CHAPTER THREE

By Tadesse.T
Objectives
Define what thermoregulation mean.

Describe how body temperature is kept constant.

Discuss altered states of temperature.

Differentiate fever from hyperthermia.

Normal body temperatures vary depending on many factors,
including a person's age, sex, and activity levels.
The normal body temperature for an adult is
around 98.6°F (37°C), but every person's baseline body
temperature is slightly different, and may consistently be a
little higher or lower.
Normal body temperature readings will vary within these
ranges depending on the following factors:
a person's age and sex
the time of day, typically being lowest in the early morning
and highest in the late afternoon
high or low activity levels
food and fluid intake
the method of measurement, such as oral (mouth), rectal
(bottom), or armpit readings
 Normal temperature in children
A normal body temperature for children aged 3–10 ranges
from 95.9–99.5°F when taken orally.
Children tend to have similar body temperatures to adults.
Normal temperature in babies
Sometimes, babies and young children have higher body
temperature ranges than adults for armpit and ear
measurements.
A normal body temperature for infants aged 0–2 years ranges
from 97.9–100.4°F when taken rectally. Body temperature
may rise a little when a baby is teething.
 The average body temperature of a newborn is 99.5°F.
A baby's temperature is higher because they have a larger
body surface area relative to their body weight. Their bodies
are also more metabolically active, which generates heat.
Babies' bodies do not regulate temperature as well as adults'
bodies. They sweat less when it is warm, meaning that their
bodies retain more heat. It may also be more difficult for
them to cool them down during a fever.
Temperature is regulated in the hypothalamus by temperature

sensing neurons that detect blood temperature and skin

temperature. The signals are integrated and appropriate
responses are generated to keep the body at the “set point
” temperature. This is 35.5°C – 37.5°C which varies depending
on the person, the time of day, ambient conditions, and
(importantly) method of measurement. The body is usually
colder in the morning and hotter at night. Oral temperatures are
typically about 0.4°C colder than rectal and tympanic membrane
temperatures are about 0.8°C colder than rectal.
THERMOREGULATION IN ALTERD CONDITIONS

