Types of and signs of hyperthermia

According to the National Institute on Aging (2004), hyperthermia in the elderly can be classified by the following categories and signs and symptoms:

• Heat cramps are painful muscle spasms in the abdomen, arms, or legs following strenuous activity. The skin is usually moist and cool and the pulse rate is normal or rapid. Body temperature remains in the normal range. A low sodium level may cause heat cramps, but salt replacement should not be considered without advice from a physician.
  • NOTE: Use of salt tablets to replace sodium is not recommended due to slow absorption and the associated risk of: gastric irritation, vomiting and cerebral edema.
• Heat edema is swelling in the ankles and feet during periods of heat.
• Heat syncope is sudden unconsciousness experienced after exertion in the heat. It is caused by hypotension secondary to cutaneous vasodilation. The skin appears pale and sweaty but feels moist and cool. The pulse may be weak, and the heart rate is usually rapid. Blood pressure is usually less than 100 mmHg systolic. Body temperature may be normal.
• Heat exhaustion is a warning that the body is getting too hot. The person may be thirsty, giddy, weak, uncoordinated, nauseous, and may be having a profound diaphoresis. The body temperature is usually normal and the pulse is normal or rapid. The skin is cold and clammy. Although heat exhaustion is often caused by water and sodium depletion, salt supplements should be taken only with a physician's consent.
• Heat stroke is a life threatening condition. Persons with heat stroke have a very high mortality rate so immediate medical attention is needed when symptoms first become evident.
  
  • Important signs of heat stroke include:
    * fainting, often an early sign
    * a core body temperature over 40C
    * a change in behavior, such as confusion, combativeness, or other unusual behaviors
    * absence of sweating, despite the heat
    * dry, flushed skin and a strong rapid pulse changing to a slow weak pulse
    * cool skin due to vascular collapse
    * EKG changes consistent with heart damage
    * delirium or coma
  • Heat stroke can be fatal even after returning to normal temperature. Intravascular coagulation and multi-organ failure may result from the release of heat shock protein and exaggerated immune response. Acute renal failure should be anticipate
  • Those patients that survive heat stroke often suffer from neurological impairment

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