Heat and sunstroke: symptoms, causes, help for heatstroke

10.06.2019

Interesting

Natalia Adnoral

Heat is energy. Internal heat is both a result and a condition for the natural functioning of our body. External is a necessary factor in maintaining his life. But everything is good in moderation. Both a lack and an excess of thermal energy are destructive for all living things. Especially for a person with his “narrow comfort zone”.

Causes of Heat Stroke

Our organs and systems have very strict temperature requirements for the internal environment - the spread is only a few degrees. The external permissible range is somewhat wider due to numerous physico-chemical and psychological adaptive mechanisms controlling heat production and heat transfer:

• increased/decreased sweating and urination;
• decrease/increase in motor activity;
• increased/decelerated breathing rate and heart contractions;
• dressing/undressing, etc.

But it is also very small, since these mechanisms are not omnipotent. Especially if the time and/or intensity of heat exposure is large. Moreover, their critical values ​​are individual. Some people suffer more from overheating, while others tolerate it much more easily.

What does this depend on?

1. From genetic factors (for example, representatives of the Negroid race are more resistant to overheating).
2. From acquired physical and psychological habits to a certain climate.
3. From age.
4. On the presence/absence of diseases.
5. The presence/absence of “aggravating circumstances” accompanying heat exposure.

The following factors increase the body’s susceptibility to overheating and aggravate its consequences:

1. Children and old age (in both of them the mechanisms of thermoregulation are weakened).
2. Overweight.
3. Acute and chronic ailments (high blood pressure, neurocirculatory dystonia, heart and kidney failure, endocrine pathologies; diseases accompanied by increased body temperature, etc.).
4. Chronic stress in the exhaustion phase or negative psychological perception of the very fact of overheating.
5. Taking medications that increase heat production by the body itself (for example, caffeine, ephedrine, dopamine).
6. Physical activity in conditions of elevated ambient temperature.
7. Clothing made from materials that interfere with heat dissipation.

Publications in the media

Overheating (heat syncope, heat prostration, heat collapse) and heat stroke (hyperpyrexia, sunstroke, overheating of the body) are pathological reactions of the body to high environmental temperatures associated with dehydration, loss of electrolytes and disruption of thermoregulation mechanisms.

Risk factors • High environmental humidity • Old age • Obesity • Chronic alcoholism • Alcohol and drug intoxication • Asthenic syndrome • Taking drugs (for example, anticholinergic, antihistamines, psychotropic drugs) • Cardiovascular diseases • Heavy, constricting clothing.

Clinical picture • Overheating •• Gradual development •• Prodromal symptoms: increasing fatigue, weakness, anxiety, profuse sweating •• Acute vascular insufficiency: rare thready pulse, low blood pressure; the skin is pale, cold and clammy •• Confusion with disorientation and subsequent loss of consciousness (shock) is observed. • Heat stroke •• Rapid development •• Prodromal symptoms: headache, dizziness, weakness •• Decreased sweating (not always); hot hyperemic dry skin •• Pulse up to 180 per minute; increased breathing rate; Blood pressure is within normal limits •• Disorientation followed by loss of consciousness or convulsions is sometimes observed •• Increase in body temperature to 40–41 ° C •• Vascular collapse with fatal outcome is possible.

Differential diagnosis • Insulin shock • Other causes of increased body temperature • Poisoning • Internal bleeding • Traumatic shock • Arrhythmias • MI • Acute cocaine intoxication. Treatment • For overheating •• The victim is placed on a flat surface or his head is lowered •• Every few minutes, give a little cold, lightly salted water to drink • For heat stroke •• Rapid cooling: remove clothes, immerse in water, cover with ice, wrap into a wet cloth (or wet your clothes generously). Cooling can be stopped when body temperature drops to 38.9 °C and stabilizes •• Measuring body temperature every 10 minutes, not allowing it to fall below 38.3 °C to avoid transition from hyperthermia to hypothermia •• Stimulants and sedatives are contraindicated , morphine •• For convulsive syndrome - diazepam or barbiturates IV •• Infusion therapy under the control of the electrolyte composition of the blood. Complications • Arrhythmias • MI • Pulmonary edema • Coma • Seizures • AKI • DIC • Hepatocellular necrosis. Prognosis • In case of overheating, favorable • In case of heatstroke, lack of emergency assistance results in convulsions and death or irreversible brain damage. An increase in body temperature to 41 °C is a poor prognostic sign. An increase in body temperature to 42 °C is often fatal. Mortality from heatstroke (10–80%) directly depends on the duration and intensity of hyperthermia, as well as on the speed of diagnosis and the effectiveness of treatment.

