Heat stroke in adults

References

Key articles

Lipman GS, Gaudio FG, Eifling KP, et al. Wilderness Medical Society clinical practice guidelines for the prevention and treatment of heat illness: 2019 update. Wilderness Environ Med. 2019 Dec;30(4s):S33-46.Full text  Abstract

Gauer R, Meyers BK. Heat-related illnesses. Am Fam Physician. 2019 Apr 15;99(8):482-9.Full text  Abstract

Reference articles

1. Lipman GS, Gaudio FG, Eifling KP, et al. Wilderness Medical Society clinical practice guidelines for the prevention and treatment of heat illness: 2019 update. Wilderness Environ Med. 2019 Dec;30(4s):S33-46.Full text  Abstract

2. Gauer R, Meyers BK. Heat-related illnesses. Am Fam Physician. 2019 Apr 15;99(8):482-9.Full text  Abstract

3. Public Health England. Heatwave plan for England: supporting vulnerable people before and during a heatwave – advice for health and social care professionals. May 2015 [internet publication].Full text

4. Public Health England. Heatwave plan for England: protecting health and reducing harm from severe heat and heatwaves. May 2018 [internet publication].Full text

5. Hoag H. How cities can beat the heat. Nature. 2015 Aug 27;524(7566):402-4.Full text  Abstract

6. Glazer JL. Management of heatstroke and heat exhaustion. Am Fam Physician. 2005 Jun 1;71(11):2133-40.Full text  Abstract

7. Bouchama A, Dehbi M, Mohamed G, et al. Prognostic factors in heat wave-related deaths. Arch Intern Med. 2007 Nov 12;167(20):2170-6.Full text  Abstract

8. Nakai S, Itoh T, Morimoto T. Deaths from heat stroke in Japan: 1968-1994. Int J Biometerol. 1999 Nov;43(3):124-7. Abstract

9. World Health Organization. Public health advice on preventing health effects of heat . Jan 2011 [internet publication].Full text

10. Epstein Y, Yanovich R. Heatstroke. N Engl J Med. 2019 Jun 20;380(25):2449-59.Full text  Abstract

11. Anesthesia Central. Heatstroke and heat injury. April 2019 [internet publication].Full text

12. NHS England. Sepsis guidance implementation advice for adults. September 2017 [internet publication].Full text

13. National Institute for Health and Care Excellence. Sepsis: recognition, diagnosis and early management. September 2017 [internet publication].Full text

14. Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med. 2021 Nov 1;49(11):e1063-e1143.Full text  Abstract

15. O'Driscoll BR, Howard LS, Earis J, et al. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax. 2017 Jun;72(suppl 1):ii1-90.Full text  Abstract

16. Chu DK, Kim LH, Young PJ, et al. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet. 2018 Apr 28;391(10131):1693-705. Abstract

17. Bouchama A, Dehbi M, Chaves-Carballo E. Cooling and hemodynamic management in heatstroke: practical recommendations. Crit Care. 2007;11(3):R54.Full text  Abstract

18. Weiner JS, Khogali M. A physiological body-cooling unit for treatment of heat stroke. Lancet. 1980 Mar 8;1(8167):507-9. Abstract

19. Barnett A, Beasley R, Buchan C, et al. Thoracic Society of Australia and New Zealand position statement on acute oxygen use in adults: 'swimming between the flags'. Respirology. 2022 Apr;27(4):262-76.Full text  Abstract

20. Global Initiative For Asthma. Global strategy for asthma management and prevention. 2022 [internet publication].Full text

21. Siemieniuk RAC, Chu DK, Kim LH, et al. Oxygen therapy for acutely ill medical patients: a clinical practice guideline. BMJ. 2018 Oct 24;363:k4169.Full text  Abstract

22. British Thoracic Society. BTS Guideline for oxygen use in healthcare and emergency settings. Dec 2019 [internet publication].Full text

23. Voshaar T, Stais P, Köhler D, et al. Conservative management of COVID-19 associated hypoxaemia. ERJ Open Res. 2021 Mar 15;7(1):00026-2021.Full text  Abstract

24. Barbateskovic M, Schjørring OL, Russo Krauss S, et al. Higher versus lower fraction of inspired oxygen or targets of arterial oxygenation for adults admitted to the intensive care unit. Cochrane Database Syst Rev. 2019 Nov 27;2019(11):CD012631.Full text  Abstract

25. ICU-ROX Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group., Mackle D, Bellomo R, et al. Conservative Oxygen Therapy during Mechanical Ventilation in the ICU. N Engl J Med. 2020 Mar 12;382(11):989-98.Full text  Abstract

