Three things to know about heat illnesses
Heat stroke is an emergency medical condition that, if not treated properly, can cause organ damage or death
I am convinced that no place feels hotter than Houston, Texas in the summer. Along with high temperatures and humidity, the summer months also bring reports of people suffering from heat-related injuries.
As a Texas medical malpractice attorney, I have handled cases where people did not recognize situations when they needed emergency medical condition. In other cases, emergency room doctors and nurses missed the critical time window to start treatment and avoid permanent patient consequences.
Hyperthermia, or heat illness, is a condition where the body cannot properly regulate heat, whether by generating too much heat or by failing to dissipate enough heat. There are three types of heat illness that you should know about. I will discuss them here in the order of increasing danger.
Minor heat illness includes things like muscle cramps, ankle and feet swelling, rashes, and even passing out or fainting from over-exertion. Most people address this on their own by getting out of the heat and into air conditioning, and rehydrating with water or a drink with electrolytes, like Gatorade.
Heat exhaustion is more serious. Typically, people with heat exhaustion will have a high temperature that is less than 104 degrees, which is caused by dehydration (volume depletion). The signs and symptoms can be very general—things like headache, nausea, vomiting, fatigue, weakness, and muscle cramps. Some people have extensive sweating, low blood pressure when standing (orthostatic hypotension), and fainting spells.
Experts recommend seeking care at a hospital for heat exhaustion. The standard treatment for heat exhaustion is to get blood work done and then start an IV that will allow correction of the volume loss and electrolyte composition of the blood.
After the body temperature is stabilized, younger healthy patients are often discharged home, while older patients may be admitted for observation. The standard of care requires doctors to exercise caution in making the hospital discharge decision, which includes making sure that discharged patients will not be at risk for developing hyperthermia again. That could happen if the outside temperatures are very high and the patient lacks air conditioning.
The most-serious heat-related condition is heat stroke. Many emergency room doctors find it difficult to distinguish between a heat stroke and an infection, like sepsis. In fact, it is not unusual for patients to show up at the emergency room with both an infection and heat stroke.
One of the important pieces of information that doctors need in order to make the correct diagnosis and, thus, to start the right treatment is whether there was a clear history of heat exposure. Be sure to let the nurses and doctor know if the patient had been playing sports in the heat or working outdoors when the symptoms started.
People with heat stroke typically arrive at the emergency room (ER) with a high temperature of 105 degrees or greater, abnormally fast breathing (tachypnea) and heartbeat (tachycardia), and an abnormally low blood pressure (hypotension). Despite being so hot, they usually are not sweating and have hot, dry skin. Doctors also look for signs of problems in the central nervous system, like a change in mental status (unusual behavior or conversation), seizures, or even coma.
Heat stroke is an emergency medical condition that requires immediate treatment. The first stages of treatment often includes starting supplemental oxygen, cardiac monitoring, inserting a breathing tube (if the patient is having a seizure or altered mental status), placing a probe to allow continuous monitoring of the core body temperature, and lab work.
In addition, a major priority is quickly cooling down the patient, with a goal of getting him or her cooled down to a target temperature of 101 degrees within 30 minutes. Numerous research studies have concluded that the best way to cool down patients is putting them in an ice bath, and then removing them as soon as their temperature gets to 101 degrees.
It is well-established by medical studies that any delay in cooling down a patient with a heat stroke can lead to severe permanent injuries and even death.
Treating heat stroke patients in the ER is not enough. The standard of care requires the emergency room doctor to admit them to a critical care unit for close monitoring, to look out for things like another sudden rise in body temperature (rebound hyperthermia), organ failure, and electrolyte levels.
We are here to help
If you or someone you care for has been seriously injured because of poor treatment of a heat-related condition, like heat stroke, call 281-580-8800 for a free consultation with an experienced medical malpractice lawyer at Painter Law Firm, in Houston, Texas.
Robert Painter is a medical negligence attorney at Painter Law Firm, where he devotes his practice to representing seriously-injured patients and their families. He started his graduate-level academic career in medical school, and then decided to change his focus to pursue a legal career. Before starting at Baylor Law School, Robert Painter served as an officer in the U.S. Army, in a military hospital administrator role, in order to pay back his full scholarship to medical school from the Army. After law school, he started his legal career in the health litigation section of a prestigious international law firm in Houston, where he defended doctors and hospitals. Robert Painter applies his unique background and skills to benefit his clients in litigation.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.
A physician has to supervise the care and prescriptions of nurse practitioners and physician assistants under written, signed agreements [...]read more
On 4/1/2018, the new law will end the current practice where doctors can secretly enter a DNR order against patient and family wishes [...]read more
A physician has to supervise the care and prescriptions of nurse practitioners and physician assistants under written, signed agreements
On 4/1/2018, the new law will end the current practice where doctors can secretly enter a DNR order against patient and family wishes
This article was originally published in the September/October 2017 edition of "The Houston Lawyer" magazine
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