How Nurses Can Recognize Signs of Heat Stroke

• Learn what is heat stroke and what medications increase the risk of developing heat stroke.
• Understand the differences between signs of heat exhaustion and heat stroke.
• Know what nurses can do if they suspect someone is suffering from a heat stroke, complications of heat stroke, and how to prevent heat stroke.

While everyone is excited for the seasons to change and summer weather to turn to fall, many parts of the United States are still facing scorching temperatures. With increased temperatures more health problems will present, especially for our senior patients. Heat stroke is a common affliction, and those who are 65 years of age and older are more susceptible to developing it. Let’s discuss the common causes, the risk factors, and the steps that can be taken to prevent heat stroke.

Definition of Heat Stroke

Heat stroke is a life-threatening condition where the body fails to cool itself properly and the core temperature exceeds 104 degrees Fahrenheit. It may help to think of the heart as the body’s pump and the skin as the body’s radiator. As people age, their heart doesn’t pump as well and as a result, they do not sweat as easily to help cool the body.

Do certain medications increase the risk of heat stroke?

Yes, medications such as beta-blockers, calcium channel blockers, and diuretics make it more difficult for the body to respond to heat, which results in the heart working harder to cool the body.

Differences between Heat Exhaustion and Heat Stroke

Heat exhaustion is what occurs in the earlier stages of the body becoming overheated. It is important to think of heat exhaustion symptoms as a warning to take action to prevent heat exhaustion from progressing into heat stroke.

Symptoms of heat exhaustion may include:

• Cool, moist skin
• Heavy perspiration
• Faintness
• Dizziness
• Fatigue
• Muscle cramps
• Weak, fast pulse
• Nausea
• Headache

If the symptoms of heat exhaustion are present and left untreated, the risk of it progressing into heat stroke greatly increases. If heat stroke is left untreated, damage to the brain, heart, kidneys, and muscles is likely to occur. It is important to pay close attention to those older adults who are at an increased risk for heat stroke and act immediately once symptoms of overheating are suspected.

In addition to the symptoms listed above, the progression to heat stroke will also likely include:

• Vomiting
• Flushed skin
• Rapid, shallow breathing

What to do if someone is having a Heat Stroke

• Call 911
• Get the resident out of the heat and into the shade or air-conditioned place and urge them to lay down.
• If they can safely swallow, offer them fluids such as water, fruit, or vegetable juice. Avoid caffeine or alcohol.
• Apply cold, wet cloth to the wrists, neck, armpits, and groin. Blood in these areas passes closer to the skin’s surface and this should aid in cooling the body down quicker. It is important to note that the water should be cool, but not ice cold as this can shock the body.

What are the potential complications of heat stroke?

• Acute respiratory distress syndrome
• Brain swelling
• Kidney failure
• Liver failure
• Metabolic dysfunction
• Nerve damage
• Decreased blood flow to the heart and other circulatory issues

How can heat stroke be prevented?

Most cases of heat stroke are preventable and taking the following precautions as a long-term care nurse will help ensure the resident’s risk for heat stroke is decreased:

• Limit time outside, especially during the part of the day when the sun’s rays are the hottest between the hours of 10am through 2pm.
• Encourage the residents to wear light colors, as darker colors attract and absorb more heat.
• Ensure the resident’s water intake is adequate, especially those who are on diuretics as they will require more water to make up for the extra water loss from the medications.

The Bottom Line

Heat stroke can become a life-threatening health condition if interventions are not performed immediately. The longer it takes to receive treatment, the higher the risk for serious complications to develop or for death to occur.

It is important to thoroughly understand the medical history of each individual you provide care for as a nurse. This knowledge will aid you in providing a high level of nursing care and assist in preventing life-threatening situations such as heat stroke. It will also aid you in achieving positive health outcomes and better prepare you for emergent situations should they arise.

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