26. Cumpstey AF, Oldman AH, Smith AF, et al. Oxygen targets in the intensive care unit during mechanical ventilation for acute respiratory distress syndrome: a rapid review. Cochrane Database Syst Rev. 2020 Sep 1;(9):CD013708.Full text  Abstract

27. Anesthesia Central. Heatstroke and heat injury. April 2019 [internet publication].Full text

28. Royal College of Physicians. National early warning score (NEWS2). Standardising the assessment of acute-illness severity in the NHS. December 2017 [internet publication]Full text

29. Global Initiative for Asthma. Global strategy for asthma management and prevention. 2022 [internet publication]Full text

30. British Thoracic Society; Scottish Intercollegiate Guidelines Network. British guideline on the management of asthma: a national clinical guideline. July 2019 [internet publication].Full text

31. O'Driscoll BR, Howard LS, Earis J, et al; British Thoracic Society Emergency Oxygen Guideline Group; BTS Emergency Oxygen Guideline Development Group. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax. 2017 Jun;72(suppl 1):ii1-90 Abstract

32. Chu DK, Kim LH, Young PJ, et al. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): systematic review and meta-analysis. Lancet. 2018 Apr 26;391(10131):1693-705 Abstract

33. Siemieniuk RAC, Chu DK, Kim LH, et al. Oxygen therapy for acutely ill medical patients: a clinical practice guideline. BMJ. 2018 Oct 24;363:k4169Full text  Abstract

34. National Institute for Health and Care Excellence. Intravenous fluid therapy in adults in hospital. Clinical guideline CG174. May 2017 [internet publication]Full text

35. Verbrugge FH, Grieten L, Mullens W. Management of the cardiorenal syndrome in decompensated heart failure. Cardiorenal Med. 2014 Dec;4(3-4):176-88Full text  Abstract

36. World Health Organization. Public health advice on preventing health effects of heat. 2011 [internet publication]Full text

37. National Institute for Health and Care Excellence. Acute kidney injury: prevention, detection and management. December 2019 [internet publication]Full text

38. Hsu CY, Ordoñez JD, Chertow GM, et al. The risk of acute renal failure in patients with chronic kidney disease. Kidney Int. 2008 Apr 2;74(1):101-7Full text  Abstract

39. Freeman R, Wieling W, Axelrod FB, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011 Apr;21(2):69-72 Abstract

40. Hogervorst VM, Buurman BM, De Jonghe A, et al. Emergency department management of older people living with frailty: a guide for emergency practitioners. Emerg Med J. 2021 Sep;38(9):724-9 Abstract

41. NHS England. Toolkit for general practice in supporting older people living with frailty. March 2017 [internet publication]Full text

42. Rockwood K; British Geriatrics Society. Silver book II: frailty. February 2021 [internet publication]Full text

43. Royal College of Physicians. Acute care toolkit 3. Acute care for older people living with frailty. December 2020 [internet publication]Full text

44. Wallis SJ, Wall J, Biram RW, et al. Association of the clinical frailty scale with hospital outcomes. QJM. 2015 Dec;108(12):943-9Full text  Abstract

45. Conroy SP, Bardsley M, Smith P, et al. Comprehensive geriatric assessment for frail older people in acute hospitals: the HoW-CGA mixed-methods study. Health Services and Delivery Research. 2019 April:7(15)Full text

46. Quinn TJ, Mooijaart SP, Gallacher K, et al. Acute care assessment of older adults living with frailty. BMJ. 2019 Jan 31;364:l13 Abstract

47. Fritz Z, Slowther AM, Perkins GD. Resuscitation policy should focus on the patient, not the decision. BMJ. 2017 Feb 28;356:j813Full text  Abstract

48. The National Institute for Health and Care Excellence. Decision making and mental capacity. October 2018 [internet publication]Full text

49. Office of the Public Guardian. Mental Capacity Act: making decisions. October 2014 [internet publiction]Full text

50. Social Care Institute for Excellence. Independent mental capacity advocate (IMCA). January 2010 [internet publication]Full text

51. Grau AJ, Urbanek C, Palm F. Common infections and the risk of stroke. Nat Rev Neurol. 2010 Nov 9;6(12):681-94 Abstract

52. Eigenbrodt ML, Rose KM, Couper DJ, et al. Orthostatic hypotension as a risk factor for stroke: the atherosclerosis risk in communities (ARIC) study, 1987-1996. Stroke. 2000 Oct;31(10):2307-13 Abstract

53. Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2016 May 4;47(6):e98-e169Full text  Abstract

