![]() ![]() Patients may present to their primary care physician with heat exhaustion, and chronic diseases may contribute to heat-related illness. Heat-related illnesses are largely preventable, and physicians can do a great deal to ensure the safety of their patients during the hot summer months. 1, 2 Results of epidemiologic studies 2, 3 have indicated that the incidence of heatstroke in urban areas of the United States during very warm periods is approximately 20 cases per 100,000 people, and that heatstroke accounts for at least 240 deaths in the United States annually. ![]() 1 Athletes, children, and the elderly also are frequently affected, with elderly persons being particularly vulnerable to heatstroke. Outdoor laborers compose the largest percentage of patients with heat-related illnesses. These preventive measures, when paired with astute recognition of the early signs of heat-related illness, can allow physicians in the ambulatory setting to avert much of the morbidity and mortality associated with heat exhaustion and heatstroke.Įach year, millions of people are exposed to the dangers of extreme heat. Programs involving identification of vulnerable individuals, dissemination of information about dangerous heat waves, and use of heat shelters may help prevent heat-related illness. Most experts believe that physicians and public health officials should focus greater attention on prevention. Physicians also must monitor electrolyte abnormalities, be alert to signs of renal or hepatic failure, and replace fluids in patients with heatstroke. Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. Other systemic effects, including rhabdomyolysis, hepatic failure, arrhythmias, disseminated intravascular coagulation, and even death, are not uncommon. Untreated heat exhaustion can progress to heatstroke, a much more serious illness involving central nervous system dysfunction such as delirium and coma. Treatment involves monitoring the patient in a cool, shady environment and ensuring adequate hydration. Heat exhaustion is characterized by nonspecific symptoms such as malaise, headache, and nausea. Recent research has identified a cascade of inflammatory pathologic events that begins with mild heat exhaustion and, if uninterrupted, can lead eventually to multiorgan failure and death. Both are common and preventable conditions affecting diverse patients. Ask your doctor whether any medicine you take raises your chance of getting heat exhaustion.Heat exhaustion and heatstroke are part of a continuum of heat-related illness.
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