Variations of Body Temperature
Heat Exhaustion
Definition: Heat exhaustion is an acute heat problem, above 100.4°F (38°C), caused by dehydration. It occurs when the body no longer can dissipate heat effectively because of hot environmental conditions or increased body heat production. It may progress to heatstroke, above 104°F (40°C), when the body's heat regulating mechanism becomes overwhelmed and fail.
Heat exhaustion
- Symptoms often are non-specific and may be insidious in onset.
- Fatigue and weakness
- Nausea and vomiting
- Headache
- Dizziness
- Muscle cramps and pain
- Irritability
Heatstroke
- This condition may be characterised by any or all of the symptoms of heat exhaustion.
- The critical feature of heatstroke is CNS dysfunction, which can have a sudden onset.
- Symptoms include bizarre behaviour, hallucinations, altered mental status, confusion, disorientation, and coma.
- Patients may be sweating. Although anhydrosis (Failure of the sweat glands) may be a classic feature of heatstroke, more than half of presenting patients are sweating, especially in cases of exertional heatstroke. Anhydrosis usually is a late finding.
Febrile Convulsions
Febrile convulsions occur when a child has a high temperature. The convulsions occur because the electrical systems in the brain have not yet matured sufficiently to cope with the stress of a high temperature. Most occur with common illnesses such as ear infections, coughs, colds, flu, and other virus infections. The use of liquid Paracetamol will help reduce the temperature.
General Management + see under for particular condition
ASHICE (Consider)
Transport to Hospital
Professional Handover
Heat Exhaustion - Move patient to cooler environment, Place patient at rest, Give cool drinks, Sponge with luke warm water
Heat Stroke - Remove as much clothing as possible, Wrap in a wet sheet, Fanning the patient, Cool packs around neck and under arms, treat accordingly if unconscious
Febrile Convulsions - Remove clothing and sponging with luke warm water if child has a fever, reassure the parents as it can be frightening for them.
Hypothermia
Definition: is a medical condition in which the patients core body temperature has dropped below normal and normal metabolism begins to be impaired. This begins to occur when the core temperature drops below 35 degrees Celsius (95 degrees Fahrenheit). If body temperature falls below 32 degrees Celsius (90 degrees Fahrenheit), the condition can become critical and eventually fatal. Body temperatures below 27 C (80 F) are almost uniformly fatal.
The body loses heat through:
- Evaporation (sweating) and respiration (breathing) when the body temperature is greater than 99 °F(37.22 °C). During strenuous exercise, the body loses 85% of its heat through sweating.
- Radiation (similar to heat leaving a wood stove). This method of transferring heat usually occurs with air temperatures less than 68 °F(20 °C). The body loses 65% of its heat through radiation.
- Conduction (such as sleeping on cold ground). Heat is transferred in air temperatures less than 68 °F(20 °C). The body loses about 2% of its heat through air conduction. However, water conducts more heat away from the body than air, so heat can be lost from the body very quickly when it is exposed to cool water.
- Convection (such as sitting in front of a fan or wind chill). Convection helps the body lose 10% to 15% of its heat.
Signs and Symptoms
- Shivering - but only in the early stages
- Dry, cold skin
- Slow pulse
- Slow breathing
- Drowsiness - sometimes mistaken for drunkenness - which can lapse into coma.
- Babies do not shiver. They may appear generally unwell and cold to touch.
Never assume someone has died, as at low temperatures the body can survive very much longer than at normal temperatures.
Management of Hypothermia
Take temperature, Remove wet clothing, Cover patient with blanket, Monitor ECG, Warm drink if patient is conscious, Reassurance, Oxygen, Make patient comfortable, a patient with hypothermia could be at risk of cardiac arrest. Do not apply external heat, especially to the arms and legs, as this can force cold blood back toward the heart, lungs and brain, causing the core body temperature to drop and induce cardiac arrest
ASHICE (Consider)
Transport to Hospital
Professional Handover