SlideShare a Scribd company logo
HEAT RELATED
ILLNESSES
Saunora Prom, DO, CAQSM
Tidewater Sports & Osteopathic
Medicine
TPMG
May 17, 2018
Overview
• Description/definitions
• Epidemiology
• Incidence/prevalence
• Etiology
• Risk factors
• Diagnosis and differential
• Treatment
• Prevention
• Conclusion
Definitions
A continuum of increasingly severe exertional heat illnesses caused by
dehydration, electrolyte losses, and failure of body’s thermoregulatory
mechanisms.
 Exercise Associated Muscle Cramps (Heat Cramps)
 Heat Exhaustion
 Heat Injury
 Heat Stroke
Epidemiology
 Predominantly in children and elderly
 Male >Female
 EHS- 4.5/100,000 person’s affected per FB season
 ~600 deaths/year in the USA
Exercise Associated Muscle Cramps (Heat
Cramps)
• painful involuntary muscle contractions/spasms
occurring in the setting of strenuous exercise and hot
temperatures
Heat Exhaustion
• Athlete has obvious difficulty continuing with exercise
• Core body temperature is usually 101 to 104ºF at the time
of collapse
• No significant dysfunction of the central nervous system
(seizure, altered consciousness, persistent delirium) is
present
Heat Exhaustion Symptoms
• Tachycardia and hypotension
• Extreme weakness
• Dehydration and electrolyte losses
• Ataxia and coordination problems, syncope, light-
headedness
• Profuse sweating, pallor, "prickly heat" sensations
• Headache
• Abdominal cramps, nausea, vomiting, diarrhea
• Persistent muscle cramps
Heat Injury
• Exertional heat illness with evidence of both hyperthermia
and end organ damage, but without any significant
neurologic manifestations.
• Collapse during strenuous activity, a core temperature
above 104 to 105°F, and the absence of neurologic
findings.
Exertional Heat Stroke
• Multisystem illness characterized by central nervous
system (CNS) dysfunction (encephalopathy) and
additional organ and tissue damage (eg, acute kidney
injury, liver injury, rhabdomyolysis).
• Core temp > 104F
EHS- Symptoms
• Disorientation
• Headache
• Irrational behavior
• Irritability
• Emotional instability
• Confusion
• Altered consciousness
• Coma
• Seizure
Severe Non-Exertional Hyperthermia
(Classic Heat Stoke)
• Most often patients over 70, with underlying chronic
medical conditions that impair thermoregulation, prevent
removal from a hot environment, or interfere with access
to hydration or attempts at cooling
Thermoregulation
Evaporation-occurs when water vaporizes from the skin
and respiratory tract. Most effective mechanism.
Conduction-direct heat transfer to an adjacent, cooler
object.
Convection-transfer of heat to a gas or liquid moving over
the body. Heat transfer occurs when the gas or liquid is
colder than the body.
Radiation-is the emission of electromagnetic heat waves
Risk Factors
 Poor physical conditioning
 Salt or water depletion
 Obesity
 Acute febrile or GI illnesses
 Chronic disease (HTN, DM, CAD)
 ETOH
 Clothing
 Medications
Medications
• ●Anticholinergic agents
• ●Antiepileptic agents
• ●Antihistamines
• ●Decongestants
• ●Phenothiazines
• ●Tricyclic antidepressants
• ●Amphetamines
• ●Ergogenic stimulants (eg, ephedrine, dimethylamylamine)
• ●Lithium
• ●Diuretics
• ●Beta blockers
Differential Diagnosis
 Febrile illnesses, sepsis
 Drug induced fluid loss
 Arrhythmia or MI
 Acute cocaine intoxication
 Neuroleptic malignant syndrome
 Malignant hyperthermia – autosomal disorder where patients have
abnormal muscle metabolism on exposure to halothane or skeletal
muscle reactants
Treatment
 General measures
• Gradual fluid and electrolyte replacement with normal saline
• Body immersion in ice water
• Evaporative cooling
• *any method to cool patient’s body*
Prevention
 Proper hydration
 Elderly at increased risk because of diminished thirst signaling
 Patient education to emphasize importance of appropriate
conditioning and acclimatization
 Adjusting activity according to Wet Bulb Globe Test (WBGT)
 WBGT = 0.1 x Dry Bulb Temperature (DBT) + 0.7 x Wet Bulb
Temperature (WBT) + 0.2 x Globe Temperature (GT)
Copyrights apply
Conclusion
 While these ailments are not that common, they can produce
devastating consequences if not addressed
 Incidence will likely increase with growing elderly population
 Patient education important
Questions????

