Last reviewed: 28 Apr 2023
Last updated: 16 Jun 2020
Summary
Definition
History and exam
Key diagnostic factors
- profound central nervous system disturbance
- hyperthermia
More key diagnostic factors
Other diagnostic factors
- headache
- nausea and vomiting
- anxiety
- dizziness
- tachycardia
- jaundice
- muscle tenderness
- hypotension
- gastrointestinal bleeding
- bruising and skin bleeding
Other diagnostic factors
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
More risk factors
Diagnostic investigations
1st investigations 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
More 1st investigations to order
Investigations to consider
- cranial CT scan
- lumbar puncture
- blood culture
More investigations to consider
Treatment algorithm
ACUTE
heat exhaustion
heat stroke
Contributors
Authors
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
Disclosures
JM declares that he has no competing interests.
Paul Hamilton, MD
Director
Department of Emergency Medicine
Mount Sinai School of Medicine
New York
NY
Disclosures
PH declares that he has no competing interests.
Differentials
- Delirium
- Meningitis
- Diabetic ketoacidosis
More DifferentialsGuidelines
- National Athletic Trainers’ Association Position Statement: Exertional Heat Illnesses
- Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Heat-Related Illness: 2014 Update
More GuidelinesPatient leaflets
Heat stroke
More Patient leafletsLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer