-exhaustion-heatstroke-sheet.html

  Teach kids to always drink plenty of liquids before and during any activity in hot, sunny weather even if they aren’t thirsty. Make sure kids wear light-colored, loose clothing in warm weather. Remind kids to look for shaded areas and rest often while outside. Wear sunscreen and hats to avoid getting a sunburn. Don’t let kids do intense activities outdoors during the hottest hours of the day. Teach kids to come indoors right away if they feel overheated. Do not leave kids alone in a parked car.

• #74 About Heat and Your Health | Heat Health | CDC

  https://www.cdc.gov/heat-health/about/index.html

  Protect yourself and others when it’s hot outside by staying cool, staying hydrated, and knowing the symptoms. […] Work with your doctor to create a Heat Action Plan. […] Check on your family, friends, and neighbors, especially if they have chronic medical problems or live alone. […] If your body gets too hot, you can get sick. Know the symptoms of your body overheating and know when to seek medical care. […] Many medicines can make you dehydrated or overheated on hot days. Also, some medicines need to be kept out of hot places. […] Although anyone at any time can suffer from heat-related illness, some people are at greater risk than others. Check on your family, friends, and neighbors, especially if they live alone or have chronic medical problems. […] Some groups may have to take additional action on hot days, including: People, especially children, with asthma, People with heart disease, Pregnant women, People 65 years of age or older, People who are working or exercising outside in the heat, Infants and young children. […] CDC’s heat and health site provides healthcare professionals with information about how to manage heat and conditions like asthma, pregnancy, and cardiovascular disease.

• #75 How to Handle Heat Illness (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/heat-exhaustion-heatstroke-sheet.html

  Teach kids to always drink plenty of liquids before and during any activity in hot, sunny weather even if they aren’t thirsty. Make sure kids wear light-colored, loose clothing in warm weather. Remind kids to look for shaded areas and rest often while outside. Wear sunscreen and hats to avoid getting a sunburn. Don’t let kids do intense activities outdoors during the hottest hours of the day. Teach kids to come indoors right away if they feel overheated. Do not leave kids alone in a parked car.

• #76 Dangers of Heatstroke in Nursing Home Residents | Disparti Law Group

  https://www.dispartilaw.com/dangers-of-heatstroke-in-nursing-home-residents/

  These conditions, often coupled with medications that either interfere with the body’s sweating mechanism or impair cognitive function, significantly increase the susceptibility of these individuals to heat-related illnesses. […] Nursing homes should be aware of how to respond to each heat-related illness before the patient’s condition worsens. […] For nursing home residents, it’s especially important to note any changes in behavior or physical condition, as they may not always be able to communicate their discomfort clearly. […] If heatstroke is suspected, it is critical to seek emergency medical help immediately and begin cooling the individual by any means available, such as immersing them in cool water or applying ice packs to key areas like the neck, armpits, and groin. […] Nursing home operators face the complex task of ensuring the safety of their residents while also maintaining seamless business operations during scorching heat waves.

• #77 Dangers of Heatstroke in Nursing Home Residents | Disparti Law Group

  https://www.dispartilaw.com/dangers-of-heatstroke-in-nursing-home-residents/

  Nursing home staff must be proactive in preventing heat-related illnesses in their residents. […] When proper steps are not taken to protect the elderly, this may be a sign of nursing home neglect. […] Immediate action when symptoms appear can be the difference between life and death for the resident. […] Nursing homes must have proper protocol and training for how to respond when heat-related illnesses occur. […] If your loved one suffered injuries or even death due to a heatstroke while in a nursing home, consider speaking to an attorney if you suspect nursing home negligence.

• #78 Preventing Heatstroke: Tips And Strategies | TGH Urgent Care

  https://www.fasttrackurgentcare.com/preventing-heatstroke-tips-and-strategies/

  Air conditioning is considered the most effective way to prevent heat-related illnesses, including heatstroke. […] To prevent heat stroke while working outdoors or participating in strenuous activities, it is crucial to take frequent breaks and mist oneself with a spray bottle. […] Heatstroke can have severe consequences, including permanent damage or even death. Therefore, it is crucial to take prompt and decisive action to save lives. If you suspect that someone may be suffering from heat-related injury, you should: Call for medical assistance immediately. Move the affected person out of the heat and into a cool environment. Remove any tight or heavy clothing to help the individual cool down. Apply cold water to the person’s skin or fan them to stimulate sweating. Place ice packs under the armpits and groin of the individual to initiate rapid cooling. Have the person lie down on their back with their feet slightly elevated. Offer cool water or a non-alcoholic, non-caffeinated beverage for the individual to drink. Take the person’s temperature with a thermometer if possible and closely monitor their condition.