More Related Content

What's hot

Army Heat Injuries
Army Heat Injuries Army Heat Injuries
Army Heat Injuries
Sarah-Beth Roach
 
Environmental injuries
Environmental injuriesEnvironmental injuries
Environmental injuries
Josyann Abisaab
 
Heat Injury Prevention
Heat Injury PreventionHeat Injury Prevention
Heat Injury Prevention
314mcd
 
Heat related illnesses
Heat related illnessesHeat related illnesses
Heat related illnesses
Vyjayanthi Kadambi
 
Heat Stroke
Heat StrokeHeat Stroke
Heat Stroke
DJ CrissCross
 
1.3.5 heat exhaustion
1.3.5 heat exhaustion1.3.5 heat exhaustion
1.3.5 heat exhaustion
prssncdcc
 
Hyperthermia
HyperthermiaHyperthermia
Hyperthermia
vetdrfahadriaz
 
GEMC: Hypothermia and Frostbite
GEMC: Hypothermia and FrostbiteGEMC: Hypothermia and Frostbite
GEMC: Hypothermia and Frostbite
Open.Michigan
 
Heat related injuries
Heat related injuriesHeat related injuries
Heat related injuries
Ryan Maxwell
 
Hyperthermia and hypothermia
Hyperthermia and hypothermiaHyperthermia and hypothermia
Hyperthermia and hypothermia
Bibi Bibi
 
Thermoregulation of Body
Thermoregulation of BodyThermoregulation of Body
Thermoregulation of Body
Physioaadhar Physiotherapy Services
 
Heat stroke and rhabdomyolysis 2017 final
Heat stroke and rhabdomyolysis 2017 finalHeat stroke and rhabdomyolysis 2017 final
Heat stroke and rhabdomyolysis 2017 final
CHAKEN MANIYAN
 
Heat stroke by dr nida
Heat stroke by dr nidaHeat stroke by dr nida
Heat stroke by dr nida
West Medicine Ward
 
Heat stroke and its managemnets
Heat stroke and its managemnetsHeat stroke and its managemnets
Heat stroke and its managemnets
Ruhul Amin
 
heat stroke
heat strokeheat stroke
heat stroke
Srirama Anjaneyulu
 
Environmental injuries part ii 2018 06 18
Environmental injuries part ii 2018 06 18Environmental injuries part ii 2018 06 18
Environmental injuries part ii 2018 06 18
Paleenui Jariyakanjana
 
The Health Effect of Heat-Illness on Baseball and Softball Umpires
The Health Effect of Heat-Illness on Baseball and Softball UmpiresThe Health Effect of Heat-Illness on Baseball and Softball Umpires
The Health Effect of Heat-Illness on Baseball and Softball Umpires
The Windsdor Consulting Group, Inc.
 
Hypothermia
HypothermiaHypothermia
Hypothermia
Ganesh Gupta
 
Heat Related Disorders
Heat Related DisordersHeat Related Disorders
Heat Related Disorders
Dima Lotfie
 
Heat stroke
Heat strokeHeat stroke
Heat stroke
Mahmoud Ahmad
 

What's hot (20)

Army Heat Injuries
Army Heat Injuries Army Heat Injuries
Army Heat Injuries
 
Environmental injuries
Environmental injuriesEnvironmental injuries
Environmental injuries
 
Heat Injury Prevention
Heat Injury PreventionHeat Injury Prevention
Heat Injury Prevention
 
Heat related illnesses
Heat related illnessesHeat related illnesses
Heat related illnesses
 
Heat Stroke
Heat StrokeHeat Stroke
Heat Stroke
 
1.3.5 heat exhaustion
1.3.5 heat exhaustion1.3.5 heat exhaustion
1.3.5 heat exhaustion
 
