Heat Exhaustion

WHAT YOU SHOULD KNOW:

• Heat exhaustion, also called heat prostration, is the most common heat-related problems. It often results from heavy physical activity in hot conditions, and not drinking enough liquids. The body's cooling system in these conditions may not work well and cause an increase in body temperature. Normal body temperature for an adult is generally 37 degrees Celsius, or 98.6 degrees Fahrenheit. With heat exhaustion, body temperature is usually between 37 to 40 degrees Celsius (98.6 to 104 degrees Fahrenheit). Heat exhaustion may damage cells and cause dehydration (loss of too much water and mineral salts). As the body temperature increases and affects your brain, heat exhaustion can lead to heatstroke.
  
  
• Signs and symptoms of heat exhaustion appear when the amount of water and minerals in your body drops too low or too fast. You may have too much sweating, abdominal (stomach) cramping, nausea (upset stomach), or vomiting (throwing up). Other signs include irregular or fast breathing, fast or pounding heartbeat, and low blood pressure. Blood and urine tests, blood gases, or an electrocardiogram (ECG) may be needed to diagnose heat exhaustion. Treatment includes rest, use of cooling units, intravenous fluids (IV), or oral rehydrating solutions. With early rehydration and treatment, you may prevent further problems and continue with your usual activities.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Treatment for heat exhaustion should be given as soon as possible. If heat exhaustion is not treated early, you may get more dehydrated and develop heatstroke. If this happens, you may pass out, have seizures (convulsions), or your body organs may stop working. Your blood, kidneys, lungs, liver, heart, and brain may shut down, and you may even die. Sometimes, treatment for heat exhaustion may cause unwanted side effects. Cooling you down too rapidly and receiving too much fluid may worsen your condition. Ask your caregiver if you have questions or concerns about your condition, medicines, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Activity:

At first you may need to rest in bed and stay in a cool or well-ventilated room. Your caregivers may suggest that you limit your physical activities to save your energy. If you have dizziness or trouble breathing, call your caregiver right away. You may get out of bed when your condition has improved.

Diet:

• A caregiver, called a dietitian or nutritionist, may talk to you about diet changes. He may increase the amount of electrolytes, sugar, and proteins in your diet. He may also talk to you about the best liquids for you to drink. If you have other diseases, such as kidney or liver disease, he will talk to you about the best diet for you. You may need to eat special foods to help your body work well after heat exhaustion, and to help prevent getting it again.
  
  
• Your caregiver may also give you oral rehydration solution (ORS) to drink. An ORS has the right amounts of water, salts, and sugar your body needs to replace body fluids. You may also drink other liquids that have water, sugar, and salt, such as juices, milk, or sports drinks. These drinks may help prevent dehydration.

Intake and output:

Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Monitoring:

You may need any of the following:

• Neurologic exam: This is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show caregivers how well your brain works after an injury or illness. Caregivers will check how your pupils (black dots in the center of each eye) react to light. They may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Tests:

You may have any of the following:

• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• Blood and urine tests: Samples of your blood and urine are collected. These are sent to a lab for tests to check the levels of your salts and minerals.
  
  
• Blood gases: This is also called an arterial blood gas, or ABG. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. Your blood is tested for the amount of oxygen and carbon dioxide in it. The results can tell caregivers how well your lungs are working.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.

Treatment options:

You may have any of the following:

• Cooling sheets: Different types of cooling units and materials may be used to quickly decrease your body temperature. You may be wrapped with ice-soaked blankets or sheets to lower your temperature.
  
  
• Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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