Heat stroke corresponds to an overheating of the body with a temperature above 40 degrees. It is a life-threatening medical emergency. Causes, symptoms, treatment, exercise, heat, stroke, reflexes to have, risk, duration... Advice.
When it is hot, our body reacts by activating its cooling system. The objective: is to maintain the internal temperature at 37°C even if it is warmer outside. How do we do this? By vasodilatation and sweating. Vasodilatation of the vessels, which can be felt when it is hot (heavy legs, swollen hands, and feet, hot skin surface), allows heat to be evacuated to the body surface. Sweat, on the other hand, cools the surface of the skin. The problem is that in infants, these cooling mechanisms are not always perfected and that in the elderly, they no longer work as well. As a result, the youngest (especially those under 4 years of age) and the oldest risk becoming dehydrated more quickly and seeing their internal temperature exceed 37°C. Heat stroke is a life-threatening medical emergency.
Definition: what is heat stroke?
Heatstroke corresponds to an overheating of the body with a temperature above 40 degrees. The body can no longer cope with the increase in internal temperature due to muscular activity and/or an overheated environment (heat wave). A distinction is made between classic heat stroke in people who are exposed to a hot and humid environment for a long period of time (for example, spending hours in a car or on a subway train in the middle of the heat) and exercise-induced heat stroke, which occurs after intense and sustained physical activity (classic heat stroke). Classic heatstroke occurs in epidemic form during heat waves and predominates in elderly, frail people suffering from chronic pathology: cardiovascular, pulmonary, or mental.
What is exercise-induced heat stroke?
Exercise-induced heatstroke occurs during intense and sustained physical activity in a hot atmosphere, sporadically, and affects young, healthy individuals such as elite athletes and military personnel. The symptoms are similar to classic heat stroke except that the subject's skin is moist due to heavy sweating, rather than dry.
What are the symptoms of heat stroke?
The diagnosis of classic heat stroke is based on hyperthermia and consciousness disorders after exposure to a hot and humid atmosphere. Symptoms of heat stroke include:
- a sudden fever that reaches or exceeds 40°c
- palpitations
- iolent headaches
- diffuse redness
- the skin is hot and very dry (sweating stops) / in athletes, the skin is hot and rather humid.
- vomiting
- diarrhea
- mental confusion, delirium, and severe agitation
How long does heat stroke last?
In benign forms that are quickly treated, heat stroke generally lasts less than 12 hours.
What should you do?
You must seek medical assistance as soon as possible: call 15. In the meantime :
place the subject in the shade
cool them down by spraying them with cold water and ventilating them
or give a cold shower or bath.
No adjuvant pharmacological treatment that can accelerate cooling has been shown to be effective.
What are the risks of heat stroke?
Heat stroke is a medical emergency because it can be life-threatening. It can lead to neurological disorders (delirium, convulsions, or coma) and then to so-called "multi-visceral" failures, which can lead to death. The multi-visceral failures are :
- Cardiovascular failure: arterial hypotension, shock
- Respiratory failure: polypnea, deep hypoxemia
- Renal failure: oligo-anuria, moderate to severe renal failure.
- Hematological failure: disorders of hemostasis with thrombocytopenia, even fibrinolysis and disseminated intravascular coagulation (DIC).
- Hepatic failure (rarer).
Among the most severe complications observed following a heat stroke are:
- Acute coronary syndrome
- Heart rhythm disorders, conduction disorders.
- Hemorrhagic complications
- Acute respiratory distress syndrome (ARDS)
- Acute pancreatitis
- Fulminant hepatitis.
How to avoid it?
- Drink water regularly without waiting to be thirsty (at least 1.5 L per day). The first people concerned are infants and the elderly. The latter, who sometimes do not feel thirsty, must force themselves to drink.
- Avoid physical exertion and sports that increase your body temperature.
- Wear light, loose-fitting clothing that allows air to circulate and is light in color so as not to retain heat.
- Cool down several times a day: don't hesitate to take showers, wet your head, or use misting machines or damp cloths.
- Fans? They provide a pleasant sensation of freshness through the circulation of air, but when the air is hot, it stays hot and in fact, it does not cool you. So it's not enough to keep you cool. It is better to wet yourself regularly.
- What to drink? Avoid alcohol, sugary drinks, and drinks with a high caffeine content (coffee, tea). Prefer plain and sparkling water (enriched with salt) and fresh fruit juice.
- What to eat? Continue to eat normally, giving preference to fruits and vegetables: raw vegetable salads, fresh soups, but also dairy products (liquid yoghurts, milkshakes, etc.).
- Cover your head. Hats, caps, or scarves can help you avoid sunstroke.
- Even if the heat makes you tired, don't take a nap in the sun!
- Stay in well-ventilated and cool rooms. Close the shutters and open the windows to let the air in. If your apartment is really hot, arrange to stay in cool or air-conditioned places for at least two or three hours during the day (department stores, movie theaters, public places).
Treatment and Prevention
Heat stroke is a medical emergency. Learn how to recognize the above symptoms and take appropriate action yourself. The victim of heat stroke should go to the emergency room as soon as possible, but the first step is to regain control of the internal temperature.
If you suspect that a person has suffered heat stroke, begin treating them immediately, while someone else makes an emergency call 911. The first priority is to bring the victim's temperature down immediately. The most effective solution is to move the person out of the sun and immerse them in cold water (river, stream, or bathtub). You can also help the person cool down while waiting for help to arrive by fanning him or her vigorously and giving him or her water with a warm water spray. You can also remove some of the person's clothing and apply ice water, towels, or ice packs to the groin, neck, armpits, and head.
If the person begins to shiver, slow down your sedation method, as shivering increases the internal temperature. Take his or her temperature every 10 minutes if you have a thermometer. You should aim for a temperature of 39°C (102°F), as too low a temperature can be dangerous (hypothermia). During this time, make arrangements to take the victim to an emergency room. Be alert for signs of respiratory arrest (respiratory failure), and be prepared to perform mouth-to-mouth resuscitation if necessary.
The victim of heat exhaustion should be moved to a cool area. Lay the victim on the floor and give him or her a sip of water every two to three minutes. Sports drinks are best, but water is often the most readily available. Sponge the victim with cool water and remove any unnecessary clothing. Pay particular attention to signs of deterioration, but be aware that there is no specific urgency to take the victim to the hospital in the classic case of heat exhaustion. Symptoms usually last 2-3 hours.
To avoid this type of problem, you should drink plenty of fluids during heat waves, especially if you plan to work or play sports outdoors. If you are exercising, it is recommended that you drink about 500 ml to 1.8 L of water in the 3 hours before exercise, and add 200 ml to 250 ml every 20 minutes during the exercise itself. After exercise, fluid loss continues, so it is important to continue drinking water for several hours after exercise. Some experts advise continuing until the urine turns pale.
Do not take salt tablets unless you are also drinking plenty of water. In very hot environments, drink every hour, whether you are thirsty or not, as thirst is a late indicator of dehydration. Other prevention methods include:
- during the summer, avoid strenuous outdoor activities during the hottest part of the day (between 10 a.m. and 3 p.m.);
- Avoid being in the sun, if possible;
- If you must stay in a hot environment, take a 10-20 minute break in the shade or in an air-conditioned area for each hour of activity.
- Wear loose-fitting, light-coloured clothing (light colors reflect sunlight better) and a wide-brimmed hat;
- Try to rest in the shade during the hottest part of the day;
- Avoid coffee and alcohol, especially beer, which facilitate fluid loss.
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