Prevention. should be avoided in the heat, in a poorly ventilated area, or in warm, breathable clothing. The loss of fluid and electrolytes should be compensated by frequent drinking of lightly salted liquid. Using sun protection correctly, sunbathe as much as possible and stay in humid conditions. Avoid dehydration during physical activity and exercise: drink 240 ml of fluid every 15 minutes.

ICD-10 • T67 Effects of heat and light

Symptoms of Heat Stroke

Why is overheating dangerous? Failure of the most important life support systems (cardiovascular, respiratory, excretory, nervous) and a real threat to human life.

Of course, the internal environment of the body does not immediately heat up to critical values ​​for life - above 41 degrees. First, under the influence of excess heat from the outside, our body and psyche are actively involved in the process of self-cooling. How do we feel?

1. The desire to move to a cooler place.
2. Heat.
3. Active sweating.
4. Increased breathing and heart contractions.
5. Fatigue and irritability.

If thermal “aggression” continues, the body begins to experience even greater discomfort and signals:

• headache, dizziness and tinnitus;
• “floaters” and darkening of the eyes;
• acute feeling of thirst;
• increasing palpitations, weakness, lethargy, apathy;
• nausea (possibly vomiting);
• convulsions;
• clouding (possibly loss) of consciousness.

These symptoms are very alarming . They “scream” that the defense mechanisms can no longer cope with the growing internal “fire” - the body temperature is steadily rising and is approaching critical values ​​for life - the so-called. stage of decompensation - heat stroke .

If you do not provide emergency assistance to the person at this stage, there is a real risk of losing him. According to statistics, the mortality rate from heatstroke reaches thirty percent.

What can cause it? From cardiac arrest and cessation of breathing caused by damage to the nervous and cardiovascular systems incompatible with life (cerebral edema, collapse, destruction of blood cells, hemorrhages in the brain, heart, kidneys, etc.).

Sunstroke

What is the difference between heatstroke and sunstroke? The operating factor is the same - high-intensity thermal energy (infrared range). But we risk encountering the first one both outdoors and indoors. With the second - only with direct exposure to sunlight, which penetrate into the deep layers of the body and quickly cause overheating of its tissues.

The main target of damage during sunstroke is the brain. The result is oxygen starvation of his cells, hemorrhages and swelling. All this is expressed in:

• very intense headache and dizziness;
• nausea and vomiting;
• disturbances of sensitivity and motor functions (paresis and paralysis);
• disturbances in breathing and heart function (even to the point of cardiac arrest).

How to avoid overheating of the body?

1. Start your day early.
The lowest temperature on hot days is usually in the morning.
If you have to work outside or have a long commute to the office by public transport, get up early. Most likely, you will have time to find yourself in a cool room before the extreme heat begins. 2. Drink more fluids.
Carry a bottle of water with you and drink regularly, even if you don't feel like it.
Try to drink cool, but not ice-cold water. Avoid sugary drinks, alcohol and caffeine, which quickly lead to dehydration. 3. Take frequent breaks.
If you work outside or have to walk in the heat, try to rest more often - at least 15 minutes every hour and a half. A shady place or a cool room is suitable for relaxation.

Feeling great in summer

The chief physician of the Treatment and Rehabilitation Center of the Ministry of Health and Social Development of the Russian Federation, Tatyana Shapovalenko, tells how to survive the summer heat.

4.
Choose light clothing.
On hot days, give preference to light-colored clothing made from lightweight material.
Choose loose-fitting items that allow air to circulate freely along the body. Avoid tight, tight-fitting synthetic materials that do not allow air to pass through. Don't forget about a light, light-colored hat. 5. Streamline your workflow.
In the midst of the heat, cancel trips on public transport, work in your garden and other activities that require physical activity.
6. If you come to a resort,
give your body time to acclimatize.
Don't go out into direct sunlight on the first day - allow yourself to be lazy in the shade. 7. Monitor your condition.
If you feel tired, dizzy or slightly nauseous, immediately move to a cool room.