A. HYPERTHERMIA

B. FEVER

C. HYPOTHERMIA
THERMOREGULATION IN ALTERD
CONDITIONS

What is hyperthermia and how is it

treated?
 Hyperthermia
When your temperature climbs too high and threatens your
health, it’s known as hyperthermia.
Hyperthermia is actually an umbrella term. It refers to
several conditions that can occur when your body’s heat-
regulation system can’t handle the heat in your environment.
The average body temperature is 98.6°F (37°C).
The body temperature of 100.4 F or 38 C is considered
hyperthermia.
 Who’s at risk for hyperthermia?
People who work in very hot environments or are exposed to
high heat during the course of the job are at high risk for
hyperthermia.
Construction workers, farmers, and others who put in long
hours outside in the heat should take precautions against
hyperthermia. The same is true for fire-fighters and people
who work around large ovens or in indoor spaces that are
poorly air-conditioned.
Certain health conditions can also put you at higher risk for
hyperthermia. Certain heart and blood pressure
medications, such as diuretics, can reduce your ability to cool
down through sweat.
Children and older adults are at increased risk as well.
 Stages of hyperthermia
Hyperthermia comes in many stages.
1. Heat stress
If your body temperature starts to climb and you’re unable to
cool yourself through sweating, you’re experiencing heat
stress.
In addition to feeling uncomfortably hot, you may also
experience:
dizziness
weakness
nausea
thirst
a headache
If you’re feeling signs of heat stress, get to a cooler
area and rest. Start drinking water or other fluids
with electrolytes that will help restore hydration.
Electrolytes are substances in the body, such as
calcium, sodium, and potassium that keep you
hydrated. They help regulate your heart rate,
nerve function, and muscle heal.
 Heat fatigue
If long hours in high heat are causing you physical
discomfort and psychological stress, you may be dealing with
heat fatigue. People who aren’t used to extremely hot
weather or hot working conditions are especially vulnerable
to heat fatigue.
In addition to simply feeling hot, thirsty, and tired, you may
have difficulty concentrating on your work. You may even
lose coordination.
If you notice a strain on your physical and mental well-being,
get out of the heat and cool down with fluids.
Slowly adjusting to working or exercising in a hot
environment can help prevent future heat fatigue.
 Heat syncope
Syncope, also known as fainting, occurs when your blood
pressure drops and blood flow to the brain is temporarily
reduced.
It tends to happen if you’ve been exerting yourself in a hot
environment. If you take a beta-blocker to lower your blood
pressure, you’re at greater risk for heat syncope.
Fainting is often preceded by dizziness or lightheadedness.
You may feel close to fainting, but if you relax and cool down
quickly, you may prevent actually losing consciousness.
Putting your legs up can help.
As with other heat-related illnesses, rehydrating is key. Any
fluid will do, but water or electrolyte-filled spots drink are
best.
 Heat cramps
Heat cramps usually follow intense exertion or exercise in the
heat. They’re usually the result of an electrolyte imbalance
and are typically felt in the abdomen, leg, or arm muscles.
To help relieve heat cramps, rest in a cool place, and be sure
to replenish the fluids and electrolytes that are lost when you
sweat.
 Heat edema
Heat edema can occur if you stand or sit for a long time in
the heat and are not used to being in warmer temperatures.
This can cause your hands, lower legs, or ankles to swell.
This swelling is from fluid build up in your extremities. This
is possibly related to a response involving the aldosterone-
stimulated reabsorption of sodium into the blood through
the kidneys.
Usually heat edema spontaneously subsides over time once
you become used to the warm environment. Cooling down
and putting your feet up will also help, as will staying
hydrated with adequate water and electrolyte intake.
 Heat rash
Sometimes, being active in the heat for prolonged periods of
time can cause red pimple-like bumps to appear on the skin.
This usually develops underneath clothing that has become
soaked with sweat.
Heat rash typically disappears on its own after you cool down
or change clothes.
However, infection is possible if the skin isn’t allowed to cool
soon after the rash has appeared.
 Heat exhaustion
This is one of the most serious stages of hyperthermia.
Heat exhaustion occurs when your body can’t cool itself any
more.
In addition to sweating profusely, you may experience:
dizziness
weakness
thirst
coordination issues
trouble concentrating
skin that’s cool and clammy
rapid pulse
This is the last stage before heat stroke occurs, so it’s important
that you rest and rehydrate as soon as you feel symptoms
developing.
 Heat stroke
Hyperthermia’s most serious stage is heat stroke. It can be
fatal. Other heat-related illnesses can lead to heat stroke if
they aren’t treated effectively and quickly.
Heat stroke can occur when your body temperature reaches
above 104°F (40°C). Fainting is often the first sign.
Other signs and symptoms include:
irritability
confusion
coordination issues
flushed skin
reduced sweating
weak or rapid pulse
When these signs start to emerge, sufferer should :
Try to get to a cool location, preferably one with air
conditioning.
Drink water or electrolyte-filled spots drinks.
Take a cool bath or shower to help speed up your recovery.
Place ice bags under your arms and around your groin area.
If symptoms don’t improve when you try cooling off and
rehydrating, or you see someone who appears to be having a
heat stroke, call your local emergency services immediately.
 How to prevent hyperthermia
The first step in preventing hyperthermia is recognizing the risks in

working or playing in extremely hot conditions. Being in the heat means

taking the following precautions:
Take cool-down breaks in the shade or in an air-conditioned environment.

If you don’t need to be outside in extreme heat, stay indoors.

Stay well hydrated. Drink water or drinks containing electrolytes, every 15

to 20 minutes when you’re active in the heat.

Wear lightweight, light-coloured clothing when outdoors.

