Heat stroke and heat exhaustion are not diseases but are two serious conditions. These conditions occur in hot weather when the temperature rises especially under the hot sun. But following are the difference between the two conditions.

Heat stroke and heat exhaustion

Definition:

Heat stroke:

Heat stroke is defined as a serious condition in which the temperature of the body raises rapidly and the body is unable to control its temperature. The temp rises within 10 to 20 minutes to 106 F or above and needs immediate emergency treatment.

Heat exhaustion:

Heat exhaustion is defined as a serious condition in which the temperature of the body is raised resulting in excessive sweating and loss of salt and water.

Risk factors/ causes:

Risk factors are those factors that increase the risk of certain diseases:

Heat stroke:

The following are the risk factors of heat stroke:

  • Age (extreme of ages such as very young or very old more than the age of 65 years old)
  • Sex (males as compared to females are more at risk of developing heat stroke)
  • Sudden exposure to hot weather
  • Exertion in hot weather
  • Lack of air conditioning environment
  • Poor heat adaptation
  • Strenuous activity
  • Certain medications (antihistamines, diuretics, anticonvulsants, beta blockers, diet pills, anti depressants, anti psychotics)
  • Sleep disorders
  • High fever
  • Excess clothing
  • Certain diseases (hypertension (high blood pressure), heart disease, lung disease, mental illness, kidney disease, diabetes)
  • Dehydration
  • Alcohol drinking
  • Overweight or obese people.

Heat exhaustion:

The following are the risk factors of heat exhaustion:

  • Dehydration
  • Extreme of ages
  • Excess clothing
  • Alcohol drinking
  • Certain drugs
  • Certain diseases
  • High heat index
  • Overweight or obese people
  • Sudden exposure to hot weather.

Types:

Heat stroke:

Following are the types of heat stroke:

  • Exertional heat stroke
  • Non exertional heat stroke.

Heat exhaustion:

Following are the types of heat exhaustion:

  • Water depletion heat exhaustion
  • Salt depletion heat exhaustion.

Signs and symptoms or clinical presentation:

Heat stroke:

Following are the common sign and symptoms of heat stroke:

  • Raised body temperature (temperature more than 104 F or 40 C)
  • Confusion (altered mental state)
  • Slurred speech
  • Red hot dry skin
  • Delirium
  • Throbbing headache
  • Irritability
  • Rapid pulse
  • Rapid breathing
  • Nausea and vomiting
  • Disoriented
  • Seizures and coma.

Heat exhaustion:

Following are the common sign and symptoms of heat exhaustion:

  • Cold and clammy skin plus goose bumps
  • Excessive sweating
  • Fast weak pulse
  • Muscle weakness or cramps
  • Nausea and vomiting
  • Dizziness
  • Headache
  • Low blood pressure
  • Fainting.

Investigations or lab tests:

Heat stroke:

The following are the investigations to diagnose heat stroke:

  • Complete blood count (CBC)
  • Rectal temperature
  • Serum electrolytes
  • Urine test
  • Liver function tests (LFTs)
  • Muscle function test
  • Blood culture
  • X rays
  • Computed tomography (Ct scan)
  • Lumber puncture.

Heat exhaustion:

The following are the investigations to diagnose heat exhaustion:

  • Complete blood count (CBC)
  • Rectal temperature
  • Urine test
  • Blood culture
  • Muscle function test
  • Serum electrolytes
  • Lumbar puncture.

Treatment:

Heat stroke:

The following are the treatment options for heat stroke:

  • Take a bath with cold or ice water
  • Fan air over the patient
  • Water from the sponge wet the patient’s skin
  • Applying of ice packs (put ice packs under armpits, neck, groin, and back)
  • Immerse the patient in cold water
  • Certain medications to stop shivering (such as benzodiazepines).

Heat exhaustion:

The following are the treatment options for heat exhaustion:

  • Fan air over the patient
  • Increase intake of cool liquids
  • Take a bath with cold water
  • Applying of ice packs under the armpits, neck, groin, and back
  • Change into loose clothes
  • Immerse the patient in cold water
  • Certain medications to stop shivering (such as benzodiazepines).

Complications:

Heat stroke:

The following are the complications of heat stroke:

  • Organ damage (heart, brain, muscles, and kidney damage)
  • Acute respiratory distress syndrome (ARDS)
  • Liver failure
  • Brain swelling
  • Nerve damage
  • Metabolic dysfunction
  • Shock
  • Coma
  • Death.

Heat exhaustion:

The following are the complications of heat exhaustion:

  • Heat stroke (it will lead to permanent damage of vital organs such as the heart, brain, kidney, liver, etc)
  • Rhabdomyolysis (releasing of electrolytes and proteins into the bloodstream from damaged muscle)
  • Arrhythmias (irregular heart beat)
  • Tachycardia (rapid heart beat) or bradycardia (slow heart beat)
  • Delirium
  • Shock
  • Coma
  • Death.

Conclusion:

To prevent from heat stroke or heat exhaustion one should take precautionary measures such as drinking plenty of fluids in hot weather, avoid going outside in hot weather unless necessary, use of sunblock, or wearing loose clothes.

By- Dr. Pashmina.