Overview
What effect is global warming likely to have on the prevalence of heat stroke?
What is the pathophysiology of heat stroke?
How is heat acquired in the pathophysiology of heat stroke?
What is the role of heat loss in the pathophysiology of heat stroke?
What is the role of evaporation (sweat) in the pathophysiology of heat stroke?
What is the pathophysiology of classic heat stroke?
What factors interfere with heat dissipation in heat stroke?
How is the Wet Bulb Globe Temperature (WBGT) index used to predict risk for heat stroke?
What causes increased metabolism in heat stroke?
What is the role of increased muscular activity in the etiology of heat stroke?
What is the role of drugs in the etiology of heat stroke?
What causes reduced sweating in heat stroke?
What causes reduced central nervous system (CNS) responses in heat stroke?
What causes reduced cardiovascular reserve in heat stroke?
Which drugs can result in decreased heat loss in heat stroke?
What exogenous factors can decrease heat loss in heat stroke?
What are the risk factors for heat stress in heat stroke?
Why are infants and patients who are chronically ill at increased risk for heat stroke?
What is the incidence of heat stroke in the US?
What is the global incidence of heat stroke?
What are the racial predilections for heat stroke?
How does the incidence of heat stroke vary by age?
What are the indicators of poor prognosis in heat stroke?
What is the morbidity and mortality of heat stroke?
What should be included in patient education about heat stroke?
Presentation
What are the signs and symptoms of exertional heat stroke (EHS)?
What are the signs and symptoms of nonexertional heat stroke (NEHS)?
What vital signs findings indicate heat stroke?
What are the central nervous system (CNS) findings indicative of heat stroke?
What are the ocular findings indicative of heat stroke?
What are the cardiovascular findings indicative of heat stroke?
What are the pulmonary findings indicative of heat stroke?
What are the GI findings indicative of heat stroke?
What are the hepatic findings indicative of heat stroke?
What are the musculoskeletal findings indicative of heat stroke?
What are the renal findings indicative of heat stroke?
What are potential complications of heat stroke?
DDX
What conditions should be included in the differential diagnosis of heat stroke?
What are the differential diagnoses for Heat Stroke?
Workup
What does the presence of lactic acidosis suggest in the workup of heat stroke?
Which arterial blood gas findings suggest heat stroke?
What glucose findings suggest heat stroke?
What is the role of sodium level measurement in the workup of heat stroke?
What is the role of potassium measurement in the workup of heat stroke?
What is the role of electrolyte testing in the workup of heat stroke?
What is the role of hepatic function tests in the workup of heat stroke?
How is muscle function tested in the workup of heat stroke?
What complete blood cell (CBC) count findings suggest heat stroke?
Which renal function tests are indicated in the workup of heat stroke?
What is the role of urinalysis in the workup of heat stroke?
Which cerebrospinal fluid (CSF) findings suggest heat stroke?
How do myoglobin and hemoglobin present in heat stroke?
What is the role of imaging studies in the workup of heat stroke?
What is the role of ECG in the workup of heat stroke?
Which procedures may be indicated in the workup of heat stroke?
Treatment
What is the initial treatment for heat stroke?
What therapeutic modality is most effective in the treatment of heat stroke?
When are IV lines indicated in the treatment of heat stroke?
What interventions should be performed to enable monitoring in heat stroke?
What is the goal of treatment for heat stroke?
What are the methods for cooling in the treatment of heat stroke?
What is the role of medications in the treatment of heat stroke?
What is the role of fluid resuscitation in the treatment of heat stroke?
How is rhabdomyolysis managed in heat stroke?
What is the role of metabolic support in the treatment of heat stroke?
How is hepatic injury managed in heat stroke?
How are pulmonary injuries managed in heat stroke?
How are renal injuries managed in heat stroke?
What is the role of surgery in the treatment of heat stroke?
Which specialist consultations are needed in the treatment of heat stroke?
Which dietary and activity modifications are beneficial during treatment of heat stroke?
What is included in long-term monitoring following treatment for heat stroke?
Guidelines
Which organization has released guidelines on the prevention and treatment of heat stroke?
What are the Wilderness Medical Society guidelines on the prevention of heat stroke?
Medications
Which medications are administered in the treatment of heat stroke?
Which medications in the drug class Diuretics (osmotic) are used in the treatment of Heat Stroke?
Which medications in the drug class Alkalinizing agents are used in the treatment of Heat Stroke?
Which medications in the drug class Benzodiazepines are used in the treatment of Heat Stroke?
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Sample display of equipment useful for noninvasive cooling techniques. Clockwise from top: ice pack and water, air-cooling blanket, Foley catheter, and intravenous fluids.
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Sample display of equipment useful for cooling via gastric lavage. Clockwise from top: ice water, nasogastric tube, endotracheal tube, and lavage bag.
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Sample display of equipment useful for cooling via peritoneal lavage. Clockwise from top: iced water, peritoneal catheter, and saline fluid.