小结
定义
病史和体格检查
关键诊断因素
- 严重的中枢神经系统紊乱
- 体温过高
其他诊断因素
- 头痛
- 恶心和呕吐
- 焦虑
- 头晕
- 心动过速
- 黄疸
- 肌肉压痛
- 低血压
- 胃肠道出血
- 瘀伤和皮肤出血
危险因素
- 老年
- 认知受损
- 患者无法照顾自己
- 药物治疗
- 不适应高温环境的人群
- 在高温高湿条件下剧烈运动的年轻人、活跃人群
诊断性检查
首要检查
- 核心温度测量
- 血清电解质
- 全血细胞计数 (FBC）
- 肝功能检查 (LFT)
- 代谢指标
- 肾功能检查
- 肌酸激酶
- 凝血酶原时间、活化 PPT 和 INR
- 乳酸
- 尿液分析
- 胸部 X 线检查
- 动脉血气
- 药物 / 毒物学筛查
- 甲状腺功能检测
- 血糖
需考虑的检查
- 颅脑 CT 扫描
- 腰椎穿刺：
- 血液培养
治疗流程
中暑衰竭
热射病
撰稿人
作者
James L. Glazer, MD, FACSM, CAQSM
Assistant Professor
Tufts University School of Medicine
Boston
MA
利益声明
JLG declares that he has no competing interests.
同行评议者
Martin Bocks, MD
Clinical Lecturer
University of Michigan Congenital Heart Center
Ann Arbor
MI
利益声明
MB declares that he has no competing interests.
James Milledge, MBBS
Honorary Professor
Department of Physiology
UCL
London
利益声明
JM declares that he has no competing interests.
Paul Hamilton, MD
Director
Department of Emergency Medicine
Mount Sinai School of Medicine
New York
NY
利益声明
PH declares that he has no competing interests.
参考文献
关键文献
Glazer JL. Management of heatstroke and heat exhaustion. Am Fam Physician. 2005 Jun 1;71(11):2133-40.全文 摘要
Council on Sports Medicine and Fitness and Council on School Health; Bergeron MF, Devore C, et al. Policy statement - Climatic heat stress and exercising children and adolescents. Pediatrics. 2011 Sep;128(3):e741-7.全文 摘要
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.全文 摘要
Kellerman AL, Todd KH. Killing heat. N Engl J Med. 1996 Jul 11;335(2):126-7. 摘要
Casa DJ, Becker SM, Ganio MS, et al. Validity of devices that assess body temperature during outdoor exercise in the heat. J Athl Train. 2007 Jul-Sep;42(3):333-42.全文 摘要
Harker J, Gibson P. Heat-stroke: a review of rapid cooling techniques. Intensive Crit Care Nurs. 1995 Aug;11(4):198-202. 摘要
McDermott BP, Casa DJ, Ganio MS, et al. Acute whole-body cooling for exercise-induced hyperthermia: a systematic review. J Athl Train. 2009 Jan-Feb;44(1):84-93.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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