Hyperthermia
HyperthermiaHyperthermia
Hyperthermia
 
GEMC: Hypothermia and Frostbite
GEMC: Hypothermia and FrostbiteGEMC: Hypothermia and Frostbite
GEMC: Hypothermia and Frostbite
 
Heat related injuries
Heat related injuriesHeat related injuries
Heat related injuries
 
Hyperthermia and hypothermia
Hyperthermia and hypothermiaHyperthermia and hypothermia
Hyperthermia and hypothermia
 
Thermoregulation of Body
Thermoregulation of BodyThermoregulation of Body
Thermoregulation of Body
 
Heat stroke and rhabdomyolysis 2017 final
Heat stroke and rhabdomyolysis 2017 finalHeat stroke and rhabdomyolysis 2017 final
Heat stroke and rhabdomyolysis 2017 final
 
Heat stroke by dr nida
Heat stroke by dr nidaHeat stroke by dr nida
Heat stroke by dr nida
 
Heat stroke and its managemnets
Heat stroke and its managemnetsHeat stroke and its managemnets
Heat stroke and its managemnets
 
heat stroke
heat strokeheat stroke
heat stroke
 
Environmental injuries part ii 2018 06 18
Environmental injuries part ii 2018 06 18Environmental injuries part ii 2018 06 18
Environmental injuries part ii 2018 06 18
 
The Health Effect of Heat-Illness on Baseball and Softball Umpires
The Health Effect of Heat-Illness on Baseball and Softball UmpiresThe Health Effect of Heat-Illness on Baseball and Softball Umpires
The Health Effect of Heat-Illness on Baseball and Softball Umpires
 
Hypothermia
HypothermiaHypothermia
Hypothermia
 
Heat Related Disorders
Heat Related DisordersHeat Related Disorders
Heat Related Disorders
 
Heat stroke
Heat strokeHeat stroke
Heat stroke
 

Similar to Dr. pom (2)

Neurology of heat stroke
Neurology of heat strokeNeurology of heat stroke
Neurology of heat stroke
Srirama Anjaneyulu
 
Heat and cold injuries
Heat and cold injuriesHeat and cold injuries
Heat and cold injuries
Viswanathan Pandurangan
 
Heat stroke
Heat strokeHeat stroke
Heat stroke
Tanta University
 
heat stroke and heat exhaustion in children
heat stroke and heat exhaustion in childrenheat stroke and heat exhaustion in children
heat stroke and heat exhaustion in children
SumeraAhmad5
 
Environmental injuries
Environmental injuriesEnvironmental injuries
Environmental injuries
Nadia Shams
 
Heat Stroke.pptx
Heat Stroke.pptxHeat Stroke.pptx
Heat Stroke.pptx
MUKESH SUNDARARAJAN
 
Thermoregulation and ageing
Thermoregulation and ageingThermoregulation and ageing
Thermoregulation and ageing
Raghad Abutair
 
Fever - disturbance in general systemic state
Fever - disturbance in general systemic state Fever - disturbance in general systemic state
Fever - disturbance in general systemic state
Dr-Mohamed Ghanem
 
Kin 188 Environmental Conditions
Kin 188   Environmental ConditionsKin 188   Environmental Conditions
Kin 188 Environmental Conditions
JLS10
 
Thermal emergency med surg ppt
Thermal emergency med surg pptThermal emergency med surg ppt
Thermal emergency med surg ppt
NehaNupur8
 
heat stroke.pptx by sms mc jaipur Rajasthan
heat stroke.pptx by sms mc jaipur Rajasthanheat stroke.pptx by sms mc jaipur Rajasthan
heat stroke.pptx by sms mc jaipur Rajasthan
dineshdandia
 
Vital Signs.pdf
Vital Signs.pdfVital Signs.pdf
Vital Signs.pdf
ahmad346106
 
Mechanisms of skin temperature regulation
Mechanisms of skin temperature regulationMechanisms of skin temperature regulation
Mechanisms of skin temperature regulation
Khaled Abdiaziz
 
