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Heat Stroke: Severe Hyperthermia and Cold Water Immersion

In exertional and environmental heat stroke, body temperature exceeds 40°C; cold water immersion therapy reduces mortality.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Heat Stroke: Severe Hyperthermia and Cold Water Immersion?

Heat stroke is a medical emergency characterized by elevation of body temperature above 40°C and CNS dysfunction. It has two main forms: classic (environmental) and exertional. Rhabdomyolysis, DIC, liver, and kidney failure are complications.

Pathophysiology involves heat-induced cellular damage, inflammatory cytokine storm, and intestinal endotoxin translocation. Systemic inflammatory response can progress to multi-organ failure.

The basis of treatment is early and rapid cooling. The principle of 'cool first, transport second' is adopted. The most effective method is cold water immersion (2-14°C); cooling is stopped after target body temperature drops to 38.5°C.

Symptoms

Body temperature greater than 40°C
Altered consciousness, coma
Hot and dry skin (classic type)
Sweaty skin (exertional type)
Tachycardia and tachypnea
Hypotension
Seizure, ataxia
Nausea, vomiting

Risk Factors

Strenuous exercise in hot environment
Elderly, chronic disease
Neurological/psychiatric illness
Alcohol and substance use
Diuretics, anticholinergics, antipsychotics
Heat wave and lack of air conditioning
Military/athletic training
Obesity and poor physical conditioning

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • High fever and altered consciousness
  • Collapse during exercise
  • Confused elderly during heat wave
  • Seizure and hyperthermia
  • Muscle pain + high fever + exercise
  • Anhidrosis and high body temperature

Treatment Methods

01
Active cooling must be initiated immediately
02
Cold water immersion (2-14°C) is the gold standard
03
Alternative: wet sheet + fan
04
Cooling is stopped at target temperature 38.5°C
05
IV fluid (saline or Ringer's lactate)
06
Benzodiazepine for shivering or seizure
07
Rhabdomyolysis treatment
08
Antipyretics ineffective
09
Monitoring of DIC, AKI, liver failure

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.