Heat stroke refers to a syndrome in which the human body is under high temperature or scorching sun, which causes disturbances in body temperature regulation, heat dissipation, and accumulation of heat energy, which is mainly caused by high fever, non-sweat and central nervous system symptoms. Heatstroke is more common in tropical and subtropical regions. When severe heat waves are hit in temperate regions, it can cause a large number of uncomfortable people to be affected. According to research, heatstroke can occur when the highest temperature of the day is greater than 31 degrees Celsius. In our country, heatstroke is more common in the summer in the south, and it is more common in the elderly. The population distribution is more common in people engaged in manual labor in hot temperatures, people participating in large-scale sports competitions and military training; in addition, people who travel long distances are also more common. With the global warming, people who have become accustomed to living and working in an artificial constant temperature environment are generally facing a decline in the body's heat resistance. In daily life, the incidence of heat stroke has gradually increased. According to incomplete statistics, the fatality rate of heatstroke can be as high as 20-70%. Therefore, in the hot summer, people need to actively prevent and treat heatstroke.
Causes of heat stroke
Environmental factors: The main external factors for heat stroke are high temperature, high humidity, and low wind speed. It is easy to occur in high temperature radiation working environment (dry heat environment) and high temperature and high humidity working environment (humid heat environment). According to the study, the average temperature of more than 30 degrees Celsius and the relative humidity of more than 73% for three consecutive days are most likely to occur heat stroke. At the same time, it should be noted that sometimes although the temperature is not high and the humidity is not high, heat stroke is also prone to occur due to poor environmental ventilation. For example, in summer, people are prone to heat stroke in a closed working environment. In cities, various tall buildings affect air circulation, the use of air conditioners in large areas in summer, narrow streets and increasing vehicles, the use of various instruments and equipment, the reduction of urban green areas, etc., have formed a heat island effect and increased the city. Temperature. As well as the increase in global carbon dioxide emissions, the formation of the greenhouse effect, and the rising trend of temperature, these reasons have led to an increase in heat stroke.
Own factors: mainly ○1. Increased heat production, such as engaging in physical labor and sports, and suffering from fever, hyperthyroidism and other diseases with increased metabolism. ○2. Poor thermal adaptation, such as malnutrition (how to treat malnutrition), old age and weak, pregnant and lying-in women, excessive fatigue, lack of physical exercise, lack of sleep, drinking, hunger, and sudden entry into tourist hot spots and high temperature environments. ○3. Heat dissipation obstacles, such as obesity, wearing tight-fitting, poorly breathable clothes, congenital sweat gland deficiency, scleroderma (how to treat scleroderma), heat rash (how to treat heat rash), scars recovered from patients with extensive burns . In addition, during treatment with anticholinergic drugs, antihistamines, antidepressants, B-adrenergic receptor blockers, diuretics, phenothiazines and other drugs, as well as patients suffering from dehydration, shock, heart failure and other diseases , It is also a factor that can not be ignored that causes heat stroke.
Classification of heat stroke
1. Heat stroke (heatstroke and high fever) refers to the increase in body temperature caused by the accumulation of heat in the body due to the effect of the heat source in the external environment and the inability of the body heat to dissipate through normal physiological heat. The clinical manifestations are mainly high fever, no sweating, and disturbance of consciousness (How to treat disorders of consciousness). It usually occurs after several hours of high-temperature work, or heatstroke after a few days when the heat resistance drops for a few days. When the body temperature is 42-43 degrees Celsius, the body cells will suffer irreversible damage for several minutes, the central nerve cells will be damaged, and the heart, liver and kidney will also be damaged. When the body temperature is greater than 50 degrees Celsius, the cells die within a few minutes. When heat stroke occurs, cerebral hemorrhage (how to treat cerebral hemorrhage), cerebral edema, turbid swelling of the myocardium, interstitial hemorrhage, pulmonary congestion, edema, central necrosis of liver lobules, renal ischemia, and renal tubular degeneration may occur. Skin vasodilation, coupled with loss of water and salt, blood concentration, to peripheral circulatory failure. There is also a special type of heat stroke-insolation. When working under the scorching sun or strong radiation, the head temperature will rise due to strong light and infrared rays irradiating the head for a long time, leading to brain tissue edema and intracranial hypertension. The main manifestations of the symptoms are: dizziness, headache (how to treat headaches), tinnitus, severe vomiting, irritability, coma (how to treat coma), convulsions (how to treat convulsions) in severe cases.
2. Heat cramps (heat stroke cramps): Due to excessive sweating and excessive loss of water and salt in the body, the osmotic pressure of extracellular fluid is reduced, water is transferred to the cells, muscle cells are over-diluted, edema occurs, and the muscles produce painful spasms. Heat cramps are more common in young people who sweat a lot during physical labor in a high temperature environment. It is rare in the elderly. The hot season has just begun and before heat adaptation. It is manifested as severe muscle spasm accompanied by pain during muscle contraction. It is more common in the limbs and masticatory muscles. The spasm muscles appear symmetrically, and they get better from time to time, but the patient's body temperature is normal.