THERMAL EMERGENCIES.POWER POINT PRESENTATION
THERMAL EMERGENCIES.POWER POINT PRESENTATIONTHERMAL EMERGENCIES.POWER POINT PRESENTATION
THERMAL EMERGENCIES.POWER POINT PRESENTATION
venbarani
 
Heat Injury Prevention
Heat Injury PreventionHeat Injury Prevention
Heat Injury Prevention
Williamsburg Lacrosse
 
Symptomatology
 Symptomatology Symptomatology
Symptomatology
Dr. Satyendra Singh
 
Hypothermia
HypothermiaHypothermia
Hypothermia
fathi neana
 
Metabolism and thermoregulation
Metabolism and thermoregulationMetabolism and thermoregulation
Metabolism and thermoregulation
YudiNug1
 
Climatic disorders
Climatic disordersClimatic disorders
Climatic disorders
Mona Mohsen
 
termoreglarea.ppt
termoreglarea.ppttermoreglarea.ppt
termoreglarea.ppt
OanaM4
 

Similar to Dr. pom (2) (20)

Neurology of heat stroke
Neurology of heat strokeNeurology of heat stroke
Neurology of heat stroke
 
Heat and cold injuries
Heat and cold injuriesHeat and cold injuries
Heat and cold injuries
 
Heat stroke
Heat strokeHeat stroke
Heat stroke
 
heat stroke and heat exhaustion in children
heat stroke and heat exhaustion in childrenheat stroke and heat exhaustion in children
heat stroke and heat exhaustion in children
 
Environmental injuries
Environmental injuriesEnvironmental injuries
Environmental injuries
 
Heat Stroke.pptx
Heat Stroke.pptxHeat Stroke.pptx
Heat Stroke.pptx
 
Thermoregulation and ageing
Thermoregulation and ageingThermoregulation and ageing
Thermoregulation and ageing
 
Fever - disturbance in general systemic state
Fever - disturbance in general systemic state Fever - disturbance in general systemic state
Fever - disturbance in general systemic state
 
Kin 188 Environmental Conditions
Kin 188   Environmental ConditionsKin 188   Environmental Conditions
Kin 188 Environmental Conditions
 
Thermal emergency med surg ppt
Thermal emergency med surg pptThermal emergency med surg ppt
Thermal emergency med surg ppt
 
heat stroke.pptx by sms mc jaipur Rajasthan
heat stroke.pptx by sms mc jaipur Rajasthanheat stroke.pptx by sms mc jaipur Rajasthan
heat stroke.pptx by sms mc jaipur Rajasthan
 
Vital Signs.pdf
Vital Signs.pdfVital Signs.pdf
Vital Signs.pdf
 
Mechanisms of skin temperature regulation
Mechanisms of skin temperature regulationMechanisms of skin temperature regulation
Mechanisms of skin temperature regulation
 
THERMAL EMERGENCIES.POWER POINT PRESENTATION
THERMAL EMERGENCIES.POWER POINT PRESENTATIONTHERMAL EMERGENCIES.POWER POINT PRESENTATION
THERMAL EMERGENCIES.POWER POINT PRESENTATION
 
Heat Injury Prevention
Heat Injury PreventionHeat Injury Prevention
Heat Injury Prevention
 
Symptomatology
 Symptomatology Symptomatology
Symptomatology
 
Hypothermia
HypothermiaHypothermia
Hypothermia
 
Metabolism and thermoregulation
Metabolism and thermoregulationMetabolism and thermoregulation
Metabolism and thermoregulation
 
Climatic disorders
Climatic disordersClimatic disorders
Climatic disorders
 
termoreglarea.ppt
termoreglarea.ppttermoreglarea.ppt
termoreglarea.ppt
 

Recently uploaded

Mental Health and Physical Wellbeing.pdf
Mental Health and Physical Wellbeing.pdfMental Health and Physical Wellbeing.pdf
Mental Health and Physical Wellbeing.pdf
shindesupriya013
 
CAPNOGRAPHY and CAPNOMETRY/ ETCO2 .pptx
CAPNOGRAPHY and CAPNOMETRY/ ETCO2  .pptxCAPNOGRAPHY and CAPNOMETRY/ ETCO2  .pptx
CAPNOGRAPHY and CAPNOMETRY/ ETCO2 .pptx
Nursing Station
 