• #79 Guideline for the Treatment of Heat Stroke | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/guideline-for-the-treatment-of-heat-stroke

  Predicted increases in heat-related weather phenomena will result in increasing heat exposures and heat injuries such as heat stroke. […] These SCCM guidelines outline recommendations for the treatment of patients with heat stroke. […] Active cooling measures are recommended over passive cooling methods, with cold- or ice-water immersion achieving the fastest cooling rate. […] In patients with heat stroke, there is no evidence to support pharmacological interventions that affect temperature control, so they should be avoided. […] We recommend active cooling methods over passive cooling in patients with heat stroke. […] Clinicians should prioritize cooling methods that achieve the most rapid rate of cooling. […] Clinicians should choose cooling methods that reach the target temperature within 30 minutes from recognition of heat stroke symptoms.

• #80 Heat stroke | Journal of Intensive Care | Full Text

  https://jintensivecare.biomedcentral.com/articles/10.1186/s40560-018-0298-4

  Heat stroke is a life-threatening injury requiring neurocritical care; however, heat stroke has not been completely examined due to several possible reasons, such as no universally accepted definition or classification, and the occurrence of heat wave victims every few years. […] In this review, we elucidate the definition/classification, pathophysiology, and prognostic factors related to heat stroke and also summarize the results of current studies regarding the management of heat stroke, including the use of intravascular balloon catheter system, blood purification therapy, continuous electroencephalogram monitoring, and anticoagulation therapy. […] According to the detailed analysis of risk factors, prevention strategies for heat stroke, such as air conditioner use, are important. Moreover, hematological, cardiovascular, neurological, and renal dysfunctions on admission are associated with high mortality, which thus represent the potential targets for intensive and specific therapies for patients with heat stroke.

• #81

  https://he02.tci-thaijo.org/index.php/ccc/article/view/269722

  Heatstroke is a potentially fatal condition that occurs when the bodys thermoregulatory responses are overwhelmed by excessive heat. […] Emphasis is placed on the importance of early recognition, prompt diagnosis, rapid cooling, and various cooling strategies, along with organ-supportive care, to improve patient outcomes. […] Additionally, the review underscores the need for increased awareness and public health initiatives to prevent and manage this life-threatening condition.

• #82 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Heat exhaustion and heatstroke are part of a continuum of heat-related illness. Both are common and preventable conditions affecting diverse patients. […] Untreated heat exhaustion can progress to heatstroke, a much more serious illness involving central nervous system dysfunction such as delirium and coma. […] Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. […] Physicians also must monitor electrolyte abnormalities, be alert to signs of renal or hepatic failure, and replace fluids in patients with heatstroke. […] Most experts believe that physicians and public health officials should focus greater attention on prevention. […] If a patient is suffering from heat-stroke, rapid diagnosis and effective cooling are crucial, because the condition triggers a series of metabolic events that may progress to irreversible injury or death.

• #83 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Heatstroke is a much more severe entity than heat exhaustion. The diagnosis of heatstroke rests on two critical factors: hyperthermia and central nervous system dysfunction. […] It is essential that clinicians recognize the signs of heatstroke and initiate cooling rapidly. […] Initial evaluation of a patient with suspected heatstroke should include an assessment of the airway, breathing, and circulation. […] Physical manifestations of heatstroke include hot, dry skin, as peripheral vasoconstriction often is present. […] Prompt reversal of hyperthermia is the cornerstone of heatstroke treatment. […] Immediate initiation of rapid and effective cooling is crucial in a patient with heatstroke. […] Cooling methods generally are categorized as external or internal. […] Medications have shown little efficacy in treating heatstroke. […] Heatstroke must be viewed as multisystem failure. […] Preparation for and understanding of heat-stroke can help prevent much of its associated morbidity and mortality.

