Recently, the General Medicine Department of Yiyang Central Hospital admitted a student with heat stroke. During military training under the scorching sun, he suddenly felt dizzy and sweated profusely, then fainted on the ground with limb convulsions. Heat stroke not only brought physical pain to the student, but also sounded a wake-up call to parents and teachers. Outdoor activities in high temperature environments, especially high-intensity military training, require us to pay more attention to the prevention and response to heat stroke. 1. What is heat stroke? Heat stroke is caused by prolonged exposure to high temperatures, which causes an imbalance between heat production and heat dissipation in the human body, leading to an increase in core body temperature . When the body's temperature regulation center is damaged and cannot dissipate heat effectively, heat injury diseases with central nervous system and cardiovascular dysfunction as the main clinical manifestations may occur. 2. Clinical symptoms of heat stroke ① Precursors of heatstroke : mild headache, dizziness, thirst, sweating, rapid heartbeat, and inattention. ② Mild heatstroke : body temperature rises to above 38°C, accompanied by flushed face, burning skin, rapid heartbeat, nausea and vomiting. ③Severe heatstroke : including heat cramps, heat exhaustion, and heat stroke. Heat cramps: Usually occur after strenuous exercise in a hot environment , causing muscle pain and cramps due to loss of electrolytes (mainly sodium) due to excessive sweating. Patients may feel muscle pain, especially in the abdomen, arms, and legs. Although the body temperature usually remains normal, heat cramps can develop into a more serious type of heat stroke if not treated promptly. Heat exhaustion: usually occurs in the elderly, children and patients with chronic diseases , due to insufficient circulating volume caused by excessive loss of body fluid and body sodium. Patients may experience sweating, fatigue, weakness, dizziness, headache, nausea, vomiting, muscle cramps, and obvious signs of dehydration: tachycardia, orthostatic hypotension or syncope. The body temperature may be slightly elevated, but there is usually no obvious sign of central nervous system damage. Heat stroke: This is a very serious type of heat stroke that usually occurs in hot and humid environments , especially after strenuous exercise or labor. Patients may experience high fever (body temperature over 40°C), dry skin, rapid heartbeat, low blood pressure, headache, dizziness, nausea, vomiting, confusion, delirium, coma and even death. Heat stroke requires immediate medical intervention as it can lead to organ failure and death. 3. Strategies to prevent heat stroke ① Environmental adaptation : Gradually increase the amount of activity in a high temperature environment to allow the body to adapt to the high temperature environment. ② Reasonable hydration : replenish water and electrolytes in time according to the amount of sweat to avoid dehydration. ③Dress appropriately : Choose breathable, moisture-wicking clothing to reduce heat accumulation. ④Avoid activities during high temperature periods : Try to avoid outdoor activities during the hottest periods of the day. 4. On-site first aid measures ① Rapid identification : First, you must quickly identify the signs of heat stroke, such as abnormally high body temperature, dry or flushed skin, rapid heartbeat, confusion, etc. ② Immediate cooling : Move the patient to the nearest cool place to avoid further exposure to high temperatures. If possible, use a fan or any device that can increase air flow. ③ Physical cooling : Use cool water (not ice water to avoid causing chills) to wipe the patient's body, especially areas rich in large blood vessels, such as the neck, armpits, and groin. You can also use a wet towel or wet sheet to cover the patient. ④ Cold water immersion : If conditions permit, immerse the patient in cold water, which can quickly lower the body temperature. Pay attention to monitoring the patient's reaction and avoid excessive cooling. ⑤ Rehydrate : If the patient is conscious and can swallow safely, give an appropriate amount of electrolyte drinks or water to replenish lost water and electrolytes. Avoid giving drinks containing caffeine or alcohol. ⑥ Raise the lower limbs : If the patient is able to lie flat, the lower limbs can be raised about 12 inches (about 30 cm) to help blood return to important organs. ⑦Monitoring state of consciousness : Continuously observe the patient's level of consciousness and vital signs, including breathing, pulse, and body temperature. If the patient loses consciousness or has abnormal vital signs, perform cardiopulmonary resuscitation (CPR) immediately. ⑧Avoid the use of antipyretics : In the pre-hospital stage, it is not recommended to give patients any oral antipyretics as this may aggravate symptoms of dehydration. ⑨ Maintain communication : If the patient shows severe symptoms of heat stroke, call the emergency number 120 immediately and ensure smooth communication so that you can communicate with emergency personnel about the patient's condition at any time. ⑩Record time : Record the time when the patient develops heat stroke symptoms and the measures taken. This information is very important for the doctor's diagnosis and treatment. Military training is great, but don’t overdo it! Remember, the sun can be too hot sometimes. We need more than just sunscreen and sun hats. What’s more important is to stay alert at all times, replenish water and electrolytes in time, and avoid becoming a “hot candidate” for heat stroke . References Expert consensus on diagnosis and treatment of heat stroke in China (2023) Hunan Medical Chat Special Author: Zhou Xianxian and Zhou Hong from Yiyang Central Hospital Follow @湖南医聊 to get more health science information! (Edited by YH) |
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