From the Guidelines
Heat stroke can affect anyone, but certain groups face higher risks, including athletes, domestically displaced, outdoor workers such as firefighters, construction workers, landscapers, and military personnel, as identified in the most recent guidelines from the Society of Critical Care Medicine 1. These groups are particularly vulnerable due to their increased exposure to heat and physical exertion. According to the guidelines, heat stroke is a leading cause of weather-related fatalities, and its prevalence is expected to increase 1.
Key Risk Factors
- Athletes and outdoor workers who exercise or work in hot environments
- Domestically displaced individuals
- Military personnel
- People with chronic illnesses, such as heart disease, obesity, or diabetes
- Individuals taking medications like diuretics, beta-blockers, antidepressants, or antipsychotics
- People without access to air conditioning
- Those who are dehydrated
- Individuals with a history of previous heat illness The body's temperature regulation can fail, causing core temperature to rise above 104°F (40°C), which can damage organs and potentially be fatal 1.
Prevention and Management
- Active cooling measures, such as cold- or ice-water immersion, are recommended over passive cooling methods 1
- Pharmacological interventions that affect temperature control should be avoided in heat stroke patients 1
- Good practice statements, such as providing additional clinical guidance, can help improve patient outcomes 1 It is essential to prioritize the management of heat stroke, focusing on rapid cooling and maintenance of organ support, to minimize morbidity and mortality 1.
From the Research
Patients at Risk for Heat Stroke
The following individuals are at risk for heat stroke:
- The elderly 2, 3, 4
- Infants 2, 3
- The obese 5, 2, 4
- People with hyperthyroidism 2
- Those taking certain drugs 2
- Individuals with predisposing illnesses 5
- Physically active individuals, particularly those who are not acclimatized to high temperatures 6, 3, 4
- Children 4
- Individuals with low fitness level, acute infections, illness, dehydration, and other factors that reduce heat tolerance 4
- People who are not acclimatized to high temperatures, such as those who have recently traveled to a hotter climate 4
Factors that Increase the Risk of Heat Stroke
Several factors can increase the risk of heat stroke, including:
- High ambient temperatures 5, 4
- Physical exertion 6, 3, 4
- Clothing that reduces the evaporation of sweat 4
- Individual factors such as overweight, low fitness level, acute infections, illness, dehydration, and other factors that reduce heat tolerance 4
- Sudden heat waves or changing the climate zone 4
Importance of Early Recognition and Treatment
Early recognition and treatment of heat stroke are essential to reduce morbidity and mortality 5, 2, 6, 3, 4. Rapid cooling is critical, and the aim is to reduce core body temperature to <40 °C within 30 minutes 4.