If your home isn’t well air-conditioned, consider spending time in an air-

conditioned mall, library, or other cool public place during hot spells.
What’s the difference between hyperthermia and fever?
If your body senses an infection of a virus or bacteria, the
hypothalamus may reset your body’s “thermostat” to make
your body a hotter, less hospitable host for those infectious
agents. In this case, fever occurs as part of the immune
system reaction. As the infection disappears, your
hypothalamus should reset your temperature back to its
normal levels.
With hyperthermia from heat stroke, however, the body is
responding to changes in your environment. The body’s
natural cooling mechanisms, such as sweating, aren’t enough
to overcome the heat of your surroundings. Your temperature
climbs in response, causing you to experience some of the
symptoms previously described.
Some over-the-counter medications, such as acetaminophen
(Tylenol), can help bring down a fever. However, they would
be ineffective in treating hyperthermia. Only a change in
environment, rehydration, and external cooling efforts (such
as cool water or ice packs on the skin) can reverse
hyperthermia.
 FEVER
Fever is when a human's body temperature goes above the
normal range of 36–37° Centigrade (98–100° Fahrenheit). It is
a common medical sign.
Other terms for a fever include pyrexia and controlled
hyperthermia.
Fever is one of the ways our immune system attempts to
combat an infection. However, sometimes it may rise too
high, in which case, the fever can be serious and lead to
complications.
 Causes
Fever can be caused by a number of factors:
an infection, such as strep throat, flu, chickenpox, or 
pneumonia
rheumatoid arthritis
some medications
overexposure of skin to sunlight, or sunburn
heat stroke, resulting either by exposure to high
temperatures or prolonged strenuous exercise
dehydration
silicosis, a type of lung disease caused by long-term exposure
to silica dust
amphetamine abuse
alcohol withdrawal
 SYMPTOMS
feeling cold when nobody else does
shivering
lack of appetite
dehydration — preventable if the person drinks plenty of fluids
depression
Hyperalgesia, or increased sensitivity to pain
lethargy
problems concentrating
sleepiness
sweating
If the fever is high, there may also be extreme irritability,
confusion, delirium, and seizures.
 Types
Fevers can be classified according to how long they last,
whether or not they come and go, and how high they are.
Severity
A fever can be:
low grade, from 100.5–102.1°F or 38.1–39°C
moderate, from 102.2–104.0°F or 39.1–40°C
high, from 104.1–106.0°F to or 40.1-41.1°C
hyperpyrexia, above 106.0°F or 41.1°C
The height of the temperature may help indicate what type
of problem is causing it.
 Length of time
A fever can be:
acute if it lasts less than 7 days
sub-acute, if it lasts up to 14 days
chronic or persistent, if it persists for over 14 days
Fevers that exist for days or weeks with no explanation are
called fevers of undetermined origin (FUO).
 In children
Children with a high temperature may develop a 
febrile seizure, also known as a febrile fit or febrile
convulsion; most of these are not serious and can be the
result of an ear infection, gastroenteritis, or a respiratory
virus, or a cold. Less commonly, febrile seizures may be
caused by something more serious, such meningitis, a 
kidney infection, or pneumonia.
Febrile seizures most commonly occur in children aged 6
months to 6 years and affect boys more often than girls.
Seizures occur because the body temperature rises too fast,
rather than because it has been sustained for a long time.
 There are two types of febrile seizures:
1) Simple febrile seizure - the seizure lasts no longer than 15
minutes (in most cases less than 5 minutes) and does not
occur again during a 24-hour period.
It typically involves the whole body — a generalized tonic-
clonic seizure. Most febrile seizures are of this type.
Symptoms — the body becomes stiff and the arms and legs
start to twitch, the patient loses consciousness (but the eyes
stay open).
There may be irregular breathing, and the child might
urinate, defecate, or both. There could also be vomiting.
2) Complex febrile seizure - the seizure lasts longer, comes
