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Thermogenesis – heat production
➢ Metabolic – Processing of food and nutrients ➢ Muscular – Muscular activity – Exertion – Shivering ➢ Endocrine – Role of hormones in basal metabolic rate
Thermolysis – heat loss
➢ Conduction- heat transfer from body to another object; heat loss by direct contact with colder object ➢ Convection- heat transfer through circulating air; heat loss by moving air ➢ Evaporation- body cooling through sweating ➢ Radiation- heat loss directly into the environment ➢ Respirations Compensatory Mechanism of the Body for Hyperthermia ➢ Increase heat loss by: – Sweating – Vasodilation ➢ Decrease heat production by: – Decreasing involuntary activity of muscles – Decreasing hormone secretion – Decreasing appetite Compensatory Mechanism of the Body for Hypothermia ➢ Decrease heat loss by: – Peripheral vasoconstriction ➢ Increase heat production by: – Shivering – Increasing involuntary activity of muscles – Increasing hormone secretions – Increasing appetite
➢ Occurs when volume and electrolytes lost through perspiration isn’t replaced. It is
usually caused by exercising or exertion in hot ambient temperature, more severe water and salt deficiency occurs. This electrolyte imbalances causes vasomotor regulatory disturbances and inadequate cerebral and peripheral perfusion.
➢ newborns, infants, children and elderly ➢ patients with heart disease, COPD, diabetes, dehydration, obesity
➢ patients with limited mobility ➢ alcohol and drug use
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headache, dizziness, light-headedness pale, cool, diaphoretic skin normal or slightly elevated temperature extreme fatigue/weakness heavy sweating weak, rapid pulse rapid, shallow breathing normal or slightly decreased BP minor aberrations in mental status such as irritability, confusion, poor judgment
➢ ABC ➢ remove patient from the hot environment ➢ remove restrictive clothings ➢ Position the patient supine with the feet slightly elevated ➢ cool the patient -cool, non-alcoholic beverage -cool shower, or sponge bath -lightweight clothing ➢ administer oxygen ➢ administer saline solution PO if conscious (1/2 – 1 tsp salt: 1L water) or IV ➢ give fluids, unless nauseated or vomiting ➢ Assess vital signs every 15 mins ➢ Educate patient to avoid immediate reexposure to high temperatures
➢ syndrome occurring when the thermoregulatory mechanisms that normally cool
the body fail completely. Damage occurs to the hypothalamus itself as a result of prolonged exposure to heat.
➢ People not acclimatized to heat
➢ elderly and very young people ➢ people with chronic and debilitating diseases
Classic heat stroke ➢ high temperatures and humidity ➢ risk factors • Age-infants, elderly • Chronic illness-diabetes, heart disease, alcoholism • Medications
Exertional heat stroke ➢ young, healthy patients ➢ athletes, military recruits ➢ vigorous exercise in high heat ➢ inadequate hydration
Signs and Symptoms
➢ temperature is highly elevated ➢ dizziness, confusion, delirium ➢ hot, flushed and dry skin(maybe moist if exertional heatstroke) ➢ anhidrosis (absence of sweat) ➢ headache, confusion, lethargy ➢ thirst ➢ change in behavior, decreased LOC leading to unresponsiveness ➢ rapid pulse then gradually slows down ➢ drop in blood pressure ➢ tachypnea ➢ seizures, coma
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✔ The primary goal is to reduce the high temperature as quickly as possible. ✔ Simultaneous treatment focuses on stabilizing oxygenation . Remove patient from the hot environment, place in cool place, position of comfort Cool quickly ✔ Evaporative Cooling is the most effective, spraying tepid water on skin while fans are used to blow ✔ Cool sheets and towels or continuous sponging with cool water ✔ Ice applied to the neck groin, chest, scalp and axillae while spraying with tepid water ✔ Cooling blankets ✔ Iced saline lavage of the stomach or colon if the temperature does not decrease ✔ Immersion of the patient in a cold water bath Massage patient during cooling to promote circulation and maintain cutaneous vasodilation maintain airway, oxygen, ventilation Constantly monitor temperature Caution is used to avoid hypothermia and to prevent hyperthermia, which may recur spontaneously within 3-4 hours Monitor vital signs, ECG and level of consciousness IV infusion therapy (Normal Saline or Lactated Ringer’s Solution) medications as prescribed (sedation, seizure control)