heatstroke

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Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

Heat stroke and heat collapse are among the heat illnesses. These are diseases that result from excessive exposure to the sun or excessive warming of the body. Heat stroke is the most dangerous - without timely treatment there is an acute danger to life! Find out here how you can recognize heat stroke and heat collapse and how to properly provide first aid in both cases.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. T67

Brief overview

What to do in case of heat stroke and heat collapse? Take affected person out of the heat / sun, lay flat (with raised legs), cool (e.g. with damp cloths), give liquid if the person concerned does not vomit; stable lateral position when unconscious; Resuscitation if breathing has stopped
Heat stroke and heat collapse risks: inter alia Drowsiness, nausea, vomiting, circulatory collapse with loss of consciousness
When to the doctor Since the condition can worsen quickly with heat stroke, always call an emergency doctor. In the case of heat collapse, a doctor is necessary if the symptoms worsen and / or the person concerned becomes unconscious.

Caution!

Never leave people with (suspected) heat stroke or heat collapse alone. Especially in the case of heat stroke, the condition of the person affected can suddenly worsen!
Never place cooling / ice packs directly on the skin of the person affected to lower the body temperature, but always with a cloth in between (risk of frostbite!).
Do not give victims alcohol to drink.

Heat stroke and heat collapse: what to do?

You should react quickly in both cases. But first aid is particularly important in the case of heat stroke, because the condition of the person affected can quickly become life-threatening.

Heat stroke: what to do?

Heat stroke (medical hyperthermia syndrome) creates a build-up of heat inside the body, which causes the body temperature to rise to more than 40 degrees Celsius. There are two forms:

classic heat stroke: it is caused by extreme heat and mainly affects the elderly.
Exertional heat stroke: It can occur during vigorous physical activity in great heat (e.g. intense sport on a hot summer day or hard work in blast furnaces), and in people of all ages.

In both cases of heat stroke, first aid is as follows:

In the shade: Bring the person affected out of the sun and, if possible, into the cooler place so that the body can cool down.
Shock position when fully conscious: Place a conscious person in the shock position - i.e. on their back and with their legs raised. This improves the blood circulation in the brain (this can be reduced in the event of heat stroke due to the low blood pressure).
Stable lateral position if unconscious: If the heat stroke patient loses consciousness, check your breathing and pulse. If both are present, bring him into the stable side position.
Loosen clothes: Open tight-fitting clothes of the person affected (e.g. shirt collar, tie, belt, etc.).
Cooling: Place cool packs on the overheated body, especially on the arms, legs, neck and groin - this is where the coolness can best be distributed. If your breathing and circulation are stable, you can immerse your whole body in tap water - this is especially useful for young athletes (attention: risk of chills). In the case of heat stroke that is not produced by sports (i.e. especially in the elderly), spray the skin with water or apply damp cloths and ensure a draft (e.g. with fans) - the evaporation of the water cools the body.
Lukewarm drinks: If the person concerned is clearly conscious, does not feel nausea and does not vomit, you should give him sips of lukewarm (not cold!) Liquid (e.g. water, mild juice spritzer, tea). This is supposed to compensate for the loss of fluids caused by the sweating typical of heat stroke. In the event of nausea and vomiting, on the other hand, do not instill fluids - there is a risk that the person affected will choke (aspiration).
Resuscitation: If the person is no longer breathing, start the resuscitation immediately. Continue this until the emergency doctor arrives or the person concerned is breathing independently again.

Heat collapse: what to do?

Heat collapse (heat exhaustion) results from profuse sweating at high temperatures. If too little is drunk at the same time, the body loses a lot of fluids and salts (electrolytes). This means an enormous burden on the circulatory system - possible consequences are circulatory collapse and loss of consciousness. Physical activity in the heat increases the risk of heat breakdown.

First aid looks like this:

Get out of the heat: Get the affected person out of the heat.
Shock position: Lie the person on their back and place their legs higher than the heart.
Cooling: Fan him if necessary or place damp cloths on his arms, legs, neck and groin. Exception: no additional cooling if the person concerned is already shivering.
Electrolyte-containing drinks: give the person affected (if he does not vomit) to drink plenty of fluids with minerals. This is supposed to compensate for the loss of fluids and electrolytes. For example, water, mineral water or tea with a little salt (approx. 1 teaspoon of table salt per liter) or broth (bouillon) is suitable.

Children with heat stroke or heat breakdown

First aid measures for children with heat stroke or heat collapse are basically the same as for adults. It is important to know that children are particularly at risk of heat stroke and heat collapse (especially infants). The reason: Your body is not yet able to regulate the temperature as effectively as that of an adult. In addition, many children do not think about sun protection and enough drinking when playing and romping around.

Therefore, make sure that the offspring take regular breaks to drink and relax in the shade or in the house. If heat stroke or heat collapse does occur, call the emergency doctor (especially if heat stroke is suspected) and take the above-mentioned first aid measures (bring the child to a shady, cool place, use damp compresses to lower body temperature, etc.) ).

Heat stroke and heat collapse: symptoms and risks

Depending on the severity, symptoms of heat stroke are:

hot, dry (!) skin (the affected person can hardly or no longer sweat at all)
Body temperature over 40 degrees Celsius
dizziness
headache
Nausea, vomiting
Disorientation
low blood pressure
accelerated heartbeat
accelerated breathing
Muscle spasms
Disturbances in consciousness such as drowsiness or even loss of consciousness

As a result of heat stroke, the brain can swell due to water retention - life-threatening brain edema develops. Therefore, if you do not recognize and treat symptoms of heat stroke in good time, the person affected can die within a short time!

