Understand the Culture in Which You Practise Hyperthermia: Are ...

side effects
H Y P E R T H E R M I A
Are Your Patients at Risk?
Stheir medications to provide optimal care and promote health.
ummer is upon us and, as ever, we are
mindful of the Standards of Practice
for communicating with patients
and educating them about
A recent coroner’s inquest into the death of a patient due to
complications from hyperthermia brings into focus a side effect
of medications that is rarely considered: loss of the body’s ability
to regulate temperature, possibly resulting in hyperthermia.
The regulation of a person’s core body temperature occurs
in the delicate balance between heat production and heat loss.
The goal is to keep the body temperature within an acceptable
range. If a person’s body temperature begins to rise towards
an unacceptable limit, the body automatically enacts
cooling mechanisms (i.e., sweat production for cooling by
evaporation).
The two most common forms of hyperthermia are heat exhaustion
and heat stroke. Of the two, heat stroke is especially
dangerous and requires immediate medical attention.
Heat stress occurs when a strain is placed on the body as a
result of hot weather.
Heat fatigue is a feeling of weakness brought on by a high
outdoor temperature. Symptoms include cool, moist skin and
a weakened pulse. The person may feel faint.
Heat syncope is a sudden dizziness experienced after exercising
in the heat. The skin appears pale and sweaty but is generally
moist and cool. The pulse is weakened and the heart rate
is usually rapid. Body temperature is normal.
Heat cramps are painful muscle spasms in the abdomen,
arms, or legs following strenuous activity. Heat cramps are
caused by a lack of salt in the body.
Heat exhaustion is a warning that the body is getting too
hot. The person may be thirsty, giddy, weak, uncoordinated,
nauseated, and sweating profusely. The body temperature is
normal and the pulse is normal or raised. The skin is cold and
clammy.
Heather A. Arnott, B.Sc.Phm, Inspector, OCP
Heat stroke (or
sunstroke) can be lifethreatening
and victims can die
from multiple organ failure. A person with heat
stroke usually has a core body temperature above 38.2
degrees Celsius. Other symptoms include confusion, combativeness,
bizarre behaviour, faintness, staggering, strong
and rapid pulse, and possibly delirium or coma. High body
temperature is capable of producing irreversible brain
damage. This is a medical emergency requiring immediate
treatment.
General health and/or lifestyle may increase a person’s chance
of suffering a heat-related illness. Health factors which may increase
risk include:
• poor circulation
• inefficient sweat glands and changes in the skin caused by the
normal aging process
• being substantially overweight or underweight
• consumption of alcoholic beverages
• heart, lung, and kidney diseases
• any illness that causes general weakness or fever
• high blood pressure, and
• other conditions that require changes in diet, for example,
a salt-restricted diet may increase the risk of hyperthermia
for a person taking diuretics, sedatives, tranquillizers, or certain
heart and blood pressure drugs that make them unable
to perspire.
Lifestyle factors that can increase risk are:
• unbearably hot living quarters
• lack of transportation which prevents people from seeking
respite from the heat in shopping malls, movie houses, and
libraries
• overdressing -- not feeling the heat, older people may not
dress appropriately in hot weather
• visiting overcrowded places -- trips should be scheduled during
off-peak times, and
18 pharmacyconnection • July/August 2009