3. Heat exhaustion (heatstroke exhaustion): High fever causes peripheral blood vessels to dilate, sweat a lot, lose water and salt, blood concentration, viscosity increase, cells are in a hypertonic state, water enters the cells, the effective circulating blood volume is reduced, and the body is in order to compensate , Promote heat dissipation, increase cardiac output, increase the load of the cardiovascular system, and cause cardiac or circulatory failure, transient cerebral ischemia, and shock may occur in severe cases. This type of heat stroke often occurs in the elderly and those who are unable to adapt to heat. She had a sudden onset of dizziness, headache, and suddenly fainted. She was awake when she was lying on her back and leaving the high-temperature workplace. His body temperature was slightly elevated and there was no central nervous system damage.
Heat stroke symptoms
1. Threatened heatstroke: Patients often feel a lot of sweating, dizziness, vertigo, weakness, nausea, palpitation, shortness of breath, inattention, and disorientation. Body temperature is often less than 37.5 degrees Celsius. When leaving the high-temperature working environment and entering a cool and ventilated environment, it can return to normal in a short time.
2. Mild heatstroke: In addition to symptoms of aura, some patients have symptoms such as body temperature rise above 38 degrees Celsius, skin burning, flushing; pale complexion, vomiting, clammy skin, weak pulse, decreased blood pressure and other symptoms of peripheral circulatory failure. , Usually body temperature can return to normal within 4 hours after rest.
3. Severe heat stroke: The above symptoms are further aggravated. Heat exhaustion is mainly manifested by pale skin, cold sweats, weak limbs, and rapid pulse. Blood pressure drops, (systolic blood pressure drops below 80mmHg) rapid shallow breathing, normal or small changes in body temperature, confusion or fainting (how to treat fainting). Sunstroke is mainly manifested as severe headache, dizziness, tinnitus, vomiting, flushing, head temperature above 40 degrees Celsius, normal body temperature, and coma in severe cases. Heatstroke and high fever are mainly manifested as high fever, with a body temperature of more than 40 degrees Celsius, accompanied by syncope, dry and burning skin, headache, nausea, general weakness, rapid pulse, confusion, and severe organ damage and death.
Prevention of heat stroke
1. Avoid the scorching sun: In particular, avoid walking under the scorching sun from 10 a.m. to 16:00 p.m., because the possibility of heat stroke during this period is 10 times higher than usual! Especially the elderly, pregnant women, and people with chronic diseases, Especially for people with cardiovascular disease, go out as much as possible during the hot season.
2. Shading protection: such as playing a parasol, wearing a sun hat, sunglasses, applying sunscreen, and preparing plenty of drinks. What needs to be reminded is that even strong men should also take the above protective measures, at least they should use a parasol.
3. Supplement water: Develop good drinking habits, usually the best time to drink water is after waking up in the morning, 10 am, 3-4 pm, and before going to bed at night, drinking 1-2 cups of boiled water or salty beverages (water 2 ~5 liters with 20 grams of salt). Don't wait to drink water when you are thirsty, because thirsty means that the body is dehydrated. Always pay attention to eating more fresh vegetables and fruits can also add water.
4. Sufficient sleep: In summer, the days are long and the nights are short, and it is easy to feel tired. Adequate sleep can relax the brain and body systems, which is not only beneficial to work and study, but also a good measure to prevent heatstroke.
5. Enhancing nutrition: A nutritious diet should be high in calories, high in protein, high in vitamin A, B1, B2 and C. You can usually eat tomato soup, mung bean soup, soy milk, sour plum soup, etc.
6. Prepare heatstroke prevention drugs: carry heatstroke prevention drugs with you, such as Rendan, Shidropshui, Huoxiang Zhengqi Water, Cooling Oil, Wuji Dan, etc. Once the symptoms of heatstroke appear, you can take the medicines you bring to relieve the condition.
7. Timely physical examination: It is recommended to have a physical examination before the summer vacation every year. Anyone found to have organic diseases of the cardiovascular system, persistent hypertension, ulcer disease, active tuberculosis (how to treat tuberculosis), emphysema, liver and kidney disease, hyperthyroidism, central nervous system organic disease, recovery after serious illness Those who are weak and infirm should increase their awareness of protection and should not engage in high-temperature operations.
On-site first aid measures for heat stroke
1. Move: quickly lift the patient to a ventilated, cool, and sweet place, lie down, unbuckle, loosen or take off the clothes, and change clothes if they are soaked with sweat.
2. Cooling down: The patient’s head can be covered with a cold towel, 50% alcohol, white wine, ice water or cold water can be used for body scrubbing, and then a fan or electric fan can be used to blow the air to accelerate heat dissipation. Conditions can also be used to cool down with a cooling blanket. But don't lower the patient's body temperature quickly. When the body temperature drops below 38 degrees Celsius, stop all strong cooling measures such as cold compresses.
3. Replenishing water: When the patient is still conscious, give some refreshing drinks. When replenishing water, add a small amount of salt or baking soda. But do not rush to add a lot of water, otherwise, it will cause vomiting, abdominal pain, nausea and other symptoms.
4. Awakening: If the patient has lost consciousness, he can refer to acupuncture points such as Renzhong and Hegu to make him awaken. If breathing stops, give artificial respiration immediately.
5. Transfer: For severe heatstroke patients, they must be sent to the hospital for treatment immediately. When transporting the patient, use a stretcher to transport the patient. Do not allow the patient to walk. At the same time, pay attention to the transport. Use ice packs as much as possible on the patient’s forehead, pillow, chest, elbow socket and thigh roots, and actively perform physical cooling to protect the brain, heart and lungs. And other important organs.
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