54. Pendlebury ST, Klaus SP, Mather M, et al. Routine cognitive screening in older patients admitted to acute medicine: abbreviated mental test score (AMTS) and subjective memory complaint versus Montreal Cognitive Assessment and IQCODE. Age Ageing. 2015 Oct 13;44(6):1000-5Full text  Abstract

55. Hodkinson HM. Evaluation of a mental test score for assessment of mental impairment in the elderly. Age Ageing. 1972 Nov;1(4):233-8 Abstract

56. National Institute for Health and Care Excellence. Delirium: diagnosis, prevention and management. March 2019 [internet publication]Full text

57. National Institute for Health and Care Excellence. Dementia: assessment, management and support for people living with dementia and their carers. June 2018 [internet publication]Full text

58. Scottish Intercollegiate Guidelines Network. Risk reduction and management of delirium. March 2019 [internet publication]Full text

59. Nova Scotia Health Authority. This is not my Mom. 2012 [internet publication]Full text

60. Inouye SK, Schlesinger MJ, Lydon TJ. Delirium: a symptom of how hospital care is failing older persons and a window to improve quality of hospital care. Am J Med. 1999 May;106(5):565-73 Abstract

61. Bellelli G, Morandi A, Davis DH, et al. Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age Ageing. 2014 Mar 2;43(4):496-502Full text  Abstract

62. MacLullich AM, Shenkin SD, Goodacre S, et al. The 4 'A's test for detecting delirium in acute medical patients: a diagnostic accuracy study. Health Technol Assess. 2019 Aug;23(40):1-194Full text  Abstract

63. White S, Griffiths R, Baxter M, et al. Guidelines for the peri-operative care of people with dementia: guidelines from the Association of Anaesthetists. Anaesthesia. 2019 Jan 11;74(3):357-72Full text  Abstract

64. Siddiqi N, Harrison JK, Clegg A, et al. Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev. 2016 Mar 11;3:CD005563Full text  Abstract

65. Martinez F, Tobar C, Hill N. Preventing delirium: should non-pharmacological, multicomponent interventions be used? A systematic review and meta-analysis of the literature. Age Ageing. 2014 Nov 25;44(2):196-204Full text  Abstract

66. Public Health England. Urinary tract infection: diagnostic tools for primary care. October 2020 [internet publication]Full text

67. Medicines and Healthcare products Regulatory Agency. Haloperidol (haldol): reminder of risks when used in elderly patients for the acute treatment of delirium. 2021 [internet publication]Full text

68. Ma H, Huang Y, Cong Z, et al. The efficacy and safety of atypical antipsychotics for the treatment of dementia: a meta-analysis of randomized placebo-controlled trials. J Alzheimers Dis. 2014;42(3):915-37 Abstract

69. Huybrechts KF, Gerhard T, Crystal S, et al. Differential risk of death in older residents in nursing homes prescribed specific antipsychotic drugs: population based cohort study. BMJ. 2012 Feb 23;344:e977Full text  Abstract

70. Van Leeuwen E, Petrovic M, van Driel ML, et al. Withdrawal versus continuation of long-term antipsychotic drug use for behavioural and psychological symptoms in older people with dementia. Cochrane Database Syst Rev. 2018 Mar 30;3:CD007726Full text  Abstract

71. Joint British Diabetes Societies for inpatient care. The management of diabetic ketoacidosis in adults. June 2021 [internet publication]Full text

72. Joint British Diabetes Societies for inpatient care. The management of the hyperosmolar hyperglycaemic state (HHS) in adults. February 2022 [internet publication]Full text

73. Chowdhury TA, Cheston H, Claydon A. Managing adults with diabetes in hospital during an acute illness. BMJ. 2017 Jun 22;357:j2551 Abstract

74. Joint British Diabetes Societies for inpatient care. Self-management of diabetes in hospital. August 2021 [internet publication]Full text

75. Joint British Diabetes Societies for inpatient care. Glycaemic management during the inpatient enteral feeding of stroke patients with diabetes. November 2019 [internet publication]Full text

76. Joint British Diabetes Societies for inpatient care. The use of variable rate intravenous insulin infusion (VRIII) in medical inpatients. October 2014 [internet publication]Full text

77. Joint British Diabetes Societies for inpatient care. A good inpatient diabetes service. July 2019 [internet publication]Full text

78. Centre for Perioperative Care. Guideline for perioperative care for people with diabetes mellitus undergoing elective and emergency surgery. March 2021 [internet publication]Full text

79. Pasquel FJ, Lansang MC, Dhatariya K, et al. Management of diabetes and hyperglycaemia in the hospital. Lancet Diabetes Endocrinol. 2021 Mar;9(3):174-88Full text  Abstract

