Summary
Definição
História e exame físico
Principais fatores diagnósticos
- profound central nervous system disturbance
- hyperthermia
Outros fatores diagnósticos
- headache
- nausea and vomiting
- anxiety
- dizziness
- tachycardia
- jaundice
- muscle tenderness
- hypotension
- gastrointestinal bleeding
- bruising and skin bleeding
Fatores de risco
- 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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- 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
Investigações a serem consideradas
- cranial CT scan
- lumbar puncture
- blood culture
Algoritmo de tratamento
heat exhaustion
heat stroke
Colaboradores
Consultores especialistas
James L. Glazer, MD, FACSM, CAQSM
Assistant Professor
Tufts University School of Medicine
Boston
MA
Declarações
JLG declares that he has no competing interests.
Revisores
Martin Bocks, MD
Clinical Lecturer
University of Michigan Congenital Heart Center
Ann Arbor
MI
Declarações
MB declares that he has no competing interests.
James Milledge, MBBS
Honorary Professor
Department of Physiology
UCL
London
Declarações
JM declares that he has no competing interests.
Paul Hamilton, MD
Director
Department of Emergency Medicine
Mount Sinai School of Medicine
New York
NY
Declarações
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.
Referências
Principais artigos
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 Resumo
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 Resumo
Gauer R, Meyers BK. Heat-related illnesses. Am Fam Physician. 2019 Apr 15;99(8):482-9.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Delirium
- Meningitis
- Diabetic ketoacidosis
Mais Diagnósticos diferenciaisDiretrizes
- 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
Mais DiretrizesFolhetos informativos para os pacientes
Heat stroke
Mais Folhetos informativos para os pacientesConectar-se ou assinar para acessar todo o BMJ Best Practice
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