In severe cases, it will be fatal, and rapid cooling is a good strategy
Dog days are here, beware of heat stroke! (Health Express Train (61st stop))
Heatstroke is a disease that is common in high-heat environments in summer. It is more likely to occur when combined with high-humidity environments. In mild cases, dizziness, weakness, and vomiting may occur, and in severe cases, convulsions, syncope, exhaustion, shock, etc. may occur. Failure to discover or dispose of it in time may lead to serious adverse consequences.
Therefore, heatstroke must not be taken lightly.
How serious can heatstroke be?
Normal human body temperature fluctuates within a narrow range, and the cells that make up the human body can survive and perform normal physiological functions only at around 37 degrees Celsius.
When the human body's high temperature continues above 42 degrees Celsius and does not retreat, the body's protein denaturation, functional inactivation, and even cell necrosis will occur.
Death caused by heatstroke is caused by high temperature causing physical malfunction, causing dysfunction or even damage and necrosis of human cells and organs, and ultimately leading to failure of multiple organs.
High temperature will lead to an increase in all-cause mortality (that is, not limited to a certain disease), which is more obvious in the elderly, coronary heart patients and other populations.
Other high-risk groups of heat stroke include the frail, long-term outdoor high-temperature environment or strong physical activity.
The adverse effects of a heat wave on human functions may last for about 1 week.
The main pathogenic link of heat stroke is due to heat dissipation barriers, which exceed the range of human body temperature regulation, and the body temperature continues to rise, leading to a series of serious consequences.
The above-mentioned various organ failures, as well as electrolyte abnormalities, acidosis, etc., affect each other, a vicious circle, and it is completely possible to put lives on the verge of danger.
Therefore, for heatstroke, the core principle of treatment is to cool down quickly.
What should I do if I have heat stroke?
Heat stroke is easy to occur in high temperature and high humidity environment, and heat stroke is more likely to occur in high-intensity exercise and labor under this condition.
The elderly, children, and the infirm are prone to heat stroke without high-intensity activities.
Some parturients who cover the quilt with long dresses and long sleeves are also prone to heatstroke.
In the event of heatstroke, quickly get out of the high temperature, high humidity, and sun environment, and lie down in a cool and ventilated place. Avoid high-intensity exercise and heavy physical labor. If possible, place the patient in an air-conditioned environment and try to remove clothes to help heat dissipation. .
People who are conscious and have no difficulty in swallowing should promptly add salty refreshing beverages, such as light salt water, cold watermelon water, mung bean soup, etc.
The mild cases can be recovered after the above treatment, and the severe cases need to go to the hospital for diagnosis and treatment.
People with heatstroke and high fever should quickly lower their core body temperature (measure rectal temperature or ear temperature), strive to reduce the core temperature to below 39 degrees Celsius within half an hour, and pay attention to vital signs, mental changes and the function of various organs, and early detection and treatment of concurrent complications disease.
The doctor will take blood to check a variety of physiological indicators, and perform imaging examinations such as head CT. The purpose is to detect organ dysfunction early, and to intervene early to prevent the further development of organ dysfunction.
Cooling mostly advocates the use of physical cooling measures, using the mechanisms of conduction, convection, radiation and evaporation.
Such as immersing the body (except the head) in 4 degrees Celsius water to cool down, but this cold water will make the conscious person feel very uncomfortable, and avoid lowering the body temperature too low; or remove the clothes, sprinkle warm water on the body, and blow it with a fan Strengthen evaporative cooling; it can also be supplemented by ice blankets or wrapped ice bags placed in large blood vessels to cool down.
It should be noted that the high fever caused by heatstroke is not equivalent to the "fever" caused by infectious inflammation (that is, what we usually call "fever"), so it is not recommended to use commonly used antipyretic drugs (such as aspirin, acetaminophen, etc.).
In addition, it is not recommended to wipe the bath with alcohol.
How to prevent heat stroke?
Prevention of high temperature and heat stroke is important.
For example, improve the working conditions of high temperature and high humidity, strengthen heat insulation, ventilation, shading and other cooling measures, pay attention to shielding from the sun when going out; drink more salty refreshing beverages instead of waiting for thirsty to add water, salt and sugar Drinks help increase the amount of drinking water; pay attention to diet and rest. Heatstroke is prone to occur under conditions of insufficient rest, fatigue and hunger; use air conditioning to cool down, or repeatedly go to the air-conditioned environment to lower body temperature, even if you stay in the air-conditioned environment for a short time, it will be greatly Reduce the occurrence of heatstroke or severe heatstroke, especially for the elderly, children, and infirm people with poor body regulation.
However, when using the air conditioner, avoid direct air blowing or the temperature is adjusted too low.
Taking a planned and proactive thermal adaptation method is also helpful to prevent heat stroke, such as intermittent contact with the thermal environment, controlling the length of stay in the thermal environment, gradually extending the time, gradually increasing the amount of exercise, and so on.
(The author is the Deputy Chief Physician of the Emergency Department of Beijing Tsinghua Chang Gung Memorial Hospital)