exertional heat injury
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Introduction
A mild form of heat stroke that occurs in athletes & other individuals who engage in vigorous exercise in a warm environment.
Etiology
(risk factors)
- environmental temperature > 80 degrees F
- relatively high humidity
- insufficient acclimatization
- poor conditioning
- obesity
- inadequate hydration
- advanced age
- previous heatstroke
Clinical manifestations
- manifestations common to all forms of heat injury
- other manifestations
Laboratory
- complete blood count (CBC)
- hemoconcentration
- thrombocytopenia (uncommon)
- evidence of hemolysis on peripheral smear (uncommon)
- serum chemistries
- hypernatremia
- elevated serum transaminases
- elevated muscle enzymes (LDH, CPK, aldolase)
- hypocalcemia
- hypophosphatemia
- hypoglycemia (occasionally)
- elevated unconjugated bilirubin (if hemolysis)
- disseminated intravascular coagulation panel (rarely abnormal)
- urinalysis
- myoglobinuria (uncommon)
- urine Na+ > 40 meq/L with acute tubular necrosis (ATN)
- urine osmolality < 350 mOsm/kg
- prothrombin time
Diagnostic procedures
Differential diagnosis
Management
- lower core temperature to 100 degrees F
- apply cold packs or fluids
- cooling fan
- massage extremities
- infuse hypotonic fluids with glucose
- follow-up within 1 week
- ensure complete recovery
- work-up & management of pre-existing illness as indicated
- patient education
More general terms
Additional terms
References
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1178-80