Michigan HealthTech Market Map 2024 with Policy Makers, Academic Innovation C...
Michigan HealthTech Market Map 2024 with Policy Makers, Academic Innovation C...Michigan HealthTech Market Map 2024 with Policy Makers, Academic Innovation C...
Michigan HealthTech Market Map 2024 with Policy Makers, Academic Innovation C...
Levi Shapiro
 
Pneumothorax and role of Physiotherapy in it.
Pneumothorax and role of Physiotherapy in it.Pneumothorax and role of Physiotherapy in it.
Pneumothorax and role of Physiotherapy in it.
Vishal kr Thakur
 
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSONNEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
SHAMIN EABENSON
 
Management of Post Operative Pain: to make doctors conscious about the benefi...
Management of Post Operative Pain: to make doctors conscious about the benefi...Management of Post Operative Pain: to make doctors conscious about the benefi...
Management of Post Operative Pain: to make doctors conscious about the benefi...
Nilima65
 
Data-Driven Dispensing- Rise of AI in Pharmacies.pdf
Data-Driven Dispensing- Rise of AI in Pharmacies.pdfData-Driven Dispensing- Rise of AI in Pharmacies.pdf
Data-Driven Dispensing- Rise of AI in Pharmacies.pdf
Jasper Colin
 
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...
DrDevTaneja1
 
1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
5sj7jxf7
 
Vicarious movements or trick movements_AB.pdf
Vicarious movements or trick movements_AB.pdfVicarious movements or trick movements_AB.pdf
Vicarious movements or trick movements_AB.pdf
Arunima620542
 
Hypotension and role of physiotherapy in it
Hypotension and role of physiotherapy in itHypotension and role of physiotherapy in it
Hypotension and role of physiotherapy in it
Vishal kr Thakur
 
Psychedelic Retreat Portugal - Escape to Lighthouse Retreats for an unforgett...
Psychedelic Retreat Portugal - Escape to Lighthouse Retreats for an unforgett...Psychedelic Retreat Portugal - Escape to Lighthouse Retreats for an unforgett...
Psychedelic Retreat Portugal - Escape to Lighthouse Retreats for an unforgett...
Lighthouse Retreat
 
Sexual Disorders.gender identity disorderspptx
Sexual Disorders.gender identity  disorderspptxSexual Disorders.gender identity  disorderspptx
Sexual Disorders.gender identity disorderspptx
Pupayumnam1
 
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdfchatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
marynayjun112024
 
English Drug and Alcohol Commissioners June 2024.pptx
English Drug and Alcohol Commissioners June 2024.pptxEnglish Drug and Alcohol Commissioners June 2024.pptx
English Drug and Alcohol Commissioners June 2024.pptx
MatSouthwell1
 
The Importance of Black Women Understanding the Chemicals in Their Personal C...
The Importance of Black Women Understanding the Chemicals in Their Personal C...The Importance of Black Women Understanding the Chemicals in Their Personal C...
The Importance of Black Women Understanding the Chemicals in Their Personal C...
bkling
 
Know Latest Hiranandani Hospital Powai News.pdf
Know Latest Hiranandani Hospital Powai News.pdfKnow Latest Hiranandani Hospital Powai News.pdf
Know Latest Hiranandani Hospital Powai News.pdf
Dr. Sujit Chatterjee CEO Hiranandani Hospital
 
Monopoly PCD Pharma Franchise in Tripura
Monopoly PCD Pharma Franchise in TripuraMonopoly PCD Pharma Franchise in Tripura
Monopoly PCD Pharma Franchise in Tripura
SKG Internationals
 
HUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COM
HUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COMHUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COM
HUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COM
priyabhojwani1200
 
leprosy Case detection and diagnosis.pptx
leprosy Case detection and diagnosis.pptxleprosy Case detection and diagnosis.pptx
leprosy Case detection and diagnosis.pptx
habtegirma
 

Recently uploaded (20)

Mental Health and Physical Wellbeing.pdf
Mental Health and Physical Wellbeing.pdfMental Health and Physical Wellbeing.pdf
Mental Health and Physical Wellbeing.pdf
 
