"Heatstroke" and "heatstrokes" redirect here. For other uses, see Heatstroke (disambiguation).

"Sunstroke" redirects here. For other uses, see Sunstroke (disambiguation).

Not to be confused with Heat intolerance.

Heat stroke

Other names Sun-stroke, siriasis[1]

Person being cooled with water spray, one of the treatments of heat

stroke, in Iraq in 1943

Specialty Emergency medicine

Symptoms High body temperature, red, dry or damp skin,

headache, dizziness, confusion, nausea[2]

Complications Seizures, rhabdomyolysis, kidney failure[3]

Types Classic, exertional[3]

Causes High external temperatures, physical exertion[3][4]

Risk factors Extremes of age, heat waves, high humidity,

certain drugs, heart disease, skin disorders[3]

Diagnostic Based on symptoms[3]

 method

Differential Neuroleptic malignant

diagnosis syndrome, malaria, meningitis[3]

Treatment Rapid cooling, supportive care[4]

Prognosis Risk of death <5% (exercise induced), up to 65%

(non-exercise induced)[3]

Deaths > 600 per year (US)[4]

Heat stroke or heatstroke, also known as sun-stroke, is a severe heat illness that results in a body
temperature greater than 40.0 °C (104.0 °F),[4] along with red skin, headache, dizziness, and confusion.
[2]
Sweating is generally present in exertional heatstroke, but not in classic heatstroke.[5] The start of heat stroke
can be sudden or gradual.[3] Heatstroke is a life-threatening condition due to the potential for multi-organ
dysfunction,[6] with typical complications including seizures, rhabdomyolysis, or kidney failure.[3]

Heat stroke occurs because of high external temperatures and/or physical exertion.[3][4] It usually occurs under
preventable prolonged exposure to extreme environmental or exertional heat.[6] However, certain health
conditions can increase the risk of heat stroke, and patients, especially children, with certain genetic
predispositions are vulnerable to heatstroke under relatively mild conditions.[7]

Preventive measures include drinking sufficient fluids and avoiding excessive heat.[8] Treatment is by rapid
physical cooling of the body and supportive care.[4] Recommended methods include spraying the person with
water and using a fan, putting the person in ice water, or giving cold intravenous fluids.[4] Adding ice
packs around a person is beneficial but does not by itself achieve the fastest possible cooling. [4]

Heat stroke results in more than 600 deaths a year in the United States. [4] Rates increased between 1995 and
2015.[3] Purely exercise-induced heat stroke, though a medical emergency, tends to be self-limiting (the patient
stops exercising from cramp or exhaustion) and fewer than 5% of cases are fatal. Non-exertional heatstroke is
a much greater danger: even the healthiest person, if left in a heatstroke-inducing environment without medical
attention, will continue to deteriorate to the point of death, and 65% of the most severe cases are fatal even
with treatment.[3]

Signs and symptoms[edit]

Heat stroke generally presents with a hyperthermia of greater than 40.6 °C (105.1 °F) in combination with
disorientation.[5][9] There is generally a lack of sweating in classic heatstroke, while sweating is generally present
in exertional heatstroke.[5]

Early symptoms of heat stroke include behavioral changes, confusion, delirium, dizziness, weakness, agitation,
combativeness, slurred speech, nausea, and vomiting.[5] In some individuals with exertional heatstroke,
seizures and sphincter incontinence have also been reported.[5] Additionally, in exertional heat stroke, the
affected person may sweat excessively.[10] Rhabdomyolysis, which is characterized by skeletal muscle
breakdown with the products of muscle breakdown entering the bloodstream and causing organ dysfunction, is
seen with exertional heatstroke.[5]

If treatment is delayed, patients could develop vital organ damage, unconsciousness and even organ failure. In
the absence of prompt and adequate treatment, heatstroke can be fatal. [11]
Causes[edit]
See also: Hyperthermia § Causes

Heat stroke occurs when thermoregulation is overwhelmed by a combination of excessive metabolic production
of heat (exertion), excessive heat in the physical environment, and insufficient or impaired heat loss, resulting
in an abnormally high body temperature. Substances that inhibit cooling and cause dehydration such
as alcohol, stimulants, medications, and age-related physiological changes predispose to so-called "classic" or
non-exertional heat stroke (NEHS), most often in elderly and infirm individuals in summer situations with
insufficient ventilation.[12]

Young children have age specific physiologic differences that make them more susceptible to heat stroke
including an increased surface area to mass ratio (leading to increased environmental heat absorption), an
underdeveloped thermoregulatory system, a decreased sweating rate and a decreased blood volume to body
size ratio (leading to decreased compensatory heat dissipation by redirecting blood to the skin). [5]

Exertional heat stroke[edit]

Exertional heat stroke (EHS) can happen in young people without health problems or medications – most often
in athletes, outdoor laborers, or military personnel engaged in strenuous hot-weather activity or in first
responders wearing heavy personal protective equipment. In environments that are not only hot but also humid,
it is important to recognize that humidity reduces the degree to which the body can cool itself by perspiration
and evaporation. For humans and other warm-blooded animals, excessive body temperature can disrupt
enzymes regulating biochemical reactions that are essential for cellular respiration and the functioning of major
organs.[11]

Cars[edit]
See also: Forgotten baby syndrome

When the outside temperature is 21 °C (70 °F), the temperature inside a car parked in direct sunlight can
quickly exceed 49 °C (120 °F). Young children or elderly adults left alone in a vehicle are at particular risk of
succumbing to heat stroke. "Heat stroke in children and in the elderly can occur within minutes, even if a car
window is opened slightly."[13] As these groups of individuals may not be able to open car doors or to express
discomfort verbally