back more often, and tends not to affect the whole body, but
rather only part of the body.
Needs concern than simple febrile seizures.
 Diagnosis
Diagnosing a fever is straightforward - the patient's
temperature is taken, if the reading is high, they have a fever.
It is important to take the person's temperature when they
are at rest because physical activity can warm us up.
A person is said to have a fever if:
The temperature in the mouth is over 37.7° Centigrade (99.9°
Fahrenheit).
The temperature in the rectum (anus) is over 37.5–38.3°
Centigrade (100–101 Fahrenheit).
The temperature under the arm or inside the ear is over 37.2
Centigrade (99 Fahrenheit).
 Treatment
NSAIDs such as PCM, aspirin or ibuprofen can help bring a
fever down. However, a mild fever may be helping combat the
bacterium or virus that is causing the infection. It may not be
ideal to bring it down.
If the fever has been caused by a bacterial infection, it can be
treated by an antibiotic.
If a fever has been caused by a cold, which is caused by a viral
infection, NSAIDs may be used to relieve uncomfortable
symptoms.
Fluid intake: Anyone with a fever should consume plenty of
fluids to prevent dehydration. Dehydration will complicate
any illness.
Heat stroke: NSAIDs will not be effective if the person's fever
was caused by hot weather or sustained strenuous exercise.
The patient needs to be cooled.
 HYPOTHERMIA
Hypothermia is a medical emergency that occurs when your
body loses heat faster than it can produce heat, causing a
dangerously low body temperature. Normal body
temperature is around 98.6 F (37 C). Hypothermia occurs as
your body temperature falls below 95F (35 C).
When your body temperature drops, your heart, nervous
system and other organs can't work normally. Left untreated,
hypothermia can eventually lead to complete failure of your
heart and respiratory system and eventually to death.
Hypothermia is often caused by exposure to cold weather or
immersion in cold water. Primary treatments for
hypothermia are methods to warm the body back to a normal
temperature.
 Causes
Hypothermia occurs when your body loses heat faster than it
produces it. The most common causes of hypothermia are
exposure to cold-weather conditions or cold water. But prolonged
exposure to any environment colder than your body can lead to
hypothermia if you aren't dressed appropriately or can't control
the conditions.
Specific conditions leading to hypothermia include:
Wearing clothes that aren't warm enough for weather conditions
Staying out in the cold too long
Being unable to get out of wet clothes or move to a warm, dry
location
Falling into the water, as in a boating accident
Living in a house that's too cold, either from poor heating or too
much air conditioning
 How your body loses heat
The mechanisms of heat loss from your body include the
following:
Radiated heat. Most heat loss is due to heat radiated from
unprotected surfaces of your body.
Direct contact. If you're in direct contact with something
very cold, such as cold water or the cold ground, heat is
conducted away from your body. Because water is very good
at transferring heat from your body, body heat is lost much
faster in cold water than in cold air. Similarly, heat loss from
your body is much faster if your clothes are wet, as when
you're caught out in the rain.
Wind. Wind removes body heat by carrying away the thin
layer of warm air at the surface of your skin. A wind chill
factor is important in causing heat loss.
 Risk factors for hypothermia
Exhaustion. 
Very young age. 
Mental problems. 
Alcohol and drug use. 
Certain medical conditions. 
Medications. 
 Symptoms
Shivering is likely the first thing you'll notice as the
temperature starts to drop because it's your body's automatic
defence against cold temperature — an attempt to warm itself.
Signs and symptoms of hypothermia include:
Shivering
Slurred speech or mumbling
Slow, shallow breathing
Weak pulse
Clumsiness or lack of coordination
Drowsiness or very low energy
Confusion or memory loss
Loss of consciousness
Bright red, cold skin (in infants)
 READING ASSIGNMENT
Treatment and preventive measures of hypothermia?????
GREAT THANKS!!!!!!