CAPNOGRAPHY and CAPNOMETRY/ ETCO2 .pptx
CAPNOGRAPHY and CAPNOMETRY/ ETCO2  .pptxCAPNOGRAPHY and CAPNOMETRY/ ETCO2  .pptx
CAPNOGRAPHY and CAPNOMETRY/ ETCO2 .pptx
 
Michigan HealthTech Market Map 2024 with Policy Makers, Academic Innovation C...
Michigan HealthTech Market Map 2024 with Policy Makers, Academic Innovation C...Michigan HealthTech Market Map 2024 with Policy Makers, Academic Innovation C...
Michigan HealthTech Market Map 2024 with Policy Makers, Academic Innovation C...
 
Pneumothorax and role of Physiotherapy in it.
Pneumothorax and role of Physiotherapy in it.Pneumothorax and role of Physiotherapy in it.
Pneumothorax and role of Physiotherapy in it.
 
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSONNEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
 
Management of Post Operative Pain: to make doctors conscious about the benefi...
Management of Post Operative Pain: to make doctors conscious about the benefi...Management of Post Operative Pain: to make doctors conscious about the benefi...
Management of Post Operative Pain: to make doctors conscious about the benefi...
 
Data-Driven Dispensing- Rise of AI in Pharmacies.pdf
Data-Driven Dispensing- Rise of AI in Pharmacies.pdfData-Driven Dispensing- Rise of AI in Pharmacies.pdf
Data-Driven Dispensing- Rise of AI in Pharmacies.pdf
 
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...
 
1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
 
Vicarious movements or trick movements_AB.pdf
Vicarious movements or trick movements_AB.pdfVicarious movements or trick movements_AB.pdf
Vicarious movements or trick movements_AB.pdf
 
Hypotension and role of physiotherapy in it
Hypotension and role of physiotherapy in itHypotension and role of physiotherapy in it
Hypotension and role of physiotherapy in it
 
Psychedelic Retreat Portugal - Escape to Lighthouse Retreats for an unforgett...
Psychedelic Retreat Portugal - Escape to Lighthouse Retreats for an unforgett...Psychedelic Retreat Portugal - Escape to Lighthouse Retreats for an unforgett...
Psychedelic Retreat Portugal - Escape to Lighthouse Retreats for an unforgett...
 
Sexual Disorders.gender identity disorderspptx
Sexual Disorders.gender identity  disorderspptxSexual Disorders.gender identity  disorderspptx
Sexual Disorders.gender identity disorderspptx
 
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdfchatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
 
English Drug and Alcohol Commissioners June 2024.pptx
English Drug and Alcohol Commissioners June 2024.pptxEnglish Drug and Alcohol Commissioners June 2024.pptx
English Drug and Alcohol Commissioners June 2024.pptx
 
The Importance of Black Women Understanding the Chemicals in Their Personal C...
The Importance of Black Women Understanding the Chemicals in Their Personal C...The Importance of Black Women Understanding the Chemicals in Their Personal C...
The Importance of Black Women Understanding the Chemicals in Their Personal C...
 
Know Latest Hiranandani Hospital Powai News.pdf
Know Latest Hiranandani Hospital Powai News.pdfKnow Latest Hiranandani Hospital Powai News.pdf
Know Latest Hiranandani Hospital Powai News.pdf
 
Monopoly PCD Pharma Franchise in Tripura
Monopoly PCD Pharma Franchise in TripuraMonopoly PCD Pharma Franchise in Tripura
Monopoly PCD Pharma Franchise in Tripura
 
HUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COM
HUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COMHUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COM
HUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COM
 
leprosy Case detection and diagnosis.pptx
leprosy Case detection and diagnosis.pptxleprosy Case detection and diagnosis.pptx
leprosy Case detection and diagnosis.pptx
 

Dr. pom (2)