How to help? Help for Heat Stroke

1. Rule No. 1 - stop the main damaging factor - thermal radiation - as soon as possible. That is, depending on the situation, move the person to the shade or to a ventilated room; provide air access; remove clothing.
2. Cool by all available means: - give cool water to drink; - wipe or even pour cold water on it; - Apply ice or a cloth regularly soaked in cold water to the neck and groin area.
3. If breathing stops and the heart stops, perform cardiopulmonary resuscitation and be sure to call an ambulance. Even if a person has fully regained consciousness, he will require hospitalization and treatment in a hospital. Its goal is to help the body cope with the consequences of serious heat injury and return to a healthy functioning mode with minimal losses.

The most reliable way of self-help is to listen to the alarming signals of your body and prevent the breakdown of protective mechanisms: open a window, go out into the fresh air, move into the shade, take a cold shower, etc.

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With the onset of the warm season, there is an increasing risk of becoming a victim of sunstroke or heatstroke. And it doesn’t matter at all where you are - on a sandy beach in a distant country or in a garden in the suburbs. The sun has an imperceptible effect on the body, and if safety measures are not taken in time, there is a high probability of disastrous consequences.

Mechanism of sunstroke

Many people mistakenly believe that heatstroke and sunstroke are the same thing. The development mechanism is, indeed, quite similar, but heat stroke can be caused by exposure to any heat, and solar stroke can be caused by heating the body under the sun.

To make it clearer, consider the situations in which the risk of heat stroke is most likely:

1. Long-term exposure of a person to an environment whose temperature is much higher than body temperature.
2. Performing heavy physical work in a stuffy, warm room.
3. Exposure to direct sunlight on the body and head (sunstroke).
4. Alcohol intoxication combined with a heavy lunch.
5. In calm and humid weather.
6. Wearing thick, waterproof clothing for long periods of time.
7. Overweight.
8. Diseases of the cardiovascular or nervous system.
9. Taking a certain group of medications, for example, tranquilizers or diuretics, also contributes to the development of hyperthermia (overheating of the body).

Signs of sunstroke

You can determine that a person has sunstroke by the following signs:

• apathy
  ;
• strong thirst;
• nagging muscle pain;
• body temperature
  rises (can reach 42 C);
• skin redness;
• skin is hot to the touch;
• in clinical cases, the skin becomes very dry;
• severe increasing headache
  , buzzing in the head;
• nausea
  , vomiting;
• increased heart rate;
• increased breathing;
• loss of consciousness;
• hallucinations;
• convulsions
  .

The consequences of sunstroke can be very different, ranging from mild illness for a few days to the development of chronic diseases, for example, kidney failure, blood contamination, jaundice may appear, and liver damage. In clinical cases, a person may fall into a coma.

First aid for sunstroke

The most important rule when providing first aid is to act very quickly. If the victim has suffered a slight degree of overheating, he will quickly come to his senses and return to normal. In the event of severe overheating, when a person exhibits clinical symptoms, the speed of your actions determines how dire the consequences will be. A minute of delay can cost a person his life.

As a rule, a person whose condition is close to sunstroke rarely adequately assesses the situation and therefore does not take any protective measures. It is important that there is someone nearby who can recognize in a sharply worsened mood and a sudden headache not just malaise, but the first symptoms of sunstroke.

So, first aid for sunstroke

consists of the following actions:

1. Assess the condition of the victim - if the blow is mild, you can handle it yourself; if it is severe, you need to call an ambulance
   .
2. Immediately move the victim to a shaded or cool area.
3. Remove the person's clothing or loosen fastenings - unbutton a shirt, undo a belt on pants, untie a tie, etc. Remove shoes.
4. Ensure air circulation - turn on the air conditioner
   ,
   fan
   , fan the victim’s face and body with a fan (fan, newspaper, any flat and wide object, clothing).
5. It is important to quickly reduce the victim's body temperature. To do this, you can place it in a bath with cool water (not ice, otherwise the body will get a shock!). If it is not possible to transfer the person to the bathtub, soak a sheet or clothing in cold water and wrap it around the body. Change the sheet or re-wet it as soon as it warms up.
6. Place ice packs wrapped in a towel on the following areas of the body (frozen vegetables or meat will also work): forehead, cheeks, palms, armpits, groin folds. Continue manipulations, constantly measuring the victim’s body temperature - as soon as it drops to 38.5 C, the body will cope on its own.
7. When sunstroke occurs, there is a strong loss of fluid, so it needs to be replenished. Let the victim drink mineral water (can be with gas), a weak saline solution, green tea
   , black sweet tea with lemon.
   Do not give alcohol
   ,
   coffee
   , or energy drinks.