80. Medicines and Healthcare products Regulatory Agency. SGLT2 inhibitors: monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness. March 2020 [internet publication]Full text

81. Peters AL, Buschur EO, Buse JB, et al. Euglycemic diabetic ketoacidosis: a potential complication of treatment with sodium-glucose cotransporter 2 inhibition. Diabetes Care. 2015 Jun 15;38(9):1687-93 Abstract

82. American Diabetes Association. 16. Diabetes care in the hospital: standards of medical care in diabetes - 2022. Diabetes Care. 2022 Jan 1;45(suppl 1):S244-S253.Full text  Abstract

83. Joint British Diabetes Societies for inpatient care. A good inpatient diabetes service. July 2019 [internet publication]Full text

84. National Institute for Health and Care Excellence. Type 1 diabetes in adults: diagnosis and management. March 2022 [internet publication]Full text

85. Joint British Diabetes Societies for inpatient care. Inpatient care of the frail older adult with diabetes. 2019 [internet publication]Full text

86. van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001 Nov 8;345(19):1359-67Full text  Abstract

87. NICE-SUGAR Study Investigators; Finfer S, Chittock DR, Su SY, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009 Mar 26;360(13):1283-97.Full text  Abstract

88. Marik PE, Preiser JC. Toward understanding tight glycemic control in the ICU: a systematic review and metaanalysis. Chest. 2010 Mar;137(3):544-51Full text  Abstract

89. Rehman A, Setter SM, Vue MH. Drug-induced glucose alterations part 2: drug-Induced hyperglycemia. Diabetes Spect. 2011 Nov;24(4):234-8Full text

90. NHS Digital. National Diabetes Inpatient Audit (NaDIA) - 2019. Nov 2020 [internet publication]Full text

91. Joint British Diabetes Societies for inpatient care. The hospital management of hypoglycaemia in adults with diabetes mellitus. March 2022 [internet publication]Full text

92. TREND Diabetes. End of life guidance for diabetes care. November 2021 [internet publication]Full text

93. Salpeter SR, Ormiston TM, Salpeter EE. Cardiovascular effects of beta-agonists in patients with asthma and COPD: a meta-analysis. Chest. 2004 Jun;125(6):2309-21Full text  Abstract

94. Au DH, Curtis JR, Every NR, et al. Association between inhaled beta-agonists and the risk of unstable angina and myocardial infarction. Chest. 2002 Mar;121(3):846-51Full text  Abstract

95. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. 2022 [internet publication]Full text

96. Walters JA, Tan DJ, White CJ, et al. Different durations of corticosteroid therapy for exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2018 Mar 19;3:CD006897Full text  Abstract

97. National Institute for Health and Care Excellence. Chronic obstructive pulmonary disease in over 16s: diagnosis and management. July 2019 [internet publication]Full text

98. National Institute for Health and Care Excellence. Diabetic foot problems: prevention and management. October 2019 [internet publication]Full text

99. Rayman G, Vas PR, Baker N, et al. The Ipswich Touch Test: a simple and novel method to identify inpatients with diabetes at risk of foot ulceration. Diabetes Care. 2011 May 18;34(7):1517-8Full text  Abstract

100. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13 Abstract

101. Boden JM, Fergusson DM. Alcohol and depression. Addiction. 2011 Mar 7;106(5):906-14 Abstract

102. Cleare A, Pariante CM, Young AH, et al. Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 2008 British Association for Psychopharmacology guidelines. J Psychopharmacol. 2015 May 12;29(5):459-525Full text  Abstract

103. National Institute for Health and Care Excellence. Depression in adults with a chronic physical health problem: recognition and management. October 2009 [internet publication]Full text

104. Taylor DM, Barnes TRE, Young AH. The Maudsley prescribing guidelines in psychiatry. 14th edition. Chichester: Wiley-Blackwell; 2021

105. Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005 Mar 17;352(11):1112-20 Abstract

106. Buckley NA, Dawson AH, Isbister GK. Serotonin syndrome. BMJ. 2014 Feb 19;348:g1626 Abstract

107. Dalton SO, Sørensen HT, Johansen C. SSRIs and upper gastrointestinal bleeding: what is known and how should it influence prescribing? CNS Drugs. 2006;20(2):143-51 Abstract

108. Dalton SO, Johansen C, Mellemkjaer L, et al. Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal tract bleeding: a population-based cohort study. Arch Intern Med. 2003 Jan 13;163(1):59-64Full text  Abstract

109. Cheng YL, Hu HY, Lin XH, et al. Use of SSRI, but not SNRI, increased upper and lower gastrointestinal bleeding: a nationwide population-based cohort study in Taiwan. Medicine (Baltimore). 2015 Nov;94(46):e2022Full text  Abstract

