1 / 12

Heat Stroke Victim

“If you asked me to name the three scariest threats facing the human race, I would give the same answer that most people would: nuclear war, global warming and W i n d o w s ” Dave Barry, American Writer. Heat Stroke Victim. Recovery from Heat Stroke?. Physiological Responses

teige
Download Presentation

Heat Stroke Victim

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. “If you asked me to name the three scariest threats facing the human race, I would give the same answer that most people would: nuclear war, global warming and Windows” Dave Barry, American Writer

  2. Heat Stroke Victim

  3. Recovery from Heat Stroke? Physiological Responses To Exercise Heat Stress Organ / Tissue Responses Robert Carter, Ph.D., M.P.H., F.A.C.S.M.

  4. Understanding EHI/HYPO Case Reports Epidemiological Studies Risk Factors i.e., Local Injury Population Organism Tissue/Cellular Gene Expression Genetic Factors Gene-Environment i.e., Sickle Cell Trait Body Temp Heart Rate Blood Markers Environmental Acutely altered physiological factors

  5. Risk Factors Exertional Heat Illness • Male Soldier (21 yr) • Heat acclimation protocol (100 min on treadmill, 3.5 mph, 4% grade, 40ºC, 20% rh) • Developed heel blister Day 2 • Initial exam following Day 3 showed local heel swelling & clear discharge • Follow-up exam confirmed cellulitis (2-wks antibiotic therapy) • Day 4 walk 5 days after treatment Carter et al, Sports Sci Exch, 2006 Carter et al, J. Sports Rehab, 2007

  6. Signs and Symptoms

  7. Carter: Current Sports Medicine Reports, 2008

  8. Carter: Current Sports Medicine Reports, 2008

  9. Heat Tolerance Testing + Biomarkers? • Heat Tolerance Test (HTT) • 120 min walk 5 km/h at 2% grade in 40oC, 40% RH • Steady-State Core Temperature <38.5oC • Assumes Heat Stroke recovery related to gross heat exchange • Modest Compensable Heat Stress • 70 kg, 1.92 m2 Soldier have Ereq/Emax = ~45% (223/485 w/m2) • Large Core-to-Skin Temperature Gradient (~4oC), so low skin blood flow & compensatory vasoregulatory requirement • No sophisticated thermoregulatory control evaluation & no pre-injury baseline • No profile of organ injury • Best criteria for return? • Issue is Multi-Organ Dysfunction, NOT gross heat exchange • Wallace et.al. (Science Direct 2007) – Soldiers hospitalized for heat stroke subsequently had increased mortality (30 years) from cardiovascular, liver, renal & GI diseases.

  10. Heat Tolerance Testing + Biomarkers? • John Bowen – PA at TMC 14, Camp MacKall, MC • Heat Stroke Return for Special Force Qualification Course • “Best Guess from Experience” • Clean Clinical Picture • 30 days – P3(T) Profile (limit of 15 min vigorous exercise) • 30 days – P3 Profile (limit maximal exercise & MOPP) • 30 days – PT & Training (ramp & observation) • “USARIEM Twist” (core temperature telemetry & blood analyses) • Clean Clinical Picture • 30 days – Observe & walk / jog to Tc to 38.5oC (PT Uniform) • 30 days – Observe & ramp military activities to Tc to 38.5oC (ACU) • 30 days – Observe & ramp military activities to Tc to 39.5oC (no restrictions)

  11. Heat Tolerance + Exercise • Exercise promotes early recovery of • skeletal muscle • Avoids development of fibrosis • May better tolerance (muscle injury, heat stress?) • Promotes muscle mass • Inactivity significant MM losses

  12. Heat Tolerance Testing Summary • Addition information such as repeated laboratory values, biomarkers of tissue damage, ??? may be needed. • Progress responses to exercise heat stress • Repeated Exercise Bouts • Start mild exercise to “speed up” recovery • Adequate Surveillance for Follow-up

More Related