Summary
Definition
History and exam
Key diagnostic factors
- profound central nervous system disturbance
- hyperthermia
Other diagnostic factors
- headache
- nausea and vomiting
- anxiety
- dizziness
- tachycardia
- jaundice
- muscle tenderness
- hypotension
- gastrointestinal bleeding
- bruising and skin bleeding
Risk factors
- older age
- impaired cognition
- patients unable to care for themselves
- medications
- people who are unacclimatized to hot environments
- young, active people exercising intensely under hot, humid conditions
Diagnostic tests
1st tests to order
- core temperature measurement
- serum electrolytes
- CBC
- LFTs
- metabolic profile
- renal function tests
- creatine kinase
- prothrombin time, activated PPT, and INR
- lactic acid
- urinalysis
- chest x-ray
- arterial blood gas
- medication/toxicology screen
- thyroid function tests
- plasma glucose
Tests to consider
- cranial CT scan
- lumbar puncture
- blood culture
Treatment algorithm
heat exhaustion
heat stroke
Contributors
Expert advisers
James L. Glazer, MD, FACSM, CAQSM
Assistant Professor
Tufts University School of Medicine
Boston
MA
Disclosures
JLG declares that he has no competing interests.
Peer reviewers
Martin Bocks, MD
Clinical Lecturer
University of Michigan Congenital Heart Center
Ann Arbor
MI
Disclosures
MB declares that he has no competing interests.
James Milledge, MBBS
Honorary Professor
Department of Physiology
UCL
London
Divulgaciones
JM declares that he has no competing interests.
Paul Hamilton, MD
Director
Department of Emergency Medicine
Mount Sinai School of Medicine
New York
NY
Divulgaciones
PH declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
Eifling KP, Gaudio FG, Dumke C, et al. Wilderness Medical Society clinical practice guidelines for the prevention and treatment of heat illness: 2024 update. Wilderness Environ Med. 2024 Mar;35(1 suppl):112S-27.Texto completo Resumen
Roberts WO, Armstrong LE, Sawka MN, et al. ACSM expert consensus statement on exertional heat illness: recognition, management, and return to activity. Curr Sports Med Rep. 2023 Apr 1;22(4):134-49.Texto completo Resumen
Gauer R, Meyers BK. Heat-related illnesses. Am Fam Physician. 2019 Apr 15;99(8):482-9.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
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Más DiferencialesGuías de práctica clínica
- Wilderness Medical Society clinical practice guidelines for the prevention and treatment of heat illness: 2024 update
- ACSM expert consensus statement on exertional heat illness: recognition, management, and return to activity
Más Guías de práctica clínicaFolletos para el paciente
Heat stroke
Más Folletos para el pacienteInicie sesión o suscríbase para acceder a todo el BMJ Best Practice
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