• #84 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Heat exhaustion and heatstroke are part of a continuum of heat-related illness. Both are common and preventable conditions affecting diverse patients. […] Untreated heat exhaustion can progress to heatstroke, a much more serious illness involving central nervous system dysfunction such as delirium and coma. […] Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. […] Physicians also must monitor electrolyte abnormalities, be alert to signs of renal or hepatic failure, and replace fluids in patients with heatstroke. […] Most experts believe that physicians and public health officials should focus greater attention on prevention. […] If a patient is suffering from heat-stroke, rapid diagnosis and effective cooling are crucial, because the condition triggers a series of metabolic events that may progress to irreversible injury or death.

• #85 Heat stroke | Journal of Intensive Care | Full Text

  https://jintensivecare.biomedcentral.com/articles/10.1186/s40560-018-0298-4

  The effectiveness of cooling devices, drugs, and therapies in heat stroke remains inconclusive. Further large studies are required to continue to evaluate these treatment strategies. […] Heat stroke progresses to multiorgan dysfunction syndrome; therefore, rapid, effective cooling followed by close monitoring and specific treatment for injured organs are fundamental to treatment success. […] To date, several cooling methods are available in the clinical settings, including immersion, evaporation, and the use of cold water bladders, gastric and rectal lavage, and noninvasive cooling systems. […] However, there is no evidence supporting the superiority of any one cooling method for patients with heat stroke. […] Blood purification therapy has not been discussed in the two previously reported review articles; however, good recovery cases have been reported in Japan.

• #86 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  Heatstroke is a severe heat-related illness involving an elevation in body temperature, typically but not always greater than 40 C. The patient has clinical signs of central nervous system dysfunction that may include confusion, ataxia, delirium, or seizures brought on after strenuous physical exertion or exposure to hot weather. This activity illustrates the evaluation and treatment of heat stroke and reviews the role of the interprofessional team in this condition. […] Management of heat stroke includes ensuring adequate airway protection, breathing, and circulation. After ABCs, rapid cooling becomes the mainstay of treatment with ancillary management in response to other end-organ damage. […] Optimal treatment in heatstroke patients relies on early recognition and expedition of rapid cooling. If expecting a heatwave, a designated area with equipment for multiple patients should be available in the emergency department. The physician should understand what resources are available for cooling patients, as each facility may use evaporative, ice-bath, or other methodologies depending on its protocol. Careful coordination with nursing staff is necessary. Close monitoring of patients with a continuous rectal or esophageal temperature probe is necessary, with careful communication to stop cooling measures at the desired 38 to 39C.

• #87 Heatstroke – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/heat-illness/heatstroke

  Patients should be admitted to an intensive care unit and observed for multiple organ dysfunction, disseminated intravascular coagulation, and rhabdomyolysis. […] Mortality and morbidity are significant in heatstroke patients but vary markedly with age, underlying disorders, maximum temperature and, most importantly, duration of hyperthermia and promptness of cooling. […] Rapid recognition of heatstroke and effective, aggressive cooling are extremely important. […] Use cool water immersion or evaporative cooling to rapidly cool the patient. […] Patients will require intensive care monitoring with aggressive supportive care.

• #88 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Heat exhaustion and heatstroke are part of a continuum of heat-related illness. Both are common and preventable conditions affecting diverse patients. […] Untreated heat exhaustion can progress to heatstroke, a much more serious illness involving central nervous system dysfunction such as delirium and coma. […] Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. […] Physicians also must monitor electrolyte abnormalities, be alert to signs of renal or hepatic failure, and replace fluids in patients with heatstroke. […] Most experts believe that physicians and public health officials should focus greater attention on prevention. […] If a patient is suffering from heat-stroke, rapid diagnosis and effective cooling are crucial, because the condition triggers a series of metabolic events that may progress to irreversible injury or death.

• #89 Heatstroke – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/heat-illness/heatstroke

  Patients should be admitted to an intensive care unit and observed for multiple organ dysfunction, disseminated intravascular coagulation, and rhabdomyolysis. […] Mortality and morbidity are significant in heatstroke patients but vary markedly with age, underlying disorders, maximum temperature and, most importantly, duration of hyperthermia and promptness of cooling. […] Rapid recognition of heatstroke and effective, aggressive cooling are extremely important. […] Use cool water immersion or evaporative cooling to rapidly cool the patient. […] Patients will require intensive care monitoring with aggressive supportive care.

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