Dr Nikhil Juneja

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HEAT EXHAUTION AND HEAT STROKE

Exposure to excessive heat, causing loss of fluids and a rise in body temperature. This may occur at any age but most common in babies and elderly people. Prolonged exposure to high atmospheric temperature. Brief exposure to very high atmospheric temperature. (direct exposure to sun is not necessary). Heavy manual work in high temperature, high humidity. Pre-existing chronic diseases and alcoholism are some of the predisposing factors.
In a hot environment, the body loses heat by diverting blood to the skin and by sweating. Profuse sweating may lead to an excessive loss of fluids and salts, resulting in heat exhaustion. This condition is rarely serious ,but, if exposure to heat continues, heat stroke may occur as the body normal cooling mechanisms break down and the temperature of the body rises. Heat stroke is a life-threatening medical emergency
Heat exhaustion and heat stroke most commonly occur above 104 degree F (40 degree C).High humidity increases because sweating is ineffective and heat loss is decreased.
WHO IS AT RISK ? Heat exhaustion and heat stroke may affect otherwise healthy people, particularly after physical exertion in a hot climate. People who come from temperate climates and travel to the tropics need time to acclimatize to the heat before they can safely exert themselves.
The body’s cooling mechanisms are less efficient in babies and elderly People, making them more susceptible to heat exhaustion and heat stroke. Obesity, diabetes mellitus, alcohol dependence, and chronic heart failure all decrease the body’s ability to lose heat. Diarrhoea may contribute to dehydration and increase the risk of development heat exhaustion and heat stroke.
WHAT ARE THE SYMPTOMS?
After prolonged exposure to hot conditions, the following symptoms of heat - exhaustion may develop:
1. Profuse Sweating
2. Fatigue
3. Muscle cramps
4. Nausea and vomiting
5. Faintness and unsteadiness
6. Headache
If exposure to heat continues, the body temperature rises and heatstroke may develop, causing symptoms such as:
1. Fast, shallow breathing.
2. Confusion and disorientation
3. Seizure
Left untreated, heat stroke may progress to coma in minutes .Death may be due to kidney failure, acute heart failure, or direct heat –induced damage to the brain.
WHAT CAN I DO IT ?
Heat exhaustion can be treated easily. The affected person should rest in a cool place, ideally in an air- conditioned building, and sip cool, salty drinks until he or she feels comfortable. If heat stroke is suspected, he or she should be admitted to the hospital as soon as possible.
WHAT MIGHT THE DOCTER DO ?
Once in the hospital, an examination is done, and blood tests are carried out to assess the level of salts in the blood.
Treatment of heat stroke is usually carried out in a critical care unit. The body temperature is lowed by sponging the body with tepid water or loosely wrapping the person in a wet sheet and placing him or her near a fan. Intravenous fluids are given. Once the body temperature has been reduced to 100 degree F(38 degree), These cooling procedures are stopped to prevent hypothermia (below) from developing. Monitoring is still carried out continuously to make sure that the body temperature returns to normal level and that the vital organs are functioning normally. In some severe cases, mechanical ventilation may be required to help breathing.
Most people with heat exhaustion recover in a few hours if they are moved to a cooler place and fluids are gradually replaced. If heat stroke is treated promptly, most people usually recover after a few days of bed rest, although their body temperature may fluctuate for several weeks after ward
CAN THEY BE PREVENTED?
Heat-related disorders can be largely prevented by avoiding strenuous exertion in the heat of the day, spending as much time as possible in the shade, consuming large quantities of liquids, and avoiding alcoholic beverages.
HOMOEOPATHIC APPROACH: - Following homoeopathic medicines can be given according to the totality of symptoms.
1. Aconite:- It is the best remedy when the cause is lying with head exposed to the direct rays of sun, patient < after sleep, faintness and dizziness.
2. Ant. C:- All symptoms seem to center about the mind and the stomach, < from the heat of sun, warm air, hot drinks, motion, bodily exertion > rest air, hot bath or applied heat .
3. Bell:- Violent shooting pains in head which come and go suddenly making the patient scream. Heat about the head with cold feet. Blood shot eyes and visible throbbing of the carotids. 4. Bry :- Must not be forgotten in summer complaints when great thirst for large quantity of water, amelioration from rest and quite ness are present.
5. Carbo. V :- Lower vitality and great foulness of all the secretions on one side on the flatulence in the upper abdomen and constant desire to be fanned are the main symptoms.
6. Gels:- Useful in sun –stroke, high temperature with drowsiness or tendency to coma, thirstlessness.
7. Glon :- A most valuable remedy for effects of sun- stroke, great remedy for congestive headaches,hyperaemia of the brain from excess of heat.
8. Lach :- One of our best remedies for sun- headaches.Effect of hot weather, patient < after sleep,faintness,dizziness.
9. Lyco :- Flatulence or heaviness immediately after eating < towards evening, summer complaints, > un- covering and on getting cold.
10.Nat C :-Chronic effects of sun- stroke; now, with return of hot weather, suffers from headache. Excellent for debility and exhaustion caused by heat of summer ; for headache caused by sun,gas-light and from slightest mental exertion;chronic effects of sun-stroke like headache etc.
11. Nat Mur :- This tissue remedy in the 6x potency proves excellent in sun-stroke and other summer complaints.
12.Nux Mos :- Tendency to faint, drowsiness, great dryness without thirst are the special indications of Nux Mos. In summer complaints.