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M.A. Stroud

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date: 24 April 2017

Rising body temperature triggers behavioural and physiological responses including reduction in physical activity, alterations of clothing, skin vasodilatation, and sweating. Heat-related illness is relatively common, especially with high humidity or prolonged physical activity. Risk can be reduced by acclimatization with repeated heat exposure, but some individuals seem to be particularly susceptible.

Clinical presentations of heat-related illness include (1) ‘heat exhaustion’—the commonest manifestation, with symptoms including nausea, weakness, headache, and thirst. Patients appear dehydrated, complain of being hot, and are flushed and sweaty. Treatment requires rest and fluids, given orally or (in severe cases) intravenously. (2) ‘heat stroke’—victims often complain of headache, may be drowsy or irritable, and may claim to feel cold. Core temperature is usually 38 to 41 °C, but the patient is shivering with dry, vasoconstricted skin. Treatment requires (a) aggressive rapid cooling—tepid water and fan-assisted evaporation in the first instance, with more invasive measures, e.g. intraperitoneal fluids, if required; (b) close biochemical monitoring; (c) supportive care for organ failure. There is significant mortality.

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