Topic: Heatstroke
Subject: Medicine
A 72-year-old male is brought to your office by a friend because of increasing confusion, irritability, and difficulty walking. This began shortly after the patients car broke down and he had to walk a mile to get to a phone and call the friend. The temperature outdoors has been near 39.5°C (100°F).
On examination you note a rectal temperature of 39.5°C (103.1°F). His pulse rate is 110 beats/min and his blood pressure is 100/60 mm Hg.
Which one of this patients findings indicates that he has heatstroke rather than heat exhaustion?
Confusion
Sweating
His temperature
His heart rate
Correct Answer :
A. Confusion
Heat exhaustion and heatstroke are both on the continuum of heat-related illness. Heatstroke is a much more severe condition than heat exhaustion. Evidence of central nervous system dysfunction is evidence of heatstroke rather than heat exhaustion, even if other symptoms are not severe and point to heat exhaustion. Heatstroke is a medical emergency. Heatstroke is the most severe form of the heatrelated illnesses and is defined as a body temperature higher than 41.1°C (106°F) associated with neurologic dysfunction. However, when a patient is allowed to cool down prior to measurement of the temperature (as may occur during transportation in a cool ambulance or evaluation in an emergency department), the measured temperature may be much lower than 41°C, making the temperature criterion relative. Similarly, some patients may retain the ability to sweat, removing anhidrosis as a criterion for the diagnosis of heatstroke. Therefore, strict adherence to the definition is not advised because it may result in dangerous delays in diagnosis and therapy.
Related Questions
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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