What are the symptoms of heat stroke?

People who work outdoors for a long time in hot summer are prone to heat stroke if they are not careful. Therefore, you should drink more water and avoid working under the scorching sun for a long time. People with severe heatstroke should be sent to the hospital for treatment in time. In severe cases, they may even have convulsions or coma. So, what are the symptoms of heat stroke? Now let me introduce to you the symptoms of heat stroke and what to do after heat stroke. What are the symptoms of heat stroke?

Heat stroke can be divided into the following types according to the severity of the condition:

1. Premonitory heat stroke. After a period of time in a high-temperature environment, people will experience fatigue, dizziness, dizziness, weakness, nausea, slow movement, chest tightness, palpitations, profuse sweating, thirst, and inability to concentrate, which is a precursor to heatstroke. At this time, the body temperature is normal or slightly higher. If you leave the high temperature environment, rest for several hours to recover.

2. Mild symptoms. In addition to the symptoms of early heatstroke, patients may also experience flushed complexion, hot and dry skin, chest tightness, or signs of peripheral circulatory failure, such as profuse sweating, pale complexion, thin and rapid pulse, clammy limbs, and decreased blood pressure. Body temperature can further rise to above 38°C.

3. Severe heat stroke. According to different pathogenesis and clinical manifestations, it can be divided into:

(1) Heat stroke and high fever: more common in the elderly. It often occurs after several days of hot weather or long-term exercise, when the body produces too much heat and dissipates heat. Insufficiency will lead to a sharp rise in body temperature, general weakness, dizziness, nausea and vomiting, uncoordinated movements, and even coma. Typical symptoms are high fever, body temperature can be as high as 41-43℃, flushed complexion, burning skin, no sweat, fast and weak breathing, rapid pulse, decreased blood pressure, and enlarged pulse, followed by restlessness, confusion, and drowsiness. , twitching of limbs or even coma; pupillary light reflex is slow or disappears; in severe cases, serious complications such as cerebral edema, heart failure, pulmonary edema, renal failure, shock, metabolic acidosis, and invasive intravascular coagulation may occur and rapidly develop. die.

(2) Heatstroke spasm: In a high-temperature environment, due to excessive sweating during exercise, excessive salt loss, oral exhaustion, and then drinking a large amount of water without adequate salt replenishment, the sodium chloride in the blood will The concentration decreases, resulting in increased muscle excitability and bone pain in the limbs. This condition is more common in healthy young adults who are often adapted to high-temperature environments. They often develop the disease after strenuous physical labor and heavy sweating. When this type of heat stroke occurs, muscles will suddenly experience paroxysmal spasms, pain, and muscle weakness in the limbs. The spasm pain usually lasts for a few minutes. Muscle spasms are more likely to occur in the limbs and abdomen that move more. The most common ones are the intestinal muscles, followed by the rectus abdominis muscles. They are symmetrical and can be relieved by themselves. Body temperature is generally normal.

(3) Heat exhaustion: It is the most common type of heat stroke. Performing strenuous exercise or labor in the hot season will cause you to sweat a lot. In this case, if drinks are not replenished in time, it can lead to dehydration, sodium loss, hemoconcentration, and increased blood consistency; in addition, skin telangiectasia, insufficient blood volume, and peripheral circulatory failure can occur. This kind of heat stroke has a rapid onset and often occurs in the elderly and people who cannot adapt to the high temperature for a while. They may faint suddenly when the onset occurs. The main clinical manifestations are dizziness, headache, palpitation, thirst, nausea, vomiting, pale bread, profuse sweating, rapid pulse, wet skin, decreased blood pressure or confusion, and convulsions may occur if not treated in time. , the patient will soon develop circulatory collapse. The body temperature at this time is normal or slightly elevated.

(4) Heat stroke: During labor, exercise or military training under the scorching sun, the head lacks protection and is directly exposed to the scorching sun, which can cause meningeal congestion, edema and brain tissue damage. Since the head is mainly injured, the initial symptoms are severe headache, as well as clinical manifestations such as dizziness, dizziness, tinnitus, nausea, vomiting, irritability, etc. In severe cases, convulsions and even coma may occur. The body temperature is normal or slightly elevated. What to do if you suffer from heatstroke in summer

Physical cooling

Place the patient in a quiet ward at normal temperature (25°C). Place ice packs on the head, armpits and groin, rub the body with cold water, ice water or alcohol, and use a fan to blow air to the patient. If necessary, the patient's whole body, except the head, can be immersed in a 4°C water bath to cool the patient's limbs to prevent stasis of peripheral blood circulation. In the early stages of physical cooling, the cold stimulation of the epidermis can cause cutaneous vasoconstriction and muscle tremors, which in turn affects heat dissipation and even promotes the body's heat production, causing the body temperature to rise. Therefore, most currently advocate the use of combined drug and physical cooling methods.

Drug cooling

The currently used cooling drug is mainly chlorpromazine, which has the following functions: control the hypothalamic temperature regulation center; expand peripheral blood vessels, accelerate heat dissipation, and relax Muscles, reduce muscle tremors, prevent the body from excessive heat production; reduce the oxygen consumption of cells, enable the body to better tolerate hypoxia, counter the effects of histamine, and prevent shock. Drugs such as aspirin can be used in conjunction with chlorpromazine. During the various cooling processes mentioned above, care must be strengthened and body temperature, blood pressure and heart conditions must be paid close attention to. Once the rectal temperature drops to about 38°C, cooling should be stopped immediately to avoid the risk of hypothermia and collapse.

Prevention and treatment of comorbidities

The elderly and those with cardiovascular disease should not replenish intravenous fluids too quickly; those with a tendency to heart failure should use rapid digitalis preparations as early as possible; those with acute renal insufficiency , it is necessary to strictly limit the intake of water and sodium salt, especially the concentration of blood potassium; patients with jaundice should take a large amount of vitamins B and C; comatose patients are prone to aspiration pneumonia or other secondary infections, and antibiotics can be used appropriately prevention.

Cooling therapy

Including physical cooling. For physical cooling, you can pour cold water on the body, place ice packs on the head and neck, enema with ice salt water or let the patient stand in cold water. You can also wipe the body surface with alcohol to promote heat dissipation. For drug cooling, chlorpromazine 1 to 2 mg/kg body weight can be used for intramuscular injection or intravenous injection mixed with 5% sugar saline.

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