1/7. hyponatremia associated with overhydration in U.S. Army trainees.This report describes a series of hyponatremia hospitalizations associated with heat-related injuries and apparent over-hydration. Data from the U.S. Army Inpatient Data System were used to identify all hospitalizations for hyposmolality/hyponatremia from 1996 and 1997. Admissions were considered as probable cases of overhydration hyponatremia if this was the only, or primary, diagnosis or if it was associated with any heat-related diagnosis. Seventeen medical records were identified, and the events leading to hospitalization were analyzed. The average serum sodium level was 122 /- 5 mmol/L (range, 115-130 mmol/L). All 17 patients were soldiers attending training schools. Seventy-seven percent of hyponatremia cases occurred in the first 4 weeks of training. Nine patients had water intake rates equal to or exceeding 2 quarts per hour. Most patients were in good health before developing hyponatremia. The most common symptoms were mental status changes (88%), emesis (65%), nausea (53%), and seizures (31%). In 5 of 6 cases in which extensive history was known, soldiers drank excess amounts of water before developing symptoms and as part of field treatment. The authors conclude that hyponatremia resulted from too aggressive fluid replacement practices for soldiers in training status. The fluid replacement policy was revised with consideration given to both climatic heat stress and physical activity levels. Field medical policy should recognize the possibility of overhydration. Specific evacuation criteria should be established for exertional illness.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/7. Chronic idiopathic anhydrosis--a rare cause of heat stroke.A 27 year old man presented with heat stroke following exposure to a humid, hot environment in the absence of physical exertion. Investigation revealed the presence of generalized anhydrosis without evidence of an associated disease. Although chronic idiopathic anhydrosis is rare, this entity should be considered in cases of unexplained heat intolerance and heat stroke.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/7. Heatstroke. Underlying processes and lifesaving management.Heatstroke occurs during intense physical exertion or environmental exposure to heat without exertion. The ability to eliminate heat is limited by volume depletion, cardiac and vascular insufficiency, and skin disorders or protective coverings that prevent sweating and evaporative heat loss. Also, many drugs predispose patients to heatstroke by impairing normal thermoregulatory function. Critical management strategies include (1) recognition of hyperthermia, (2) rapid cooling, and (3) supportive care and observation for heat-related complications of tissue injury (eg, hepatic failure, renal failure, disseminated intravascular coagulation).- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/7. Full skin thickness burns caused by contact with the pavement in a heat-stroke victim.A 70-year-old woman, with a previous history of heat-stroke, suffered another heat-stroke on a hot summer day (air temperature 43 degrees C (109 degrees F)). She presented the rare complication of a heat-stroke plus deep burns sustained while lying unconscious on the pavement. In addition to age, obesity, previous illness, incidental fever, drugs, dehydration and physical effort, a previous history of heat-stroke is probably an important risk factor for a second heat-stroke. burns from contact with the pavement are uncommon but possible, especially if the patient is obese, immobile and poorly insulated.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/7. Multi-organ damage in exertional heat stroke.Exertion-induced heat stroke is a relatively rare disorder in the moderate maritime climate of The netherlands. Serious complications of excessive physical activity rarely occur. We describe a marathon runner with multi-organ failure after exertion-induced heat stroke. The patient developed shock, diarrhoea, coma, rhabdomyolysis, acute renal failure, liver cell damage and disseminated intravascular coagulation but recovered completely.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/7. Investigation of a fatal heatstroke.On June 30, 1981, a young, apparently healthy, obese white male suffered a fatal heatstroke. This was the beginning of summer in southern ohio, when mid-day temperatures can reach into the 30s degrees C (90s degrees F) and the humidity can climb above 70%. The predisposition of the individual in terms of acclimatization, physical size and dietary intake, along with strong motivation to perform well on a job requiring a heavy workload in a hot environment, pushed him beyond his physiologic capacity. Of those people who attended him, only professional rescue personnel recognized the illness and properly treated the man. The death may have prevented by acclimatization and training as to the hazards, recognition and treatment of heat illness.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/7. Fatal classic and exertional heat stroke--report of four cases.heat stroke is the outcome of impaired heat dissipation which is aggravated by hot and humid environmental conditions. The very young and debilitated on the one hand and healthy individuals under considerable physical stress on the other are vulnerable to heat stroke. Post-mortem findings will depend on the time lapse between the stroke event and death. We report on the deaths resulting from heat stroke in a 12-month-old baby and three 19-year-old soldiers. Reconstruction of the environmental conditions enables elucidation of the circumstances that precipitated exogenous hyperpyrexia. The Discomfort Index presents reliable criteria for the assessment of heat load: values above 28 units are considered as severe heat load and are life threatening. awareness of the hazards related to severe heat load on the body is helpful in preventing avoidable calamities.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |