Heat exhaustion

Heat exhaustion
Other names: Heat stress[1]
Differentiation between heat exhaustion and heat stroke
SpecialtyEmergency medicine
SymptomsHeadache, nausea, lightheadedness, sweating, increased body temperature[2]
ComplicationsHeat stroke[3]
CausesHigh temperatures with not enough fluids[3]
Risk factorsOlder age, high blood pressure, intense exercise[2][1]
TreatmentMoving to a cool environment, drinking fluids, putting cool water on the body[2]
Frequency4 per 10,000 ER visits (USA)[4]

Heat exhaustion is the body’s response to an excessive loss of water and salt, usually through excessive sweating.[2] Symptoms include headache, nausea, lightheadedness, sweating, and increased body temperature but not more than 40.5°C (104°F).[2][1] Onset may be rapid or over several days.[5][2] Without treatment, heat stroke may occur.[3]

The cause is typically being in high temperatures with not enough fluids.[3] Risk factors include older age, younger, high blood pressure, and intense exercise.[2][1][5] It is a type of heat illness of moderate severity.[2][5] Unlike heat stroke, it is not associated with confusion.[4]

Management involves moving to a cool environment, drinking cool fluids, and putting cool water on the body.[2] Exercise should be stopped and direct sun exposure should be avoided.[5] Assessment in an emergency department is recommended.[4] Heat acclimatization and fitness training can decrease the risk.[5]

Heat exhaustion affects millions of people a year.[5] It represents about 4 per 10,000 emergency department visits in the United States.[4] Heat illness is predicted to become significantly more common over the next few decades.[5] Recommended planning for heat waves, including the availability of air conditioned spaces, is recommended.[5]

Signs and symptoms

Symptoms of heat exhaustion include skin tingling, nausea, dizziness, irritability, headache, thirst, weakness, vomiting, high body temperature, excessive sweating, pupil dilation, and decreased urine output.[6]

Causes

Common risk factors include:[7]

Especially during physical exertion, risk factors for heat exhaustion include:[7]

  • Wearing dark, padded, or insulated clothing; hats; and/or helmets (for example, football pads, turnout gear, etc.)
  • Having a higher percentage of body fat
  • Dehydration
  • Fever
  • Some medications, like beta blockers and antipsychotic medicines[8]

Diagnosis

The evaluation of an individual with heat exhaustion is consistent with the following:[9]

Treatment

Drink water or sports drink

First aid for heat exhaustion includes:[6][8]

  • Moving the person to a cool place
  • Having the patient take off extra layers of clothes
  • Cooling the patient down by fanning them and/or putting wet towels on their body
  • Having them lie down and put their feet up if they are feeling dizzy
  • Having them drink water or "sports drinks" unless they are unconscious, too disoriented to drink, or vomiting
  • Turning the patient on their side if they are vomiting

Other measures may include:[10]

  • Provide supplemental oxygen
  • Administer intravenous fluids and electrolytes if they are too confused to drink or are vomiting

Prognosis

If left untreated, heat exhaustion may progress to heat stroke.[6]

See also

References

  1. 1 2 3 4 Leiva, DF; Church, B (January 2022). "Heat Illness". PMID 31971756. {{cite journal}}: Cite journal requires |journal= (help)
  2. 1 2 3 4 5 6 7 8 9 "Heat Stress Related Illness | NIOSH | CDC". www.cdc.gov. 18 May 2022. Archived from the original on 13 January 2022. Retrieved 10 July 2022.
  3. 1 2 3 4 "Heat Illness". medlineplus.gov. Archived from the original on 4 July 2016. Retrieved 10 July 2022.
  4. 1 2 3 4 Gauer, R; Meyers, BK (15 April 2019). "Heat-Related Illnesses". American family physician. 99 (8): 482–489. PMID 30990296.
  5. 1 2 3 4 5 6 7 8 Kenny, Glen P.; Wilson, Thad E.; Flouris, Andreas D.; Fujii, Naoto (2018). "Heat exhaustion". Handbook of Clinical Neurology. 157: 505–529. doi:10.1016/B978-0-444-64074-1.00031-8. PMID 30459023.
  6. 1 2 3 Jacklitsch, Brenda L. (June 29, 2011). "Summer Heat Can Be Deadly for Outdoor Workers". NIOSH: Workplace Safety and Health. Medscape and NIOSH. Archived from the original on December 4, 2012. Retrieved June 14, 2022.
  7. 1 2 "Heat Injury and Heat Exhaustion". www.orthoinfo.aaos.org. American Academy of Orthopedic Surgeons. July 2009. Archived from the original on September 19, 2017. Retrieved January 1, 2016.
  8. 1 2 3 "Heat Exhaustion and Heatstroke". www.nhs.uk. National Health Service of the United Kingdom. June 11, 2015. Archived from the original on October 3, 2017. Retrieved January 1, 2016.
  9. ↑ Leiva, Daniel F.; Church, Ben (2023). "Heat Illness". StatPearls. StatPearls Publishing. Archived from the original on 2022-11-02. Retrieved 2023-07-24.
  10. ↑ Mistovich, Joseph J.; Karren, Keith J.; Hafen, Brent (July 18, 2013). Prehospital Emergency Care (10 ed.). Prentice Hall. ISBN 978-0133369137.
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