The victim, even after a mild sunstroke, is advised to exercise extreme caution for several months when going out into the sun, since there is a predisposition to a recurrence of the stroke.

Prevention and safety measures.

In order to never become a victim of the insidious summer sun and to protect family members, it is recommended to take safety measures when going to the beach, working in the garden or just walking around the city.

Prevention of sunstroke is as follows:

1. Avoid midday - from 13:00 to 15:00 the sun is most active. At this time, it is not recommended to go to the beach, do physical labor outside, or simply be under the sun, since along with heat it “gives” ultraviolet radiation, which is harmful in large quantities.
2. Wear the “right” summer clothes - they should be made from natural, well-ventilated fabrics, such as cotton, linen or silk. Things should be loose-fitting, and it is better to wear a wide-brimmed hat on your head to protect your neck and shoulders.
3. It is recommended to follow a light summer diet - drink more fluids, eat more fruits, and, if possible, exclude too fatty, heavy, salty and smoked foods from the diet. In summer, the body loses more moisture than in other seasons, so it is important to constantly replenish this supply. Give up sweet carbonated drinks and replace them with milk - it quenches thirst much better and cools the body faster.
4. Get yourself a small pocket water spray. A very useful solution, especially for those who travel or work in an office. Spray your face and exposed areas of the body so that the skin does not experience a lack of moisture. This way you will not only protect yourself from hyperthermia, but also prolong your beauty and youth.
5. Do not allow children to stay in the sun for long periods of time, even in the morning or afternoon. Babies cannot rationally assess their condition, so it is important to eliminate the slightest risk of sunstroke. Be sure to wear a Panama hat made of lightweight cotton material to your child and make sure that he does not take it off. Measure your temperature periodically ( a thermometer
   when walking, just put your hand to your forehead). Give your child more juices, fruit drinks, tea and other liquids.

Heatstroke and sunstroke in a child

Symptoms of local and general overheating in children are practically no different from those in adults. Children become apathetic and whiny, refusing to drink and eat. When overheated, they often experience nosebleeds (much more often than adults). Due to the imperfection of the thermoregulation mechanism, a child’s body tolerates overheating more difficult than an adult, and it only takes 15 minutes for a child to develop its symptoms. That is why on hot summer days you should especially carefully monitor the condition of children and avoid factors that provoke overheating.

Differences between local and general overheating

One of the most significant differential diagnostic signs is the presence of I-II degree burns during sunstroke, since during the exposure of the head to direct rays of the sun, the skin manages to receive excess insolation. With the general variant of overheating, skin burns most often do not occur.

Local overheating may occur delayed, several hours after exposure to direct sunlight, but its symptoms can almost always be associated with insolation. Diagnosis of heatstroke often goes the wrong way precisely because of the lack of connection with overheating.

It should be remembered that a long vacation on the beach without a hat or umbrella can lead to both local and general overheating.

Sunstroke

Occurs with prolonged and/or intense exposure to direct rays of the sun on an uncovered head. Most often it appears after a long stay on the beach or simply outdoors in the sun, but sometimes its symptoms also occur at relatively low temperatures - for example, in the mountains.

The mechanism of development is the expansion of blood vessels in the brain under the influence of infrared rays and the subsequent flow of blood to the head. Excessive blood supply causes compression of brain cells and disruption of their function. The ventricles of the brain become overfilled with cerebrospinal fluid, and the membranes swell. Blood pressure increases. Small capillaries may not be able to withstand this and burst. The condition is accompanied by symptoms of damage to the central nervous system.

Provoking factors

Factors that provoke the development of general overheating of the body include:

• wearing thick clothing made of synthetic materials (including rubberized parts);
• high air humidity indoors and outdoors;
• outdoor games, sports and physical activity in the heat;
• non-compliance with drinking regime;
• consumption of alcoholic beverages and drugs;
• taking antidepressants, diuretics, antiparkinsonian drugs, antihistamines and laxatives.

The risk group includes people with the following problems:

• weather sensitivity;
• obesity;
• hyperhidrosis/anhidrosis;
• tendency to allergies;
• pathology of internal secretion organs;
• history of acute disorders of cerebral and coronary circulation;
• chronic diseases of the heart, lungs, liver, pancreas.

Children, pregnant women and the elderly are more easily affected by heat, even in the absence of chronic diseases and other listed pathologies.