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Oxford Textbook of Medicine (5 ed.)

Edited by David A. Warrell, Timothy M. Cox, John D. Firth

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Latest update

The May 2013 update sees updates to chapters focusing on Respiratory Medicine and Haematology.

Respiratory Medicine updates include substantial updates to key chapters and new material on a wide range of topics including: new bronchoscopic techniques for early detection of lung cancer, specific causes of effusion and pleural disease, and chronic obstructive pulmonary disease.

Haematology updates include extensive revisions of key chapters on chronic myeloid leukaemia, aplastic anaemia and bone marrow failure disorders, and blood transfusion, with new information on a wide range of matters.

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Publisher:
Oxford University Press
Print Publication Date:
May 2010
Print ISBN-13:
9780199204854
Published to Oxford Medicine:
May 2010
DOI:
10.1093/med/9780199204854.001.1

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Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Contents

Heat

Chapter:
Heat
Author(s):

M.A. Stroud

DOI:
10.1093/med/9780199204854.003.090501

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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