Heat Stroke, Dehydration & Prevention

Heat stroke, on the other hand, is a life-threatening emergency . Without proper care, heat stroke victims will most likely die. David displayed the classic signs and symptoms of exertional heat stroke. David's situation was much more serious than his companions,' because he began to generate heat faster than he could shed it, which caused his core temperature to rise to dangerous levels.

Once our cooling mechanism fails, core temperature rises rapidly. Death can occur in as little as 30 minutes. When the core temperature rises, the brain, which can only function in a very narrow temperature range, begins to fail. In an effort to cool the blood and lower the core temperature, the brain will dilate all the blood vessels in the skin. As a result, the skin becomes RED and HOT, but may still be WET. (Note: Classical heat stroke, suffered more commonly by the ill and/or elderly, usually produces DRY skin from severe dehydration.)

As the brain overheats, the individual may become disoriented, combative, argumentative, and may hallucinate wildly. David exhibited all of these symptoms and was appropriately taken to the local emergency room. But heat stroke treatment should be begun immediately in the backcountry.

The primary goal of therapy is to cool the victim as rapidly as possible. Since the sweating mechanism has failed, we have to sweat for the patient. The simplest and most effective method is to remove all non-cotton clothing and soak the victim with water, fanning to increase the rate of evaporation, and massaging extremities to encourage the return of cool blood to the core. With a limited supply of water, cooling the head and neck becomes the top priority. If available, ice packs should be placed at the neck, armpits and groin, in that order. All heat stroke victims must be transported to the hospital as quickly as possible, continuing the cooling process during evacuation.

Heat stroke victims are dehydrated and require rehydration. Unfortunately, getting the patient to drink may be impossible. With impaired mental condition, it is inappropriate to force fluids. Continue cooling externally in hopes the patient will recover enough to begin oral rehydration.

Prevention

Heat stroke, like all heat-related illnesses, is preventable. The same prevention methods that work for dehydration and exhaustion will work for heat stroke. The guiding principle is to stay well hydrated. Do not rely on your thirst mechanism to tell you when and how much you need to drink. Under conditions of exertion, it is probably impossible to drink too much water.