Heat related illnesses can be grouped as:
- Exertion associated collapse
- Heat exhaustion
- Heat stroke
Exertion Associated Collapse:
It is a feeling of light headedness, collapse or syncope after a strenuous exercise is stopped. The contraction of muscles maintains venous return to heart during exercise. When exercise is stopped, venous return decreases, resulting in decreased blood flow to brain.
It is the most common heat related illness which occurs due to a low cardiac output which is insufficient to support the increased circulatory demand required for heat dissipation. The hypovolemia is caused by water and/or sodium depletion, vasodilation and increased skin blood flow. In heat exhaustion, temperature is usually <41* C and heat dissipation is still functioning so that the child appears flushed and sweaty ,CNS function is preserved, but may experience mild confusion, irritability and poor co-ordination.
This is a combination of hyperthermia (temperature of at least 40.6* C), often with loss of the capacity to dissipate heat and CNS impairment (confusion, agitation, ataxia, irritability, coma). Thermoregulatory centre may fail, so that the patient has dry, vasoconstricted skin. It involves coagulopathies, and can result in systemic inflammatory response syndrome and multiple organ dysfunction.
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