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ER or Not: Heatstroke

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ER or Not: Heatstroke

Jun 30, 2021

During the summer months, heat exposure can be common. But could it be life-threatening? According to emergency physician Dr. Troy Madsen, heatstroke is an extremely dangerous condition that can lead to organ and brain damage. Learn how to identify the symptoms of heatstroke, prevent overheating, and determine when it’s time to call 911.

Episode Transcript

Interviewer: It is time for "ER or Not," the game where we come up with a scenario and give it to emergency room physician, Dr. Troy Madsen, and you get to play along at home and decide whether or not that scenario is something you'd go to the ER or not and Dr. Madsen will tell us the definitive answer. Dr. Madsen, are you ready to play?

Dr. Madsen: I am ready.

Interviewer: So the weather has been getting quite hot lately, especially for us here in the Southwest, and we've been getting a lot of questions coming from people that are really concerned about overheating, so everything from heat exhaustion to heatstroke. So the question is, heatstroke, we know it's pretty serious, but is it serious enough for the emergency room? Troy Madsen, ER or not?

Dr. Madsen: It is, Mitch. Yeah, heatstroke, you need to go to the ER. And that's an important distinction. You mentioned there, heat exhaustion and heatstroke. So heat exhaustion is just when you start to get very overheated. So this is when you start to feel very hot, maybe you feel lightheaded, a little bit nauseous, maybe a headache. This is when your body is overheating, your body temperature is rising.

But then heatstroke is the next step beyond that. And heatstroke, we're talking about people who are really experiencing severe effects, very high body temperatures, and then they start to even experience some damage to the organs in their body, maybe their kidneys, even their brain. It can affect the brain. It can affect the heart. These are cases where people become confused. They're just not responding as well, maybe passing out. These are very serious cases. So if someone is truly experiencing severe symptoms, where they have been in an environment, say in a house without air conditioning or they've been outside exposed to the heat for a long period and they seem confused, they're passing out, they're just not responding to you well, absolutely get them to the ER. And I would say even in these cases, don't hesitate to call 911 to get them to the ER, just because it's essential that we get them in a situation where we can make sure everything is okay and then get their body cooled down rapidly.

Interviewer: Wow. So what are like the top signs, I guess? Because it sounds like heatstroke could be a real problem for your organs, for your brain, like almost as serious as maybe even a stroke.

Dr. Madsen: The biggest signs I would say to look out for are people who are not responding, who seemed confused, or just not responding altogether. You try to get them to respond, they're not answering questions. People who are passing out. Those would be the biggest things I see in people who have moved just beyond heat exhaustion to heatstroke, where you're seeing very serious effects on their body from this.

Interviewer: Is there anything that people can do at home while they're, say, waiting for help to arrive or to get to the ER?

Dr. Madsen: Absolutely. If you can get a fan going on the person, get a spray bottle with cool water in it, spray that on the person, that evaporative cooling can really help, especially in a dry environment like Utah, where evaporative cooling can decrease your body temperature. So spraying down with a cool mist, getting a fan going, circulating air, that can definitely help get that cooling process started. And if someone is in a situation where they're not to heatstroke, but they just say, "Hey, I just don't feel great. I feel a little bit nauseous. I'm just feeling hot." Those are things you can do at home as well to avoid having to go to the ER.

Interviewer: So heatstroke, it's serious. Time is of the essence. Get help as soon as possible?

Dr. Madsen: That's exactly right. If someone is hot, they're confused, they're not responding well, get help, get to the ER.