A heat collapse triggers - similar to heat stroke - symptoms such as headache, dizziness, nausea, accelerated pulse and low blood pressure. However, the affected person's skin is not dry, but rather damp - the affected person sweats a lot.

The blood volume decreases due to the heavy loss of fluid caused by sweating. The blood vessels then narrow so that those organs that need a lot of oxygen (e.g. the brain, kidneys) can continue to be supplied. On the other hand, the hands and feet are less well supplied with blood: They appear cold, pale and sweaty.

Symptoms in Children

The aforementioned heat breakdown and heat stroke symptoms also occur in affected children. In a baby or toddler, there may be other signs that something is wrong. These include refusal to eat and abnormal behavior (e.g. irritability or indifference, high-pitched screaming).

Heat stroke and heat collapse: when to see a doctor?

In the event of a heat breakdown, you should call an (emergency) doctor if the person's symptoms worsen or if they lose consciousness.

In the event of heat stroke (or any suspicion) you should call the emergency doctor immediately. It can quickly become life-threatening for those affected! He must therefore be treated and monitored in the hospital.

Heat stroke and heat collapse: medical examinations

A doctor can usually recognize both heat collapse and heat stroke very quickly - based on the symptoms and information from the initial consultation (anamnesis). In this conversation, the doctor asks the patient or accompanying person about the previous situation. For example, did the patient exercise in extreme heat or in the blazing sun shortly before the symptoms appeared? Has he been wearing warm clothing that has caused heat build-up? Questions about any underlying illnesses are also part of the anamnesis interview.

The interview will be followed by a physical exam. Body temperature, blood pressure and heart rate are particularly important. They help the doctor further assess the patient's condition and the severity of the heat sickness.

The doctor will take your body temperature in the anus (rectally). Due to the poor circulatory situation in the event of heat stroke / heat collapse, the skin is often no longer adequately supplied with blood. A temperature measurement in the armpit would then be too low.

The doctor can use simple neurological tests to check the patient's brain function. This is especially necessary in the event of (suspected) heat stroke. For example, the doctor uses simple questions to check whether the patient can orientate himself with regard to place and time. It also tests the brainstem's reflexes, such as the pupillary reflex.

Further examinations are generally necessary, especially in the case of heat stroke:

Blood tests will show whether there is a deficiency or excess of certain salts (electrolytes) in the blood due to heat stroke. The therapy depends directly on these results - a strong shift in the electrolyte balance must be treated immediately. Certain blood values can also indicate damage to important organs (liver, kidneys, heart) that has occurred as a result of the heat stroke shock.

To rule out other causes of a circulatory collapse, the doctor can perform an electrocardiogram (EKG). This can also indicate possible cardiac arrhythmias, which can be caused by the severe salt and fluid deficiency in heat stroke.

If the doctor suspects cerebral edema as a result of heat stroke, imaging tests are necessary for clarification. These include, for example, magnetic resonance imaging (MRI) and computed tomography (CT).

Heat stroke and heat collapse: Treatment by the doctor

In the event of a heat breakdown, the resulting lack of fluids and electrolytes should be remedied as quickly as possible. Drinking a lot helps. If necessary, the doctor can also give the patient an infusion. The rapid replacement of fluids and salts stabilizes the circulation. After a few days of rest and relaxation, most of those affected are completely fine again.

Heat stroke treatment should always be done in the hospital, in severe cases even in the intensive care unit. The first thing to do is to stabilize the patient's circulation by giving infusions. In addition, the greatly increased body temperature is reduced by cooling measures. For example, the patient can be immersed in cold water for this purpose, provided that his vital functions (such as breathing and circulation) are stable.

Depending on the severity, heat stroke requires further treatment measures, for example the administration of anti-seizure medication.

How long heat stroke lasts depends on its severity. With early treatment, symptoms can subside and go away after a few hours. However, it is possible that those affected will still feel weak for a while afterwards. A few days of rest are therefore advisable, also to avoid a relapse.

The majority of those affected survive heat stroke and heat collapse without permanent damage.

Prevent heat stroke and heat collapse

If you want to prevent heat stroke and heat collapse, you should first know who is particularly susceptible to such heat illnesses. First and foremost, these are people whose body's own temperature regulation is not yet or no longer fully efficient. These include babies, (small) children and the elderly. People who spend long periods of time or work in narrow and poorly ventilated rooms when it is warm are also at an increased risk. This applies, for example, to certain occupational groups (workers in mining or the metalworking industry, sauna masters, etc.).

In addition, physical activity in the blazing sun increases the likelihood of heat stroke and heat breakdown. This applies to road construction workers, for example. Athletes who train or compete in strong sunlight or in hot and humid air are also at risk.

So the most important tips to prevent heat stroke and heat collapse are:

Do not expose to high temperatures for long periods of time. Find a cool, shady place, especially at lunchtime.
Try to avoid direct sunlight for long periods of time. Wear a hat in the sun.
As an athlete, you shouldn't train in the midday heat, but rather in the morning or evening hours.
Drink enough when it's hot - about two to three liters per day!
Wear air-permeable, loose clothing when it is hot.
Avoid alcohol and heavy meals in high temperatures.
Do not leave children alone or in a car parked in the sun for long periods of time.
Make sure that your child takes regular breaks to drink and rest in the shade when the weather is hot.

Note the regional heat warnings from the German Weather Service. This is especially true if you are prone to heat stroke and heat collapse yourself, or if you have children.

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