Hyperthermia

Hyperthermia is a high body temperature. It happens when a person is not able to control their body temperature. This can happen for many reasons, like very hot weather, fever, and some medicines or illegal drugs.

Doctors define hyperthermia as a body temperature that is over 101 degrees Fahrenheit (equal to 38.3 degrees Celsius).^[1] This is higher than the normal healthy human body temperature, which is normally around 98.6 degrees Fahrenheit (37 degrees Celsius). When a person gets hyperthermia, they can have heat-related injuries, where the high body temperature hurts the body.

There are three forms of heat-related injuries caused by hyperthermia: heat cramps (the least serious), heat exhaustion, and heat stroke (the most serious).

The opposite of hyperthermia is hypothermia.

Causes of hyperthermia

Drugs like Ecstasy can cause severe hyperthermia

All types of hyperthermia can be caused by the same things. Some common causes are:^[2]

• Weather: Weather that is very hot, sunny, and humid
• Activity: Exercising or working a lot, especially if it is hot out
• Older people and infants can get hyperthermia even if they are resting inside, if the weather outside is hot and humid, and they are not getting enough cool air. This can happen because very old and very young people have trouble controlling their body temperatures.
• Illegal drugs, especially ecstasy and amphetamines, can make the body's temperature get very hot, very quickly^[3]

Other things that make a person more likely to get hyperthermia, especially if they are exercising or working, include:^[2]

• Clothing: Wearing dark clothing, hats or helmets, or padded clothing (like football pads)
• Body weight: Having more body fat makes it harder for the body to cool down
• Dehydration (not having enough fluids in the body): This makes it harder for the body to cool itself down by sweating
• Fever: Because the body's temperature is already higher than normal
• Medicines: Some medications, like beta blockers and antipsychotic medicines^[3]

Heat cramps

Heat cramps are the least serious form of hyperthermia. (A "cramp" is a sharp pain caused by a muscle getting tighter and shorter.)

The body sweats to try to cool itself down

Symptoms

The major symptoms of heat cramps are:^[2]

• Painful cramps, usually in the legs or abdomen
• Sweating a lot, which can cause dehydration and loss of electrolytes (important salts that the body needs)

Treatment

People with heat cramps usually do not need medical treatment. The best treatments for heat cramps are:^[2]

• Moving to a cool place and resting
• Resting the muscles that hurt
• Drinking water or sports drinks to treat dehydration

Heat exhaustion

Heat exhaustion is more serious than heat cramps. If affects the whole body instead of just certain muscles, like heat cramps.

Symptoms

Symptoms of heat exhaustion may include:^[3]

• Syncope (fainting) or dizziness
• Low blood pressure
• More serious dehydration
  • The person may be orthostatic (this means they get dizzy or faint when they stand up; it is a sign of dehydration)
• Feeling very thirsty with a dry mouth
• Cool, clammy skin (because the body is trying as hard as it can to pull heat out of the body by sweating)
• Nausea or vomiting (because of dehydration)

Treatment

People with heat exhaustion may need medical treatment.

First aid for people with heat exhaustion includes:^[3]

• Moving the person to a cool place
• Having the patient take off extra layers of clothes
• Cooling the patient down by fanning them and putting wet towels on their body
• Having them lie down and put their feet up if they are feeling dizzy
• Having them drink water or sports drinks - but only if they are awake, not confused, and not vomiting
• Turning the person on their side if they are vomiting

If a person with heat exhaustion gets medical treatment, EMTs or doctors may:

• Give them oxygen
• Give them water and electrolytes intravenously (through a needle placed into a vein) if they are too confused to drink, or are vomiting

Heat stroke

Heat stroke is a medical emergency. If it is not treated quickly enough, it causes brain damage and death.^[1] It is one of the most common causes of death in sports that can be prevented.^[4]

Heat stroke happens when a person gets so hot that their body cannot do anything to bring their temperature down. The body has tried every strategy it has to cool itself down. But the body is so hot that none of those strategies work any more. This causes the body temperature to rise very quickly. The body gets so hot inside that its tissues, especially the brain, get damaged. Usually, people with heat stroke have a body temperature of 104 degrees Fahrenheit or higher. The brain cannot survive for long at these temperatures. Heat stroke can very quickly cause damage to the brain, heart, kidneys, and muscles.^[1]

Symptoms

Early symptoms

Often, the first signs of heat stroke are:^[1]

• Agitation (the person gets upset and restless)
• Confusion
• A strong, fast heart rate

Late symptoms

As heat stroke gets worse, symptoms that can kill the person start to appear. For example:^[4]

• Seizures, especially status epilepticus
• Very low blood pressure (too low to get blood and oxygen to the brain)
• A weak, slow heart rate (this is a sign that the heart cannot beat strongly enough to get blood and oxygen to the body)
• Delirium or coma (caused by the brain getting so hot that it cannot work, and not getting enough oxygen)
• The patient's skin will also be flushed (red), hot, and dry (because the body is no longer able to cool itself by sweating)

Treatment

A British soldier in the Middle East has heat stroke and is being cooled with water spray (1943)

People with heat stroke always need emergency medical treatment as soon as possible. If a person might have heat stroke, 9-1-1 or another emergency telephone number should be called right away. The emergency medical dispatcher can explain what to do to help the person until an ambulance gets there.

Once the person with heat stroke gets to an ambulance or a hospital, treatments for heat stroke may include:^[4]

• Cooling the person down as fast as possible. Ways to do this include:
  • Taking the person's clothes off
  • Covering the person with wet towels
  • Turning up the air conditioning or turning on a fan, if possible
  • Putting ice packs in the person's armpits, on the back of their neck, and in their groin
  • Putting the person into an ice bath
  • Giving cold intravenous fluids, both to help cool the person down and to help with dehydration
• Giving benzodiazepines to stop shivering from being cooled down so quickly (shivering makes the body even warmer)
• Giving medicines to stop seizures
• Giving medicines to help heart problems caused by the heat stroke
• Giving oxygen, or putting a tube down the person's throat to help them breathe (this is called intubation)

Prognosis

The prognosis for people with heat stroke depends on how high their body temperature got, how quickly their body temperature increased, and how quickly they got treatment.

Up to 80% of people who do not get treatment for heat stroke right away die.^[4] But cooling people with heat stroke down right away, and getting them treatment very quickly, can change this so that only 10% die.^[4] But some people who survive have brain damage or other health problems caused by their heat stroke.

References

1. "Heat Stroke". www.mayoclinic.org. The Mayo Clinic. July 12, 2014. Retrieved January 1, 2016.
2. "Heat Injury and Heat Exhaustion". www.orthoinfo.aaos.org. American Academy of Orthopedic Surgeons. July 2009. Retrieved January 1, 2016.
3. "Heat Exhaustion and Heatstroke". www.nhs.uk. National Health Service of the United Kingdom. June 11, 2015. Archived from the original on October 3, 2017. Retrieved January 1, 2016.
4. Helman, MD, Robert S.; Habal, MD, Rania (May 1, 2015). "Heatstroke". Medscape. Retrieved January 1, 2016.