Treatment and Prevention of Heat-Related Illness
Cecilia Sorensen, Jeremy Hess
Abstract
A 71-year-old man with a history of coronary artery disease, congestive heart failure, and schizoaffective disorder presents to the emergency department with confusion. On the day of presentation, he was seen walking near his apartment complex in a busy urban area and was later found collapsed outside his building. The local heat index (accounting for temperature and relative humidity) is 105F (40.6C). On arrival in the emergency department, he is conscious but confused. His heart rate is 130 beats per minute, blood pressure 100/70 mm Hg, respiratory rate 28 breaths per minute, rectal temperature 40.5C, and oxygen saturation 90% while he is receiving oxygen at a rate of 3 liters per minute through a nasal cannula. He opens his eyes to voice and can state his name. He is able to move his arms and legs and has no focal neurologic deficits. His skin is hot and dry to the touch. His medications include furosemide, risperidone, and carvedilol. The patient lives alone in a top-floor apartment without air conditioning. How should this heat-related illness be treated, and how could it have been prevented?