  • 1. HEAT RELATED ILLNESSES Saunora Prom, DO, CAQSM Tidewater Sports & Osteopathic Medicine TPMG May 17, 2018
  • 2. Overview • Description/definitions • Epidemiology • Incidence/prevalence • Etiology • Risk factors • Diagnosis and differential • Treatment • Prevention • Conclusion
  • 3. Definitions A continuum of increasingly severe exertional heat illnesses caused by dehydration, electrolyte losses, and failure of body’s thermoregulatory mechanisms.  Exercise Associated Muscle Cramps (Heat Cramps)  Heat Exhaustion  Heat Injury  Heat Stroke
  • 4. Epidemiology  Predominantly in children and elderly  Male >Female  EHS- 4.5/100,000 person’s affected per FB season  ~600 deaths/year in the USA
  • 5. Exercise Associated Muscle Cramps (Heat Cramps) • painful involuntary muscle contractions/spasms occurring in the setting of strenuous exercise and hot temperatures
  • 6. Heat Exhaustion • Athlete has obvious difficulty continuing with exercise • Core body temperature is usually 101 to 104ºF at the time of collapse • No significant dysfunction of the central nervous system (seizure, altered consciousness, persistent delirium) is present
  • 7. Heat Exhaustion Symptoms • Tachycardia and hypotension • Extreme weakness • Dehydration and electrolyte losses • Ataxia and coordination problems, syncope, light- headedness • Profuse sweating, pallor, "prickly heat" sensations • Headache • Abdominal cramps, nausea, vomiting, diarrhea • Persistent muscle cramps
  • 8. Heat Injury • Exertional heat illness with evidence of both hyperthermia and end organ damage, but without any significant neurologic manifestations. • Collapse during strenuous activity, a core temperature above 104 to 105°F, and the absence of neurologic findings.
  • 9. Exertional Heat Stroke • Multisystem illness characterized by central nervous system (CNS) dysfunction (encephalopathy) and additional organ and tissue damage (eg, acute kidney injury, liver injury, rhabdomyolysis). • Core temp > 104F
  • 10. EHS- Symptoms • Disorientation • Headache • Irrational behavior • Irritability • Emotional instability • Confusion • Altered consciousness • Coma • Seizure
  • 11. Severe Non-Exertional Hyperthermia (Classic Heat Stoke) • Most often patients over 70, with underlying chronic medical conditions that impair thermoregulation, prevent removal from a hot environment, or interfere with access to hydration or attempts at cooling
  • 12. Thermoregulation Evaporation-occurs when water vaporizes from the skin and respiratory tract. Most effective mechanism. Conduction-direct heat transfer to an adjacent, cooler object. Convection-transfer of heat to a gas or liquid moving over the body. Heat transfer occurs when the gas or liquid is colder than the body. Radiation-is the emission of electromagnetic heat waves
  • 13. Risk Factors  Poor physical conditioning  Salt or water depletion  Obesity  Acute febrile or GI illnesses  Chronic disease (HTN, DM, CAD)  ETOH  Clothing  Medications
  • 14. Medications • ●Anticholinergic agents • ●Antiepileptic agents • ●Antihistamines • ●Decongestants • ●Phenothiazines • ●Tricyclic antidepressants • ●Amphetamines • ●Ergogenic stimulants (eg, ephedrine, dimethylamylamine) • ●Lithium • ●Diuretics • ●Beta blockers
  • 15. Differential Diagnosis  Febrile illnesses, sepsis  Drug induced fluid loss  Arrhythmia or MI  Acute cocaine intoxication  Neuroleptic malignant syndrome  Malignant hyperthermia – autosomal disorder where patients have abnormal muscle metabolism on exposure to halothane or skeletal muscle reactants
  • 16. Treatment  General measures • Gradual fluid and electrolyte replacement with normal saline • Body immersion in ice water • Evaporative cooling • *any method to cool patient’s body*
  • 17. Prevention  Proper hydration  Elderly at increased risk because of diminished thirst signaling  Patient education to emphasize importance of appropriate conditioning and acclimatization  Adjusting activity according to Wet Bulb Globe Test (WBGT)  WBGT = 0.1 x Dry Bulb Temperature (DBT) + 0.7 x Wet Bulb Temperature (WBT) + 0.2 x Globe Temperature (GT)
  • 18.
  • 19.
  • 21. Conclusion  While these ailments are not that common, they can produce devastating consequences if not addressed  Incidence will likely increase with growing elderly population  Patient education important