110. Loke YK, Trivedi AN, Singh S. Meta-analysis: gastrointestinal bleeding due to interaction between selective serotonin uptake inhibitors and non-steroidal anti-inflammatory drugs. Aliment Pharmacol Ther. 2008 Jan 1;27(1):31-40Full text  Abstract

111. Flowers L. Nicotine replacement therapy. Am J Psychiatry Resid. 2016 Jun;11(6)4-7Full text

112. Desai HD, Seabolt J, Jann MW. Smoking in patients receiving psychotropic medications: a pharmacokinetic perspective. CNS Drugs. 2001;15(6):469-94 Abstract

113. Oliveira P, Ribeiro J, Donato H, Madeira N. Smoking and antidepressants pharmacokinetics: a systematic review. Ann Gen Psychiatry. 2017;16:17Full text  Abstract

114. National Centre for Smoking Cessation and Training. Smoking cessation and mental health. 2014 [internet publication]Full text

115. National Institute for Health and Care Excellence. Liaison psychiatry. In: Emergency acute medical care in over 16s: service delivery and organisation. March 2018 [internet publication]Full text

116. National Confidential Enquiry into Patient Outcome and Death (NCEPOD). Treat as one. Bridging the gap between mental and physical healthcare in general hospitals. 2017 [internet publication]Full text

117. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000 Jul 24;160(14):2101-7 Abstract

118. Clarke DM, Currie KC. Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence. Med J Aust. 2009 Apr 6;190(7 suppl):S54-60 Abstract

119. Prina AM, Cosco TD, Dening T, et al. The association between depressive symptoms in the community, non-psychiatric hospital admission and hospital outcomes: a systematic review. J Psychosom Res. 2014 Nov 8;78(1):25-33Full text  Abstract

120. World Health Organization. Excess mortality in persons with severe mental disorders. 2016 [internet publication]Full text

121. National Institute for Health and Care Excellence. Tobacco: preventing uptake, promoting quitting and treating dependence. Jan 2023 [internet publication].Full text

122. Lindson N, Chepkin SC, Ye W, et al. Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2019 Apr 18;4(4):CD013308.Full text  Abstract

123. Rigotti NA, Kruse GR, Livingstone-Banks J, et al. Treatment of tobacco smoking: a review. JAMA. 2022 Feb 8;327(6):566-77.Full text  Abstract

124. Thomas KH, Dalili MN, López-López JA, et al. Comparative clinical effectiveness and safety of tobacco cessation pharmacotherapies and electronic cigarettes: a systematic review and network meta-analysis of randomized controlled trials. Addiction. 2022 Apr;117(4):861-76.Full text  Abstract

125. NHS Specialised Clinical Frailty Network. Clinical frailty scale. 2018 [internet publication]Full text

126. Varghese GM, John G, Thomas K, et al. Predictors of multi-organ dysfunction in heatstroke. Emerg Med J. 2005 Mar;22(3):185-7.Full text  Abstract

127. Yamamoto T, Fujita M, Oda Y, et al. Evaluation of a novel classification of heat-related illnesses: a multicentre observational study (Heat Stroke STUDY 2012). Int J Environ Res Public Health. 2018 Sep 8;15(9):1962.Full text  Abstract

128. Epstein Y. Heat intolerance: predisposing factor or residual injury? Med Sci Sports Exerc. 1990 Feb;22(1):29-35. Abstract

129. Johnson EC, Kolkhorst FW, Richburg A, et al. Specific exercise heat stress protocol for a triathlete's return from exertional heat stroke. Curr Sports Med Rep. 2013 Mar-Apr;12(2):106-9. Abstract

130. Druyan A, Makranz C, Moran D, et al. Heat tolerance in women - reconsidering the criteria. Aviat Space Environ Med. 2012 Jan;83(1):58-60. Abstract

131. Martins PN, Mcdaid J, Hertl M, et al. Heat-stroke as a cause of liver failure and evaluation for liver transplant: 1385. Transplantation. 2012 Nov 27;94(10S):413.Full text

132. Bouchama A, Bridey F, Hammami MM, et al. Activation of coagulation and fibrinolysis in heatstroke. Thromb Haemost. 1996 Dec;76(6):909-15. Abstract

133. Wang JC, Chien WC, Chu P, et al. The association between heat stroke and subsequent cardiovascular diseases. PLoS One. 2019;14(2):e0211386.Full text  Abstract

134. Faculty of Sport and Exercise Medicine. Exertional heat stroke: position statement. May 2018 [internet publication].Full text

Use of this content is subject to our disclaimer