Heat stroke warning in healthy people due to strenuous exercise

Coma after running

Doctors at the Central Military Hospital 108 (Hospital 108, Hanoi ) recently admitted a patient to the emergency room diagnosed with heatstroke with organ damage (liver, kidney, hematology). The patient is a 29-year-old male, transferred from Thach That District Hospital (Hanoi).

If the weather is too hot, strenuous outdoor physical activity should be reduced to prevent heatstroke.

The patient's family reported that before being admitted to the hospital, the patient had been jogging around 5 PM. After jogging for about 5 km, the patient felt dizzy, lightheaded, and had a hot flashes throughout the body. The patient then quickly fell into a coma and was promptly taken to the nearest hospital for emergency treatment.

At Military Hospital 108, the patient was transferred to the Internal Medicine and Toxicology Intensive Care Unit - Intensive Care Center for treatment. The patient's tests showed elevated creatine kinase (CK) levels, indicating muscle damage; renal failure with a glomerular filtration rate of 50 ml/min; and impaired coagulation function…

During treatment, the patient's body temperature was monitored, fluids were administered, electrolytes were replenished, and other intensive medical treatments were provided. After more than a week of treatment, the patient's organ function improved, there were no sequelae, and the patient was discharged from the hospital.

2 TYPES OF HEAT SHOCK

Dr. Pham Dang Hai, Deputy Head of the Department of Internal Medicine and Toxicology, noted: The young patient mentioned above received proper and timely emergency treatment, thus avoiding unfortunate consequences. Heatstroke, especially during hot weather, always poses many dangers.

Dr. Hai stated that heatstroke can be divided into two types: classic heatstroke and exertional heatstroke.

Classic heatstroke is commonly seen in the elderly, those with weakened immune systems, children, and people with cardiovascular disease, neurological disorders, or endocrine disorders, usually occurring after passive exposure to high temperatures for many hours or days.

Exertion heat stroke is common in young, healthy individuals with normal thermoregulation systems, occurring after exposure to elevated ambient temperatures and simultaneously due to heat generation during strenuous exercise.

According to Dr. Hai: "Heatstroke damages multiple organs including the central nervous system, respiratory system, circulatory system, liver, kidneys, and hematology, causing rapid multi-organ failure if not treated promptly , and even death. Therefore, understanding heatstroke, its early signs, timely emergency care, and prevention is extremely important, helping us reduce morbidity and mortality."

Recognizing heatstroke

Some early signs of heatstroke include altered consciousness: coma, seizures; respiratory disorders: shortness of breath, respiratory failure; cardiovascular disorders: arrhythmias, hypotension, oliguria, accompanied by fatigue, headache, flushed face, possibly vomiting, diarrhea, body temperature above 40°C, hot and dry skin.

Doctors at Hospital 108 advise that emergency care for heatstroke patients outside the hospital should immediately remove the patient from the hot environment, move them to a cool, shaded place, remove their clothing, and immediately lower their body temperature by: placing the patient in a cool room at 20-22 degrees Celsius and using a fan; and placing cool compresses on the groin, armpits, and neck.

Lowering the patient's body temperature by any means necessary should be undertaken, but this should not hinder the transportation of the patient to the nearest medical facility. Transportation can be done in air-conditioned vehicles or with windows open, while simultaneously lowering the patient's temperature. Organizations and associations are encouraged to conduct widespread awareness programs about the signs, symptoms, and risks of the disease to facilitate early diagnosis and treatment.

To prevent heatstroke during hot weather, at-risk groups should be aware of the following: children, the elderly, and individuals with underlying medical conditions such as cardiovascular, respiratory, endocrine, or metabolic diseases, as well as those with weakened immune systems. Those with these risk factors should avoid exercising in excessively hot weather.

Each individual should train themselves to adapt to the heat, but it's necessary to schedule physical exercise during cooler times of the day and reduce strenuous physical activity when the weather is excessively hot.

If working outdoors in hot weather is unavoidable, drink plenty of water and salt, cover your body by wearing loose, light, breathable, and light-colored clothing, wear a wide-brimmed hat, and use sunscreen. Schedule outdoor work for cooler times, such as early morning or late afternoon. If working outdoors is unavoidable, avoid prolonged periods in hot environments and strenuous physical activity. Take regular breaks of 15-20 minutes in a cool, well-ventilated area every 45 minutes to 1 hour.

(Source: Central Military Hospital 108)

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